Why Choline is a Vital Nutrient in your Fertility & Pregnancy Diet

Choline is a vital nutrient that is increasingly recognised as a cornerstone of the preconception and pregnancy diet. Its significance lies in its potential to support neural tube development, contribute to cognitive development in the baby, and support the overall health of both the mother and the developing child.

Despite its importance, choline is one of the most commonly overlooked nutrients in pregnancy nutrition, with research suggesting only a small proportion of pregnant women meet recommended intakes through diet alone.¹

The importance of choline during pregnancy

Choline plays a critical role in supporting the growth and development of the baby and in helping to prevent birth defects, making it an essential nutrient for expectant mothers. Research has shown that choline is particularly important during the third trimester and breastfeeding, when rapid brain growth and development are taking place.²

Choline contributes to the development of the baby's brain and spinal cord, making it important for healthy neural tube development. It works alongside folate as a methyl donor in DNA methylation, the process by which the body regulates gene expression during the critical early weeks of fetal development. Research suggests choline may play an independent role in reducing the risk of neural tube defects alongside folate, which is one reason it is increasingly discussed as a preconception as well as a pregnancy nutrient.³

Higher maternal choline intake during the third trimester has been associated with improved infant cognitive outcomes. A randomised controlled trial found that infants born to mothers consuming higher choline intakes showed faster information processing speed at 4, 7 and 10 months of age, with effects persisting into early childhood.²

How much choline do you need in pregnancy?

Pregnant women need approximately 450mg of choline per day to support their own health and that of their developing baby. The body is able to produce small amounts of choline via the liver, but this is not sufficient to meet requirements, meaning the majority must come from food and supplements.

The EFSA recommended daily intake for adult women is 400mg, rising to 480mg during pregnancy and 520mg during breastfeeding. Most standard prenatal multivitamins provide significantly less than this, which is why many practitioners now recommend a dedicated choline supplement alongside a prenatal multivitamin.

Food sources of choline in pregnancy

Choline is found in a range of foods. Good sources include:

• Eggs: A single large egg contains approximately 147mg of choline, making it one of the richest dietary sources. Two eggs provide roughly half the recommended daily intake for pregnancy.
• Beef and chicken: Lean cuts of beef and chicken provide approximately 70 to 85mg per 85g serving.
• Fish and seafood: Salmon, cod and tuna are useful sources, typically providing 60 to 90mg per serving.
• Liver: One of the most concentrated dietary sources of choline, though intake during pregnancy should be limited due to high vitamin A content. Always consult your midwife or GP.
• Dairy: Milk, yoghurt and cheese provide moderate amounts of choline.
• Plant sources: Broccoli provides around 63mg per cooked cup. Soybeans, beans, quinoa and cruciferous vegetables are useful plant-based sources, though generally lower in choline than animal foods.

Even with a varied diet, reaching 450 to 480mg daily consistently during pregnancy can be challenging, particularly for women experiencing nausea, food aversions or following a plant-based diet.

Zita West Choline

400mg of choline bitartrate per serving, formulated to complement the Vital Essence range from trimester 1 through to trimester 3 and the postnatal period with Revital Essence. 60 capsules providing a one month supply.

Shop Zita West Choline

Who may be at higher risk of choline deficiency in pregnancy?

Certain groups may be at greater risk of not meeting choline requirements during pregnancy:

• Women following vegetarian or vegan diets: Plant-based diets tend to be lower in choline since the richest sources are animal foods. Careful planning and supplementation may be particularly important for this group.
• Women with PEMT gene variations: The PEMT gene is involved in the body's ability to synthesise choline internally. Variations in this gene reduce the amount the body can produce, increasing dependence on dietary and supplemental sources.
• Women experiencing significant nausea or food aversions: First trimester nausea often leads to reduced egg and meat intake, which may temporarily reduce choline intake at a critical stage of fetal development.
• Women taking prenatal multivitamins without choline: Most standard prenatal supplements provide little or no choline, meaning women relying solely on their multivitamin may have a significant gap in their intake.

Further reading on choline in pregnancy

• Choline in pregnancy — a comprehensive guide to choline needs, food sources and supplementation throughout pregnancy
• Choline and fetal brain development — the evidence for choline's role in cognitive outcomes
• Choline and fertility — why choline matters before conception as well as during pregnancy
• Folate vs folic acid — understanding the difference between the two forms of vitamin B9

FAQs: choline and pregnancy

How much choline do I need when pregnant?

Approximately 450 to 480mg per day during pregnancy. Most women do not meet this through diet alone, and most prenatal multivitamins provide insufficient choline. Zita West Choline provides 400mg per serving to complement your dietary intake.

Why do most prenatal vitamins not include enough choline?

Choline is a bulky nutrient that is difficult to include at meaningful doses within a standard multivitamin capsule. This is why a dedicated standalone choline supplement is increasingly recommended alongside a prenatal multivitamin rather than relying on the multivitamin to cover choline needs.

Is choline safe in pregnancy?

Yes, choline is considered safe at recommended doses during pregnancy. The tolerable upper intake level is 3,500mg per day from all sources. Always discuss any new supplement with your midwife, GP or healthcare provider before starting during pregnancy.

When should I start taking choline in pregnancy?

Ideally from the preconception period or as early in pregnancy as possible, given choline's role in neural tube formation and early brain development. If you are already pregnant and have not been taking choline, starting at any stage is still worthwhile.

References

1. Nguyen HT et al. (2025). Choline in pregnant women: a systematic review. Nutr Rev. 83(2):e273-e288. PubMed
2. Caudill MA et al. (2018). Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed. FASEB J. 32(4):2172-2180. PubMed
3. Zeisel SH, da Costa KA. (2009). Choline: an essential nutrient for public health. Nutr Rev. 67(11):615-623. PubMed

External references: NHS: Vitamins, supplements and nutrition in pregnancy  |  EFSA: Dietary Reference Values for choline

This content is for educational purposes only and is not intended to diagnose, treat, or replace medical advice. Always consult your midwife, GP or healthcare provider before starting or changing any supplement during pregnancy.