Food for thought: how choline endows the infant brain

Better Nutrition, July, 2002 by Larry Canale

Boost your baby's brain power! How to raise baby's IQ! Make your baby smarter!

If you're a parent--or about to become one--you've probably seen headlines like these screaming from the covers of parenting magazines.

Wouldn't it be nice if all it took to accomplish those objectives was just a pinch more of a certain nutrient? Wouldn't it be nice, too, if that same nutrient helped improve our own memories, allowing us to cut down on missed appointments and lost keys? And what if that nutrient offered cardiovascular benefits while also promoting liver health?

Such a nutrient is, indeed, part of our daily diets: choline, an essential vitamin that may play a crucial role in stimulating infant brain development.

a profound effect

"Some of the researchers who've done work on choline are saying, essentially, that they know of no other compound, drug or nutrient that has such a profound effect on memory," says Gregory Paul, PhD, director of nutrition science at Central Soya Co. Inc. "And where the real interesting information lies is for women who are going to become pregnant or who already are pregnant. That's where the solid scientific data exists in animals."

Paul likens choline's potential as a "baby brain enhancer" to the well-documented effects of folate in pregnant women: "Most mothers know to take folic acid before the critical period when the baby's neural tube is developing," he says. "If you don't have adequate levels of folate, your risk for neural-tube defect goes up. Choline works in much the same way, except it works at the memory center in the brain.

"There's a critical period when the fetal brain is being formed--around week 20 to 25," Paul adds. "Having additional choline in the mother's diet before and during this period seems to improve the ability of the child to form and retrieve memories throughout life."

And the evidence is mounting. "Choline studies have been repeated many times in many different laboratories, and it's been found to have a very robust and profound effect," Paul says. "The question is, will the same conclusions be found in humans? That study is beginning now at the University of North Carolina at Chapel Hill."

UNC's research, slated to last 12 to 18 months, is headed by Stephen Zeisel, MD, PhD, chair of the university's Department of Nutrition. Not surprisingly, Zeisel--who served as a member of the Food and Nutrition Board that established choline as an essential nutrient (see sidebar, p. 26)--is bullish on choline's impact.

"The development of the memory center in the brain seems to be dependent on the availability of choline," he told members of the press at a recent media conference.

Paul notes that UNC's research "is more or less a feasibility study, or a pilot study, to generate meaningful data, allowing UNC to get a grant from the government to do a full-scale follow-up study involving a large number of women. That study would give a definitive answer" about choline's benefits.

While the definitive answer on choline's impact on fetal brain development may be several years away, the story of the nutrient's emergence actually began more than 100 years ago. According to Lecithin & Choline: A Clinical Monograph, written by Zeisel, Amanda J. Jolitz, RPh and David J. Canty, PhD, choline was first isolated by chemist A.F.L. Strecker in 1862. But its benefits weren't truly understood until the early years of the 20th century. "Choline's importance as an essential nutrient was first realized in studies on insulin in the 1930s. Research performed over the years established choline as an essential nutrient in many animal species, including primates. Choline deficiency has been shown to cause growth impairment abnormal kidney function, infertility, decreased hematopoiesis, bone abnormalities and hypertension."

Given those proven health benefits, why have scientists only recently begun to promote choline as an "essential nutrient?"

"Up until 1998, when the Food and Nutrition Board at the Institute of Medicine [a unit of the National Academy of Sciences] recognized it as an essential nutrient," says Paul, "it was assumed that your body made all the choline it needed, so it wasn't a necessary nutrient to add to the diet. For that reason, you didn't see a lot of research on choline."

Once choline earned status as an essential nutrient, the next step was consumer awareness. The Food and Drug Administration helped last fall when it authorized food-labeling claims for choline. The FDA's authorization allows manufacturers to plaster "Enriched with Choline" announcements on food packages. Choline is, in fact, the first nutrient to earn approval for such claims under the Food & Drug Administration's Modernization Act of 1997.

getting the word out

While choline isn't as well-known as folic acid and vitamin C, the public is slowly becoming more aware, says Jo Ann Hattner, a Palo Alto, California-based clinical nutritionist and American Dietetic Association spokesperson. "I've had mothers call me because they're concerned that they don't have enough choline here or don't have enough there, and they're worried about how much should be in their baby's formula."