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Updated: Aug 23, 2025

Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Effects of phosphatidylcholine and betaine supplements on women's serum choline
M Camille Hoffman1, Ann Olincy1, Angelo D'Alessandro1
1Department of Obstetrics and Gynecology (MCH), Psychiatry (MCH, AO, SKH, RF, RGR and Biochemistry Molecular Genetics (AD'A, JAR, KCH), University of Colorado School of Medicine, USA.
Insights
Betaine supplements did not increase serum choline levels in women. However, phosphatidylcholine supplements effectively raised choline concentrations, suggesting it remains the preferred supplement for increasing choline intake during pregnancy.
Area of Science:
- Nutritional Biochemistry
- Maternal-Fetal Medicine
- Human Physiology
Background:
- Maternal phosphatidylcholine supplementation supports fetal brain development.
- High doses of phosphatidylcholine are difficult for pregnant women to consume.
- Betaine is explored as a potential substitute for choline's effects.
Purpose of the Study:
- To investigate if betaine supplementation can increase serum choline concentrations in women.
- To compare the effects of betaine and phosphatidylcholine on serum choline levels.
Main Methods:
- A three-arm crossover clinical trial was conducted.
- Normal, non-pregnant women received betaine or phosphatidylcholine supplements.
- Serum choline and betaine concentrations were assessed after single and repeated doses.
Main Results:
- Betaine supplements did not significantly alter serum choline concentrations.
- Phosphatidylcholine supplementation increased serum choline levels after both single and repeated doses.
- Serum betaine concentrations increased following both betaine and phosphatidylcholine intake.
Conclusions:
- Betaine does not effectively substitute for phosphatidylcholine in raising serum choline.
- Phosphatidylcholine remains effective for increasing choline levels via single or repeated administration.
- Serum betaine may serve as a reliable biomarker for choline intake.
Background:
Maternal phosphatidylcholine supplements have shown benefit in the development of the human fetal brain, as assessed both by newborn physiological measurements and by a related decrease in later childhood behavioral abnormalities. However, the relatively low choline component of phosphatidylcholine mandates high doses that are difficult for pregnant women to consume.
Objective:
Betaine can substitute for some choline effects. The hypothesis was that betaine supplementation would significantly increase women's serum choline.
Design:
A three-arm crossover clinical trial was used to assess serum concentrations of choline after betaine supplements at two doses, in comparison with phosphatidylcholine supplementation. The effects of both a single dose and of one-week twice-daily doses were assessed in normal non-pregnant women.
Results:
Betaine supplements at two doses failed to increase serum choline concentrations after single administration or one-week twice-daily dosing. Phosphatidylcholine supplements raised choline concentrations after both single doses (mean change from baseline 8.34 ± 7.29 ng/ml, paired t = 3.24, df 7, p = 0.014, range 1-21 ng/ml, d' = 1.15) and one-week twice-daily doses (mean change from baseline 4.58 ± 3.68 ng/ml standard deviation; paired t = 3.51, df 7, p < 0.001, range 2-13 ng/ml, d' = 2.65). Betaine concentrations rose after both betaine and phosphatidylcholine supplementation.
Conclusions:
Betaine supplements did not substitute for phosphatidylcholine supplements, which raise serum choline concentrations both after a single dose and after repeated administration. However, serum betaine concentrations did rise after both betaine and phosphatidylcholine consumption and, therefore, betaine may be a stable indicator of choline intake.
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