Higher choline intake during pregnancy is linked to lower inflammation. Digest
Inflammation during pregnancy can increase the risk of complications for both mother and baby. Researchers in Canada explored whether an often underconsumed nutrient, choline, might be linked to lower levels of inflammation late in pregnancy.
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The study drew on data from 1,300 participants in the Alberta Pregnancy Outcomes and Nutrition cohort. At about 32.5 weeks of pregnancy, each participant completed a detailed 24-hour dietary recall and provided a nonfasting blood sample. Researchers measured high-sensitivity C-reactive protein (hs-CRP, a sensitive blood marker of inflammation), choline intake (including five different forms of choline found in foods), and related nutrients involved in a process called one-carbon metabolism, in which the body transfers small chemical units (e.g., methyl groups) that are used to build DNA, regulate gene activity, and support other chemical reactions that keep cells functioning properly.
- Average choline intake was about 366 milligrams per day (mg/d), below the recommended 450 mg/d during pregnancy. About 19% of participants had hs-CRP levels above 5 milligrams per liter (mg/L), a common clinical cut-off for elevated inflammation.
- Higher choline intake was linked to lower hs-CRP levels. Predicted hs-CRP values dropped from about 2.2 mg/L at 200 mg/d to about 1.7 mg/L at 900 mg/d.
- Compared with women consuming less than 300 mg/d, those consuming more than 700 mg/d were about 93% less likely to have hs-CRP above 5 mg/L.
- The association appeared strongest when focusing on lower hs-CRP values, particularly below 1 mg/L and below 5 mg/L, which are more consistent with chronic low-grade inflammation rather than acute illness.
- Total choline intake was linked to hs-CRP, whereas no individual choline form showed a clear association, and the pattern did not clearly change with betaine, vitamin B12, or folate intake.
Choline can be converted into betaine, which helps recycle homocysteine, an amino acid associated with inflammation, back into the amino acid methionine. This process occurs in the methionine cycle, part of one-carbon metabolism. Lowering homocysteine may help reduce inflammatory signaling. Choline-derived methyl groups may also influence DNA methylation, a chemical tagging process that can turn genes on or off, including genes involved in regulating inflammation.
This study was cross-sectional, meaning it captured diet and inflammation at a single point in time, so it cannot prove that choline directly reduces inflammation. Even so, the findings suggest that higher choline intake during pregnancy is associated with lower inflammation levels. In this Aliquot, I explore choline's roles in metabolic and brain health, including potential supplementation risks.