Evidence supporting the use of: Choline
For the health condition: Birth Defects (prevention)

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Choline is an essential nutrient that plays a critical role in fetal brain development and the prevention of certain birth defects, most notably neural tube defects (NTDs). Scientific evidence supporting choline’s importance comes from both animal and human studies. Choline is a key component in cell membrane synthesis (as part of phosphatidylcholine), methyl group donation (as a precursor to betaine), and neurotransmitter production (as a precursor to acetylcholine). During pregnancy, the demand for choline increases significantly because of its vital role in the development of the fetal nervous system. Several epidemiological studies have shown that higher maternal choline intake is associated with a reduced risk of NTDs, even independently of folate status. For instance, the Nurses’ Health Study and other cohort studies have reported lower risks of neural tube defects in women with higher dietary choline intake.

Animal research further supports these findings, with rodent models demonstrating that choline deficiency during gestation can result in neural tube closure defects and impaired cognitive function in offspring. While folic acid supplementation remains the primary recommendation for preventing NTDs, choline is increasingly recognized as an important complementary nutrient. The Institute of Medicine and other health organizations now recommend increased choline intake during pregnancy. Overall, the scientific consensus is that adequate choline intake is important for birth defect prevention, particularly relating to neural tube development, and current evidence rates this connection as strong, though slightly less robust than the data for folic acid.

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