In the research discussion, the investigators note that the cause of NTDs is very complex and that supplementation of the food supply with folic acid, though effective, is only part of the solution. "This study is exciting because it offers new clues for preventing serious birth defects like spina bifida," said Dr. Gary M. Shaw, co-author of the study and professor of pediatrics at Stanford University School of Medicine. "This research should be repeated in other settings, so we can learn more about the best nutrition advice to give pregnant women."

The Benefits of Choline
Choline is an essential nutrient needed for many of life's most basic functions including brain and nerve function, liver metabolism, the transportation of nutrients and the normal functioning of every cell in the body. Adequate choline intake is especially important for pregnant and breastfeeding women because it has been shown to influence prenatal and infant brain and spinal cord development as well as lifelong memory and learning functions. There is a high rate of choline transfer from mother to fetus and breast milk is also rich in choline, so meeting maternal choline needs is very important.

Emerging research also shows that choline may have additional benefits in areas such as: Memory function: Animal studies have demonstrated that age-associated memory decline seems to be delayed in offspring when mothers' diets are supplemented with choline during pregnancy. Breast cancer prevention: A study funded by a grant from the National Institutes of Health (NIH) found that the risk of developing breast cancer was 24% lower among women with the highest intake of choline compared to women with the lowest intake. Cardiovascular health: Choline has been shown to play an important role in reducing homocysteine, an amino acid in the blood that may be associated with an increased risk of chronic inflammation, which is considered a risk factor for heart disease.

Closing the Choline Consumption Gap
 Despite its important role in the body, only one in 10 Americans is meeting the Adequate Intake (AI) guidelines for choline. "Most people don't know how important choline is for their bodies, or how easy it is to get the choline you need from food," explains Elizabeth Ward, a registered dietitian in private practice and author of the new book Expect the Best: Your Guide to Healthy Eating Before, During, & After Pregnancy. Ward, who is not affiliated with Stanford, also notes, "One large egg can help meet roughly one-quarter of the recommended daily intake of choline for men, women and women who are pregnant or nursing."

For those looking to add more choline to their diet, Ward offers these additional tips: Focus on Foods: Most prenatal and regular multivitamins provide far less than the AI for choline. The easiest way to get the choline you need is by eating a balanced diet rich in foods that contain choline such as eggs, lean beef, salmon, cauliflower, milk and peanut butter. Don't Skip the Yolk: Choline is found exclusively in the egg yolk, and one yolk contains 125mg of choline. The egg yolk also contains nearly half the protein in an egg, and the yolk is the only place you'll find the nutrients lutein and zeaxanthin which are important antioxidants related to eye health. While eggs contain a small amount of lutein and zeaxanthin, research suggests that these nutrients may be more bioavailable from eggs than from richer sources.

From the August 31, 2009, Prepared Foods E-dition