Does Good Mental Health Start in the Womb?

Unless you've been living under a rock, no doubt you're familiar with the crucial importance of Folate before and during pregnancy, and the role it plays in reducing the risk of neural tube defects. But ask any expecting mother about choline and you’re almost certainly going to get a look of confusion in return.Cho-what?Choline - a water-soluble essential nutrient. I’ll try not to get too bogged down with the hard-core biochemistry of it all, but it’s important to set the scene...Firstly, it’s a precursor to phospholipids (such are phosphatidylcholine), which are molecules that provide structure and protection to our cells - the very basic units of life. Secondly, it's a precursor to a neurotransmitter called 'Acetylcholine', which is responsible for movement and muscular contraction, as well as memory and cognition. Thirdly, it’s also the major donor of methyl groups, and we use methyl groups to build things in our bodies… LOTS of things! Interestingly, the most sensitive organ to deficiency however is the liver. Liver cells become damaged, and fat can accumulate in the liver when there’s a choline deficiency.So, when we’re talking liver health, brain function, nerves, cellular health and muscles…I’d say it’s pretty darn important!What does it have to do with mental health and pregnancy?Mounting research tells us that lifelong well being, including mental well being, begins in the womb. During fetal development, we can be "programmed" in many ways. We have a kind of developmental plasticity where our genes can express different ranges of physiological or morphological states in response to environmental changes (diet being a key part of this environment).During pregnancy and lactation, the demand for choline, like so many other nutrients, goes up. Studies show that adequate choline intake during pregnancy is linked to:

1. Lower risk for schizophrenia (1)
2. Infant neuro-developmental milestones at 18 months (2)
3. Higher performance IQ (at age 5) (3)
4. Positive effects on cognition (at age 7) (4)

These findings are hugely important.As a mother delivers large amounts of choline across the placenta to the baby, and after birth delivers large amounts of choline in her milk; perhaps a dip in her choline might be the cause of “baby brain”!?Meeting the demands through foodAlthough small amounts can be made in the liver, this isn’t sufficient to meet our demands (especially during pregnancy). It's been estimated that 90% of Americans are choline deficient, and unfortunately we’re likely following the same kind of trends in Australia.Pregnant women need around 440mg of choline each day.To meet that need, here are some suggestions:

• 1/3 cup beef liver = 350mg (you can grate it straight out of the freezer into a slow cooked dish!)
• 2 eggs = 300mg
• 1 cup broccoli = 65mg
• 1/3 cup beef = 95mg

For vegetarians and vegans specifically, supplementation can be useful. Choose a good quality pregnancy multi which has choline. Although choline supplementation seems is safe in doses up to 750mg/day as this study shows, more research is needed and food always trumps pills.This is exactly why I’ve recommended regular intake of pasture-raised eggs, grass-fed liver, cruciferous vegetables and nuts in my Pregnancy Program! For more nutrition advice during pregnancy, be sure to check it out.