Rodent studies demonstrate that supplementing the maternal diet with choline during pregnancy produces life-long cognitive benefits for the offspring. In contrast, the two experimental studies examining cognitive effects of maternal choline supplementation in humans produced inconsistent results, perhaps because of poor participant adherence and/or uncontrolled variation in intake of choline or other nutrients. We examined the effects of maternal choline supplementation during pregnancy on infant cognition, with intake of choline and other nutrients tightly controlled. Women entering their third trimester were randomized to consume, until delivery, either 480 mg choline/d ( n = 13) or 930 mg choline/d ( n = 13). Infant information processing speed and visuospatial memory were tested at 4, 7, 10, and 13 mo of age ( n = 24). Mean reaction time averaged across the four ages was significantly faster for infants born to mothers in the 930 ( vs. 480) mg choline/d group. This result indicates that maternal consumption of approximately twice the recommended amount of choline during the last trimester improves infant information processing speed. Furthermore, for the 480-mg choline/d group, there was a significant linear effect of exposure duration (infants exposed longer showed faster reaction times), suggesting that even modest increases in maternal choline intake during pregnancy may produce cognitive benefits for offspring.-Caudill, M. A., Strupp, B. J., Muscalu, L., Nevins, J. E. H., Canfield, R. L. Maternal choline supplementation during the third trimester of pregnancy improves infant information processing speed: a randomized, double-blind, controlled feeding study.

Iron deficiency and iron deficiency anemia have been shown to have negative effects on aspects of perception, attention, and memory. The purpose of this investigation was to assess the extent to which increases in dietary iron consumption are related to improvements in behavioral measures of perceptual, attentional, and mnemonic function. Women were selected from a randomized, double-blind, controlled food-fortification trial involving ad libitum consumption of either a double-fortified salt (DFS) containing 47 mg potassium iodate/kg and 3.3 mg microencapsulated ferrous fumarate/g (1.1 mg elemental Fe/g) or a control iodized salt. Participants' blood iron status (primary outcomes) and cognitive functioning (secondary outcomes) were assessed at baseline and after 10 mo at endline. The study was performed on a tea plantation in the Darjeeling district of India. Participants ( = 126; 66% iron deficient and 49% anemic at baseline) were otherwise healthy women of reproductive age, 18-55 y. Significant improvements were documented for iron status and for perceptual, attentional, and mnemonic function in the DFS group (percentage of variance accounted for: 16.5%) compared with the control group. In addition, the amount of change in perceptual and cognitive performance was significantly ( < 0.05) related to the amount of change in blood iron markers (mean percentage of variance accounted for: 16.0%) and baseline concentrations of blood iron markers (mean percentage of variance accounted for: 25.0%). Overall, there was evidence that the strongest effects of change in iron status were obtained for perceptual and low-level attentional function. DFS produced measurable and significant improvements in the perceptual, attentional, and mnemonic performance of Indian female tea pickers of reproductive age. This trial was registered at clinicaltrials.gov as NCT01032005.

Background Maternal nutrition during pregnancy and lactation has profound effects on the development and lifelong health of the child. Long-chain PUFAs are particularly important for myelination and the development of vision during the perinatal period. Objectives We conducted a systematic review to examine the relationship between supplementation with omega-3 fatty acids during pregnancy and/or lactation and neurodevelopment in children, to inform the Scientific Report of the 2020 Dietary Guidelines Advisory Committee. Methods We identified articles on omega-3 fatty acid supplementation in pregnant and lactating women that included measures of neurodevelopment in their children (0–18 y) by searching PubMed, CENTRAL, Embase, and CINAHL Plus. After dual screening articles for inclusion, we qualitatively synthesized and graded the strength of evidence using pre-established criteria for assessing risk of bias, consistency, directness, precision, and generalizability. Results We included 33 articles from 15 randomized controlled trials (RCTs) and 1 prospective cohort study. Of the 8 RCTs that delivered omega-3 fatty acid dietary supplements during pregnancy alone (200–2200 mg/d DHA and 0–1100 mg/d EPA for approximately 20 wk), 5 studies reported ≥1 finding that supplementation improved measures of cognitive development in the infant or child by 6%–11% (P &lt; 0.05), but all 8 studies also reported ≥1 nonsignificant (P &gt; 0.05) result. There was inconsistent or insufficient evidence for other outcomes (language, social-emotional, physical, motor, or visual development; academic performance; risks of attention deficit disorder, attention-deficit/hyperactivity disorder, autism spectrum disorder, anxiety, or depression) and for supplementation during lactation or both pregnancy and lactation. Populations with a lower socioeconomic status and adolescents were underrepresented and studies lacked racial and ethnic diversity. Conclusions Limited evidence suggests that omega-3 fatty acid supplementation during pregnancy may result in favorable cognitive development in the child. There was insufficient evidence to evaluate the effects of omega-3 fatty acid supplementation during pregnancy and/or lactation on other developmental outcomes.

Objectives To assess the effect of 3rd trimester maternal choline supplementation on child memory at 7 y of age. Animal studies have provided strong evidence that maternal choline supplementation improves offspring cognition, including memory, but few experimental studies have evaluated this intervention in humans. Methods Pregnant women (n = 26) were randomized to consume 480 mg (approx. the Adequate Intake [AI]) or 930 mg choline/d from gestational wk 27 until delivery as part of a controlled-feeding study. All food (providing 380 mg choline/d), choline supplements (100 mg or 550 mg/d), and prenatal vitamins were provided by the study. An ancillary follow-up was conducted to assess offspring cognitive functioning, including memory, at age 7 y (n = 20). Children performed a computer-based color-location memory task in which the location of dots on a cartoon figure were recalled after a retention interval (RI) of 1 or 8 s. The task increased in difficulty level (number of dots to be recalled; 1 to 5 dots) every 4 trials. Data were analyzed using mixed models; pairwise comparisons were corrected for multiplicity. Results Children in the 930 mg/d group passed more levels than those in the 480 mg/d group (P = .048; see Figure), indicative of superior memory span. While the choline group by RI interaction was non-significant (P = .31), contrasts revealed that the 930 (v. 480) mg/d group tended to pass more levels at the 1 s RI (P = .052), but not at the 8 s RI (P = .58). Similarly, the analysis of total dots correct revealed a choline group by RI interaction (P = .08) such that children in the 930 (v. 480) mg/d group recalled more dots correctly at the 1 s RI (P = .02), but not at the 8 s RI (P > .99). Conclusions Children whose mothers consumed 930 (v. 480) mg choline/d performed significantly better on a task of color-location memory at age 7 y, suggesting a long-term beneficial effect of prenatal choline supplementation on offspring cognition in humans. These findings indicate that the choline AI for pregnant women may not be sufficient for optimal offspring cognitive functioning and raise concerns about choline intake during pregnancy in North America, which on average is only approx. 70% of the AI. Funding Sources Funded by NIFA/USDA and the Balchem Corp. JEHN and CLB were supported by NIH Traineeships. CLB was supported by an Egg Nutrition Center Young Investigator Research Award for Early Exploration. Supporting Tables, Images and/or Graphs