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Choline and DHA. The Pregnancy Dynamic Duo

Eggs hard boiled 300x200 - Choline and DHA. The Pregnancy Dynamic Duo


When it comes to prenatal nutrition, several nutrients get a lot of attention. These include the usual suspects such as iron and folate, which historically makes sense.


Iron deficiency anemia is a real concern given the significant increase in blood production that’s needed for both moms-to-be and their growing babies. Folate helps to prevent spina bifida, a type of neural tube defect.


But, make no mistake, there are several other crucial nutrients needed for an optimal pregnancy and infant health including vitamins B12, D3, and E, the minerals iodine and selenium, as well as, choline and the omega-3 fat DHA. Sadly, these other key players don’t get the attention they deserve.


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Nutrients for a healthy pregnancy

It’s true, you could take a prenatal supplement to get many of these important nutrients. In fact, most pediatricians recommend one to women who are pregnant, and while that can be helpful, in no way do supplements replace the benefits of eating real food when it comes to nourishing a growing child.


This is no more apparent when it comes to choline and DHA. Without some effort and attention, it’s far too easy to miss out on getting enough of these two superstar nutrients to meet the increased need during pregnancy.

Choline, the other B vitamin

Choline is one of the B vitamins; an essential nutrient because your body cannot make enough of it to meet its needs. Choline helps your baby’s brain, spinal cord and nerves develop properly.


Not only that, choline is involved in many of the same metabolic pathways as folate, which surprise, surprise, is equally important for preventing neural tube defects as folate is (1). Considering that low blood levels of choline are associated with increased risk for neural tube defects, many suggest assessing choline status prior to pregnancy in the same way folate is (1).


Unfortunately, most women don’t get the recommended intake of 425 mg of choline per day and this becomes more concerning during pregnancy when there’s a slight increase in choline requirements (450 mg/day) (2, 3).


Does this really matter? The evidence suggests yes. Studies have shown a benefit when women both meet and exceed current choline recommendations.


In a small study of 26 women who were randomly assigned into two groups who ate identical diets except for the amount of choline where half got 480 mg/day and the other half, 930 mg/day. Babies were followed up at months 4, 7, 10 and 13 for memory and information processing speed.


While both groups show cognitive benefits, when compared to 480 mg/day, expectant mothers who got 930 mg/day saw significantly faster processing speeds in their babies (4).


Additionally, choline intakes at double the current recommended amounts improved placental function and may reduce preeclampsia (5, 6).


Choline is widely available in the food supply but it’s most concentrated in animal foods. It turns out, the best food sources are eggs, liver, and salmon. For this reason, it’s very difficult for pregnant women to consume the current recommended adequate intake of choline, let alone get the amount that research is suggesting is optimal (7).


At least according to US data, eggs are the main contributor of dietary choline:


“Consumers of eggs had almost double the usual intake of choline as compared to non-consumers (525 ± 5.17 mg/d and 294 ± 1.98; p < 0.0001). Protein food (meat, poultry and seafood) consumption also increased usual choline intakes compared to non-consumers (345 ± 2.21 mg/day and 235 ± 8.81; p < 0.0001).” (2).


In short, it’s very difficult for pregnant women to reach the adequate intake for choline without consuming eggs or taking a dietary supplement. With a whopping 294 mg per two large egg serving, eggs are the obvious choice.

DHA omega 3, your growing baby’s best friend

DHA is another crucial nutrient needed for a healthy pregnancy. DHA is one of the three main types of omega-3 fatty acids. DHA plays an important role in infant brain and eye development.


Maternal DHA intake (diet) and production, as well as, maternal body stores help meet DHA needs for both mother and her fetus during pregnancy (8, 9). Because the DHA needs of the fetus rise during pregnancy with peak requirements at the end of the third trimester (due to accumulation of DHA in the fetal brain tissue), getting lots of dietary DHA is key.


Because there’s significant increased transfer of DHA to the developing fetus, there’s a risk this can lead to depleted maternal DHA levels which are associated with increased maternal health issues including depression (10).


Because the DHA status of mothers-to-be is an important factor on fetal brain and eye health, as well as, during a child’s early life, recommended DHA intakes are based on the first 1000 days of life (11).


What does this all mean in practical terms?


According to the International Society for the Study of Fatty Acids and Lipids, most health organizations recommend between 200-450 mg of EPA+DHA per day, with an emphasis on DHA, for women who are pregnant (12).


Given that maternal status is so important, as it is with choline, a women’s omega-3 intake should be assessed prior to pregnancy too, especially considering that most adults are not meeting the recommended intake of omega-3 fats (13, 14).

Best food sources of choline and DHA

But there’s good news!


Turns out, some of the richest sources of choline tend to also have DHA, including scallops, Atlantic cod, salmon, eggs (the egg yolk), especially when they are omega-3 enriched eggs. Naturegg Omega PLUS eggs by Burnbrae Farms are packed with choline, DHA and higher amounts of other important nutrients.


Two Naturegg Omega 3 PLUS eggs contain 250 mg DHA and 50 mg EPA or 300 mg total; well within the 200-450 mg per day range as recommended by the vast majority of countries for healthy pregnancy outcomes.


Adding two eggs per day can help close this important nutrition gap for Canadian women who are pregnant or planning on becoming pregnant. Not to mention there are several other important nutrients for babies-to-be including choline, lutein, folate, vitamins B12, D, E, the mineral selenium and of course protein; 12 g per two egg serving.

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Bottom line

Good nutrition is front and center when it comes to both maternal and infant health.


A food-first approach is always the best way to meet your nutritional needs and this is no less true when it comes to a healthy pregnancy.


Two important nutrients that most pregnant women are not getting enough of are choline and the omega-3 fat DHA; both essential for optimal fetal brain, eye, and cognitive development.


Without eggs, getting enough choline is extremely difficult, and without regular fish and seafood consumption, DHA needs likely won’t be met either.


Fortunately, omega-3 enriched eggs like Naturegg Omega 3 PLUS are the ultimate tasty and nutritious convenience that pregnant women, and their growing babies, are looking for.


Doug Cook RDN is a Toronto based integrative and functional nutritionist and dietitian with a focus on digestive, gut, mental health.  Follow me on FacebookInstagram and Twitter.