CHOLINE - It's importance and why we use Phosphatidylcholine versus Choline Bitartrate

One of the biggest reasons we knew we had to make a high quality prenatal is that most of the prenatal vitamins on the market today were lacking in choline. Most have 0mg choline and some only have 50mg and use Choline Bitartrate which we have our concerns about (see below). The recommended adequate intake for pregnancy is 450mg! How could this be possible you might ask?! The simple answer is cost - choline is expensive! and the quantity required would mean 1 or two extra pills.

We felt it was of the utmost importance to make the highest quality product, with the highest quality ingredients that also delivered the recommended adequate intake for pregnancy without regard to cost or pill count! We really did our research on every ingredient and here is what we found on Choline.

WHY CHOLINE IS IMPORTANT?

We love this article on the importance of Choline in the National Library of Medicine: Choline: Exploring the Growing Science on Its Benefits for Moms and Babies 

here is a little summary:

"The importance of ensuring adequate choline intakes during pregnancy is increasingly recognized. Choline is critical for a number of physiological processes during the prenatal period with roles in membrane biosynthesis and tissue expansion, neurotransmission and brain development, and methyl group donation and gene expression. Studies in animals and humans have shown that supplementing the maternal diet with additional choline improves several pregnancy outcomes and protects against certain neural and metabolic insults. Most pregnant women in the U.S. are not achieving choline intake recommendations of 450 mg/day and would likely benefit from boosting their choline intakes through dietary and/or supplemental approaches"

Choline benefits pregnancy and beyond according to the American Pregnancy Association:

"Choline doesn’t get a lot of attention, but it is a nutrient with a number of impressive, long lasting benefits. For example, higher maternal choline intakes have been shown to reduce the risk of neural tube defects (independent of folate intake) while also improving cognition and lowering levels of circulating cortisol. This is significant because lowering a baby’s production of cortisol could, over their lifetime, reduce their risk of certain stress-related disorders. In terms of improving cognition, research finds that children who received additional choline in utero showed increased attention span, memory, and problem solving at age seven.

For mom, the benefits of increased choline intake are linked to a reduced risk of certain complications during pregnancyand an increase in placenta and liver function during pregnancy. The benefits of choline during pregnancy make it one nutrient you’re going to want to make sure is on your prenatal vitamin’s supplement facts panel.

Although the recommended Adequate Intake (AI) of choline for pregnant women is 450 mg/d, studies show only 10% of pregnant women in the U.S are actually meeting the AI.  Partly to blame for this is many prenatal vitamins lack sufficient choline support. A recent study evaluating the top 25 prenatal vitamins found that none contained the daily-recommended choline intake for a pregnant woman, and over half contained none at all"

WHY DO WE USE PHOSPHATIDYLCHOLINE?

The type of choline we use is derived from soy and egg yolk - Phosphatidylcholine - the reason we use this is that based on the latest research in September 2021 (see below) the other synthetic form of choline derived from animal products Choline Bitartrate can raise TMAO levels.

 “The higher someone's level of TMAO is, the more susceptible that person is to accumulation of cholesterol in the artery wall. This increases the risk of a heart attack or stroke,” reports Stanley Hazen, MD, PhD., Vice Chair of Translational Research at the Lerner Research Institute.

Here is a summary of the study: 

The researchers split healthy volunteers into five groups, each of whom followed a different intervention:

Hard-boiled eggs

Choline bitartrate supplements alone

Hard-boiled eggs + choline bitartrate supplements

Egg whites + choline supplements

Phosphatidylcholine supplements alone

And here’s what they found:

 “Participant’s plasma TMAO levels increased significantly in all three intervention arms containing choline bitartrate (all P<0.0001), but daily ingestion of four large eggs (P=0.28) or phosphatidylcholine supplements (P=0.27) failed to increase plasma TMAO levels.”

https://pubmed.ncbi.nlm.nih.gov/33872583/

We understand that many customers may want to avoid soy and so seeing that on our product could be a deal breaker! I do think in this situation due to the importance of choline and the risks of Choline Bitartrate it might be worth considering allowing a little soy.

If you're allergic to soy - don't worry you can simply take a prenatal without choline (there are many of these) and simply eat two eggs per day!