Choline, Betaine Prevent Birth Defects

Eating a diet rich in choline and betaine before pregnancy can lower a woman’s risk of delivering a baby with a neural tube defect (NTD), reports the American Journal of Epidemiology (2004;160:102–9).

NTDs are serious birth defects that occur early in pregnancy. They include malformation of the brain (anencephaly), malformation of the lower spinal cord (spina bifida), and several others. Between 30 and 50% of NTDs are caused by maternal folic acid deficiency during the first few weeks of pregnancy, the time when the neural tube develops. Other factors that have been shown to increase the risk of NTDs include high intake of sugar before and during the first trimester of pregnancy, maternal obesity, and maternal diabetes.

NTDs occur in about 1 to 5 births per 1,000 worldwide; approximately 3,000 pregnancies in the US are affected by NTDs each year. Over the past decade, increased awareness, folic acid–fortified cereals and grain products, and routine folic acid–supplement recommendations have led to a decline in the number of cases of NTDs in the US. In addition to folic acid, high intake of methionine (an amino acid), zinc, vitamin C, vitamin B12, and dairy foods have all been associated with a lower risk of NTDs.

Choline, a nutrient used by the body in some of the same biochemical pathways as folic acid, is also used to produce acetylcholine, a major chemical messenger (neurotransmitter). Eggs, whole grains, wheat germ, soybeans, and lecithin supplements are rich in choline. In the body, betaine is made from choline; it is also found in high amounts in certain foods such as whole grains, spinach, and beets. Some animal studies have found that a choline deficiency can increase the risk of NTDs, but others have not. The effect of choline and betaine intake on NTD risk in humans has not previously been studied.

In the current study, the pre-pregnancy diets of 424 mothers of babies with NTDs were compared with the diets of 460 mothers of babies without NTDs. Choline and betaine intake were estimated based on answers to questionnaires that the women completed about their habits and diet during the three months before their pregnancies. Babies of women with the highest choline intake had a 49% lower risk of NTDs than babies of women who had the lowest choline intake. Furthermore, babies of women with high intake of both choline and betaine were 72% less likely to have NTDs than were babies of women with the lowest intakes of both of these nutrients. Betaine intake alone did not significantly influence the risk of NTDs.

The results of this study are the first to show that eating foods rich in choline and betaine before pregnancy might reduce the risk of NTDs. More studies are needed to confirm these observations, and the effect of taking choline, betaine, or lecithin supplements on NTD risk should also be a focus of future research.

Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, VT, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.

Copyright © 2004 Healthnotes, Inc. All rights reserved. Republication or redistribution of the Healthnotes® content is expressly prohibited without the prior written consent of Healthnotes, Inc. Healthnotes Newswire is for educational or informational purposes only, and is not intended to diagnose or provide treatment for any condition. If you have any concerns about your own health, you should always consult with a healthcare professional. Healthnotes, Inc. shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Healthnotes and the Healthnotes logo are registered trademarks of Healthnotes, Inc.