American Medical Association supports more choline in prenatal vitamins

By Adi Menayang contact

- Last updated on GMT

Photo: iStock/KZenon
Photo: iStock/KZenon
The American Medical Association (AMA) supports an increase of choline in all prenatal vitamins to 450 mg/day, according to a resolution passed by delegates at the 2017 AMA Annual Meeting in Chicago earlier this month.

“Adequate levels of choline—an important nutrient that helps a baby’s brain and spinal cord to develop properly—are necessary to maintain normal pregnancy including neural development of the fetus and reducing the incidence of birth defects,”wrote​ Sara Berg, a staff writer for AMA’s communications site AMA Wire, reporting on the association’s annual meeting​.

As of 2016, none of the top 25 prenatal multivitamins​ contains the scientifically-backed choline dose for pregnant women (450 mg per day), according to a study​ published in 2016 by researchers at the University of Illinois at Chicago.

This recommended dosage was first established in 1998​ by the Institute of Medicine, which recognized choline—found naturally in beef and chicken liver, egg yolk, salmon, milk, and soybeans—as an essential nutrient.

Whopping majority of Americans don’t get enough choline

Despite its importance, the benefits of choline—and the fact that many Americans are deficient of it—has never been a hot topic in the discourse of public health. A whopping 90% of Americans aren’t getting enough choline, according to the last update of NHANES data​on choline, which was collected in 2004.

“The National Academy of Medicine has only recognized choline as an essential since 1998. There has been little to no government funding for research on choline in the past, so its not surprising that we are just beginning to discover the role this nutrient plays in human health,”​ Dr. Taylor Wallace, affiliate professor at the Department of Nutrition and Food Studies at George Mason University, told NutraIngredients-USA.

His lab at the university is one of the first to show widespread insufficient intakes of choline across the US population, published in the Journal of the American College of Nutrition​ in 2016. “Choline shortfalls are so prevalent we can’t even identify differences in among socio-economic factors such as household income level among the population like with other shortfall nutrients such as calcium and vitamin D​,” he said.

Effect of AMA’s backing

As an influential voice in public health, AMA openly stating it supports a dose of 450 mg/day in prenatal supplements is a cause for joy for many in the nutrition and supplement space. “It’s about time the medical community addressed this important nutrition issue,” ​Dr. Wallace said.

“This is an enormous public health risk given the vital role choline plays in cognitive development of the infant,”​ he added. “My hope is that doctors will begin to recommend choline supplementation, similar to the recommendations for folic acid, to all pregnant AND lactating women.”

AMA’s decision received applause from Balchem Corporation​, a manufacturer of the branded VitaCholine. “We think this will have a significant impact on awareness and prenatal use of choline,"​ Tom Druke, Director of VitaCholine Brand Development, Balchem Human Nutrition and Pharma, told NutraIngredients-USA. "The medical community knows that for the AMA to make this recommendation, they have evaluated the evidence and found it compelling. More prenatal vitamin manufacturers will add choline to their formulas if it is missing, and those that contain it already should increase the amounts to help meet the recommended intake of 450 mg a day.”

The company had been a strong proponent of increasing choline awareness among consumers. It launched the consumer-facing cholinecouncil.com​ to provide extensive information that is easily understandable. "Until recently it was thought people were getting enough choline from their diets, but we now know that is not the case,"​ Druke added.

"The Food and Drug Administration agrees, which is why they added it to the Nutrition Facts Labels and designated a reference daily intake (RDI) of 550mg per day a year ago."

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