Dietary Intake and Food Sources of Choline Among Pregnant Women Attending an Antenatal Clinic in Bloemfontein, South Africa

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Abstract Background: The importance of adequate choline intake during pregnancy has been well documented, but inadequate intake is common. Total choline intake, as well as main food sources of choline were determined in a sample of pregnant women attending an antenatal clinic at a regional hospital in Bloemfontein, South Africa.Methods: A cross-sectional study design was used. Trained fieldworkers collected dietary intake data using a validated quantified food frequency questionnaire (QFFQ), after which all food items were matched to foods in the USDA Database for the Choline Content of Common Foods (Release 2) to quantify choline intake. Logistic regression with backward selection (p < 0.05) was used to select significant independent factors associated with inadequate choline intake.Results: The median daily intake of choline was 275.0 mg (interquartile range 184.7 mg – 386.7 mg) (N = 681). Most participants (84.7%) consumed less than the adequate intake level (AI) of 450 mg/day for choline. Meat and meat products, cereals, eggs and dairy contributed mostly to choline intake. Food items that contributed most to choline intake included full-cream milk, maize porridge, brown bread, deep-fried potatoes and deep-fried dough (vetkoek). An inadequate choline intake was significantly associated with lower egg and dairy intakes (p<0.0001 and p=0.0002 respectively). Conclusion: Most pregnant women in the current study had choline intakes that were lower than recommended. It is recommended that adequate choline intake during pregnancy be encouraged through public health messaging to promote consumption of foods that can significantly contribute to choline intake, such as eggs and dairy.

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