Many dietary supplement formulators are looking to help older consumers concerned with declining cognitive performance. But perhaps the best opportunity to head these problems off at the pass comes much earlier—before birth, in fact.
Tom Druke, director of VitaCholine brand development for Balchem Human Nutrition and Pharma, told NutraIngredients-USA that choline has been known for years to health professionals as a vital nutrient. The ingredient has been recognized for its role in liver health, and more recently it has been shown to play a vital role in the proper development of the nervous systems of fetuses, but those facts have been slow to be recognized by consumers or by product formulators.
AMA recommends higher dosages
Earlier this year, the American Medical Association (AMA) supported 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.
“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.
Druke said subsequent work done at Duke University by Warren Meck, PhD, a professor of psychology and neuroscience, showed the effects of choline supplementation and deprivation during pregnancy.
“Using animal models, Professor Meck demonstrated that increased availability of choline led to improved neural communication and brain development. By comparing offspring born of supplemented pregnancies against those without additional choline, Meck showed improved cognitive performance, particularly related to visuo-spatial memory (the kind of memory you use to remember where you parked your car). Later, research conducted by Marie Caudill of Cornell University has demonstrated similar and additional benefits for choline supplementation in pregnant women,” Druke said.
Druke went on to say that work done by Cornell University by Marie Caudill, PhD, showed that adequate prenatal levels of choline improved the function of the placenta and helped lessen the risk of pre-eclampsia. Higher levels of choline also were associated with lower levels of the stress hormone cortisol.
In addition, Druke said, Caudill’s work corroborated what Meck’s studies had shown, namely that choline levels were predictive of better cognitive performance later in life.
Choline levels predictive of later performance
“Dr. Caudill continues to follow the children from her original study group and additional findings have been very positive. Cognitive testing showed that infants of mothers receiving higher levels of choline processed information more quickly and had improved visual memory than infants born of the standard choline pregnancies. As the children grow older and enter school, Dr. Caudill will be able to track their progress and continued testing suggests that choline may have a positive impact on academic performance. A separate study conducted by Dr. Caroline Boeke of the Harvard School of Public Health in 2013 showed that even modest increases in choline during pregnancy improved cognitive performance among seven year olds,”Druke said.
Druke said information from other studies shows that higher choline levels correspond to better academic performance among teenagers in Sweden in a study reported in 2016, and a study in 2015 published in Nature showed benefits for other aspects of cognitive health.
“Adults who received choline bitartrate supplements and then performed computer-based ‘aim and click’tasks showed significantly better performance and were able to make the appropriate tradeoffs to optimize the balance between speed and accuracy. This may have much broader implications for sports nutrition and other visuomotor tasks requiring good hand-eye coordination,” he said.
Druke said Americans are chronically deficient in choline, with as many as 90% not consuming enough. And only 8% of mothers are currently getting the recommended amount, though the nutrient is important at all life stages, he said.
“As we age, acetylcholine availability is reduced so it is important to maintain good choline status throughout life,” he said.