Scientists have long called it a "brain booster." Choline is a nutrient found in animal cells, like meat and fish, that is essential for human development. Not only does it aid in memory and learning, but researchers now believe choline could help prevent mental illness.
Before he was even born, five-year old William Mason and his mom were part of a landmark research study.
Mother, Lisa Mason, told Ivanhoe, "I thought that would be beneficial for my baby."
Researchers wanted to know if giving pregnant women choline would protect their babies against schizophrenia.
One half of the women in the study were given a placebo. The other half took choline. After birth, the babies whose mothers took choline continued to receive the supplement.
Researchers then followed up with sensory tests. The normal human brain responds fully to an initial clicking noise, but screens out the second click.
That filter doesn't happen with schizophrenia.
Randy Ross, MD, director of research training at the University of Colorado School of Medicine, told Ivanhoe, "Your brain is wired to not pay attention to repetitive uninformative information in the environment."
The study showed mothers who took choline had babies who were far less likely to respond to the second sound. 76 percent had a normal response compared to the 43 percent of the babies in the placebo group.
With two other children, the Masons say they're grateful for anything that can give kids the best start.
Lisa Mason told Ivanhoe, "Growing and learning, just all the time."
The study took ten years to complete and was funded by the National Institute of Mental Health. Researchers say further studies will continue to confirm the results.
BACKGROUND: Choline is a nutrient that can be produced in the liver and is healthy for liver function and normal brain development. It is similar to vitamin B in its health benefits to the body. Choline can be found in certain foods such as eggs, wheat germ, brussels sprouts, beef, fish and broccoli. Choline is a vital nutrient that aids the body in nerve signaling and is a constituent of nervous system tissues in early brain development. In 1998, the National Academy of Sciences established an adequate intake level for choline at 550mg for men and 425mg for women. (Source: http://www.drweil.com/drw/u/ART03240/Choline.html)
SCHIZOPHRENIA: Schizophrenia is one of the most serious brain disorders that patients deal with. This disorder may cause people to hear voices in their head that others cannot hear and may believe that others are controlling their thoughts and words. The disorder can be chronic and extremely severe. Schizophrenia can run in families and occurs in 10 percent of people who have a first-degree relative suffering from the disorder. Schizophrenia may also be caused by an imbalance of neurotransmitters in the brain's structure. About 1 percent of Americans have this illness. (Source: http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml)
NEW TECHNOLOGY: Scientists may have found a way to help prevent mental illness in newborns by adding a supplement into the diet of pregnant women. A new 10-year study shows that the brain-boosting nutrient choline can actually prevent mental illness like schizophrenia in new born babies. Studies on animals have also shown that adequate levels of choline during pregnancy can have lasting effects on a baby's learning ability and memory, and suggest that choline can boost the brain power of the pregnant woman if their choline levels have been depleted at all. Doctors suggest taking 450mg of choline per day for pregnant women. (Source: http://www.babycenter.com/0_choline-in-your-pregnancy-diet_10325647.bc)
FOR MORE INFORMATION ON THIS REPORT, PLEASE CONTACT:
Erika Matich | Interim Director, Communications & Media
University of Colorado Anschutz Medical Campus
Office: 303-724-1528
erika.matich@ucdenver.edu
If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at mthomas@ivanhoe.com
Randy Moss, M.D., Director of Research Training at University of Colorado Medical School, talks about a new study involving giving pregnant women taking the dietary supplement choline to prevent their babies from developing mental illness.
How did the idea for this study develop?
Dr. Ross: So, the way we got to this study; it's really the end result of a very long series of scientific experiments. The idea, people have known for about 20 or 30 years that major mental illnesses, even though they often present in adolescence or adulthood, are at least partially due to changes in the way the brain develops prenatally and that's diseases like schizophrenia, bipolar disorder, probably even autism, attention deficit disorder, and anxiety. When you actually get symptoms, it's the end result of problems that started prenatally. Corresponding to that, we know that the groups that smoke at the highest rates are individuals with mental illness. So the question is, why do they smoke so much? And over the years, we've developed a basic biological model of how the brain works that suggests that they're smoking to try to activate a process which helps part of the brain be more active. It's actually a lot of parts of the brain, but it's the parts of the brain that basically helps turn off other parts, so that you can use the right part of the brain to do what you're doing and not turn on everything else in between. So, we knew we wanted to active these parts of the brain and we knew we wanted to active them, before you were born to help them develop in a very normal way. So, after a lot of scientific experimentation, and a lot of giving choline supplements in a variety of ways, we decided that it would be worth trying this in humans to see whether or not we could do it. So, we came up with the idea that choline, which is a natural part of the diet found in meat, eggs, and soy beans, would help stimulate this part of the brain, help it grow and make brains basically more resistant to mental illness later on; and so we decided to give this trial in pregnant women.
So why is this important?
Dr. Ross: I think the reason this study is important is because one study does not make a recommendation. But again, the idea has been for a long time that prenatal brain development is really important, but nobody's had a way to think about how to intervene prenatally. Nobody wants to give pregnant women drugs. No one wants to do things to otherwise healthy people on the off chance that their children will have problems in brain development and have mental illness later on. So what this does is show that using basic scientific information, that it is possible to intervene in a very safe way, and improve brain development in ways that are really suggestive of resistance to mental illness later on.
What is choline?
Dr. Ross: So choline is a natural part of the diet. It's most common form is called phosphatidalcholine. Phosphatidalcholine is in any animal cell membrane; any animal cell. So, it's in meat; it's in fish; beef, fowl like chicken, fish, and then it's also at high rates in eggs, and in soy beans.
How important is choline in pregnancy?
Dr. Ross: It's critically important. We know that if you are very deficient in choline, then there are problems in the nervous system development and you can get spina bifida or you can get cleft lip where your lip doesn't fully close, and we know that there can be some cognitive problems later on. If you get about the average normal about, most kids do fine. If you get a lot, the brain may develop better and really be resistant to a lot of diseases.
How about after pregnancy?
Dr. Ross: We don't know. Maybe in the first month or two after pregnancy, it could be useful. Beyond that point, it doesn't seem to have any benefit. The brain has developed in the way it's going to develop and there's not a lot of additional use. It most likely won't' help once you get the illness when you're a teenager and an adult.
Is choline important for just pregnant and breast-feeding women or for everyone?
Dr. Ross: All men need to have some choline in their diet. Most young adult and middle age adult women actually make enough of their own choline in their body that whether they get it in their diet or not, is not important. The one time it's important is when they're pregnant because the developing baby needs a lot of it and they can't make enough to supply the baby, so they need to eat it in their diet.
When during breast-feeding, if you take any choline, do you need to have taken it already?
Dr. Ross: We don't know whether or not infancy makes a difference. It's possible that it might help up to 2 or 3 months of age. We don't know, but we suspect that the bigger effect is before the baby's born.
Tell me about sensory gating.
Dr. Ross: Alright, so when you do a study like this you say what we want and that is to decrease mental illness later on. It's hard to wait 15, 20, 30 years to find out if there's an effect. So in the short run, what we try to do is find ways to measure brain function that are suggestive that you would be at decreased risk for later on. One thing that's true with a lot of mental illnesses, in particular schizophrenia, but also bipolar and autism, and a number of others, such as ADHD, are your brain is wired to not pay attention to repetitive, uninformative information in the environment. So if you're sitting in a room and there's a fan going with the air conditioner, and you walk out of the room, and somebody said was there's a fan going and the air conditioner? And you'd say, no I didn't hear it; cause it was repetitive, uninformative information and your brain screened it out and that screening out is called sensory gating; gating out the information. People with mental illness, and for many of them, that's not true and they hear everything. They hear every sound, they hear the refrigerator going on and off, they hear cars going by outside, they hear the light buzzing, they hear everything. The way we test that is that we play the identical sound twice and it's just two clicks, a half second apart, and then measure brain waves to see how much the brain is responding to the sound. Most individuals, including most babies, will get a good response to the first sound, and to the second sound they won't respond at all; they'll already have figured out it's not worth responding to. For people who may be more vulnerable, or as they grow up actually have mental illness, they respond equally to both sounds, that ability to not respond to gate out information is decreased. We use that as a measure of their brain's ability to turn off parts of the brain that don't need to be used and to focus on what it does need to be doing. That was the main outcome in this study. We compared pregnant women who got choline in the form of phosphatidalcholine, to pregnant women who got a placebo that didn't have any choline in it and then we looked at how their babies' brains responded to repetitive sounds. The babies who got the choline supplementation prenatally during pregnancy were far more likely to not respond to that second sound than the babies who didn't get the choline supplementation. We've now followed some of these children up to about 4 years of age and it looks like they have better behavior. If you got the choline prenatally, you have less attention problems, less aggressiveness and acting out, and less anxiety, um and it looks like less impulsiveness than if you didn't get the choline before you were born.
So you kind of got the results you were looking for?
Dr. Ross: Yeah, and these pregnant moms that got it were all healthy pregnant moms. They didn't have mental illness. This was just in the general population.
That's great. What's the larger picture of this study? Are we learning that prenatal diet supplementation is more and more critical to the newborns disposition and development the more studies we do?
Dr. Ross: I think this adds to the idea that brain development before you're born makes a big difference and that nutrition is a way to influence brain development, both before you're born and maybe in early infancy as well.
What's your recommendation to pregnant and breast-feeding women at this point? Are you prepared to tell them to take a choline supplement?
Dr. Ross: One study does not make a recommendation. So we need to confirm it over time. I think it's really promising and suggests that nutrition may be a way to really decrease mental illnesses like schizophrenia and bipolar disorder over time.
And how many positive results do you need before you feel like you can make that statement?
Dr. Ross: We need more positive studies than we have now. It depends on how big the effect is and how big each individual study is, and how many people are in each individual study.
What's the next step for you in this study?
Dr. Ross: I think we come away from the study with really the major finding that this is a way that we can potentially intervene. The three next steps are one, about 75% of the babies who got choline prenatally were able to gate out sensory information, in other words, the choline worked. That compared to about the 40% who didn't get the choline. But that still means that of those who got the choline, 25% didn't' respond. Now, the question is why didn't they respond? One possibility is that we didn't get choline started early enough in pregnancy and we have to start it earlier, because it started about 4 months of pregnancy. The second possibility is that we didn't have the dose right and we need to give more choline. For the first study, we guessed at what the dose should be and we just could have not given enough. There could also be some other confounding factors that we need to figure out, so step one is sort of figuring how to maximize the benefit. Step two is following these kids over time to be sure that better brain development early on actually does protect against mental illness and improves behavior and cognition later on.
In 10 seconds, describe this study.
Dr. Ross: We utilized a dietary supplement, choline in pregnant women and young infants and found improved infant brain behavior, and improved 3-1/2-year-old behavior as a result of the choline supplementation.
THIRD PARTY: I think the only thing you might want to do is comment a little bit more on the question of where does this study go next.
Dr. Ross: Well, we talked about figuring out the dosage and the timing and following these kids over time.
THIRD PARTY: How will that happen?
I know that these mental illnesses usually develop in the early teens, so it's going to be a while before those kids are….
Dr. Ross: Well, one of the earliest manifestations are attentional problems and anxiety, so by 5 or 6 years of age, we should be able to see attention problems and anxiety. We're already beginning to see suggestions of that at 3 to 4 years of age. This study took 10 years to do really for two reasons; one is because, especially in early stages of a study like this, we're asking pregnant women to take a chance and take a dietary supplement while we didn't think there was any risk; it's still something different to do during pregnancy and we're very thankful to the moms who participated, but it took a while. And the second is that these kinds of studies take time and cost a fair amount of money. So I think another limitation to the future is finding funds to continue the work, whether those are research funds from national sources or donations.
Where did you get the funding for the study that you've already done?
Dr. Ross: Part of the funding came from the National Institute of Mental Health and part of the funding came from an endowing organization, The Institute for Children's Mental Disorders.