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X Fact
September 14, 2020
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Can Pregnant Women Make Enough Choline to Support Their Baby and Themselves?

Choline levels measured in the blood of a newborn baby are about 6 or 7 times higher than in an adult. Because choline needs in pregnancy and lactation are much higher, the pathway for de novo synthesis of choline ramps up to peak production in the third trimester. The key to revving up of this system is estrogen, which dials up the PEMT gene to produce more and more enzyme (PEMT) to crank out more choline in an attempt to meet the needs of the baby. But, is it enough? Despite the enhanced capacity in the last trimester to make choline, the extraordinary demand in the fetus is so high, that invariably the mother's choline supply is depleted, and she needs choline supplementation.

When women in their third trimester were supplemented with choline, it was found that a dose significantly exceeding current recommendations (450mg/day) was needed to meet the high demand of the pregnancy.

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PEMT stands for Phosphatidylethanolamine N-Methyltransferase. It is an enzyme that converts phosphatidylyethanolamine into phosphatidylycholine in the liver. The gene that codes for this enzyme is found on chromosome 17 in humans and is the site of frequent misspellings (or SNPs) that impact the function of the protein in this very important metabolic process to produce the phospholipid phoshatidylcholine.

De Novo
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De Novo

A biochemical pathway where a more complex molecule is synthesized anew from simple precursor molecules.

Who Wrote This X Fact
Jonathan Bortz MD
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Jonathan’s background as a practicing diabetes specialist for 15 years and 17-year career developing nutritional prescriptive products for the pharmaceutical industry has contributed to his ability to understand nutrients, how they work and why they are important.

Over the years he has acquired broad and in-depth knowledge in minerals, essential fatty acids and other nutrients, but has special expertise in Vitamin B12 and choline metabolism. He is often asked to speak at national and international venues to articulate why B12, folate and choline are so important to gene function, brain development, liver and cardiovascular health. He applies pharmaceutical standards to nutrient science and has developed a unique ability to translate complicated concepts into simple promotional messages that resonate with practitioners and consumers. He has developed dozens of innovative nutritional products, of which many are category leaders in the US. Jonathan obtained his medical degree from the University of the Witwatersrand Medical School in South Africa and did his fellowship in Endocrinology at Washington University in St. Louis, MO.

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