Synergy Between Choline and DHA

Metabolic synergy exists between choline, phospholipid, and polyunsaturated fatty acid
metabolism. Previous evidence from our laboratory has shown that higher dietary choline
intakes increase the amount of docosahexaenoic acid (DHA) incorporated into
phosphatidylcholine (PC), as measured by PC-DHA concentrations in circulating erythrocytes.
PC-DHA results from the production of PC through the phosphatidyl N-ethanolamine
methyltransferase (PEMT) pathway and is critical for exporting fat from the liver to
peripheral tissues. We are expanding this work to pregnant women, for whom DHA intake is
critical to support the developing infant's growth, by undertaking a double blind, randomized
controlled trial of choline supplementation (500mg) throughout the 2nd and 3rd trimesters of
pregnancy. All women will consume 200mg of docosahexaenoic acid (DHA), a prenatal vitamin,
and 25-50mg of deuterated choline (choline d9) daily throughout the duration of the trial.
The use of a stable isotope will allow for modeling of choline dynamics throughout the 2nd
and 3rd trimester of pregnancy, and calculate the activity of PEMT in pregnant women.
Consenting participants will provide a baseline blood draw, followed by 2 additional blood
draws throughout their pregnancies, and maternal/cord blood at birth, in addition to the
placenta. This trial will test the hypothesis that choline supplementation increases the
amount of PC-DHA in the blood of pregnant women and increase its supply to the developing
fetus.

Inclusion Criteria:

- healthy, singleton pregnant women gestational weeks 12-16, ages 21-40, willingness to
comply with the study protocol

Exclusion Criteria:

- Habitually high choline/DHA intake

- BMI >32

- Pregnancy complications and comorbidities (at baseline and throughout the study)

- Current smokers, drinkers, or drug users