Today’s episode was filmed at the Future Directions in Choline Symposium put on by the University of North Carolina Nutrition Research Institute.Our day two episode opens with Dr. Eric Ciappio and Dr. Jonathan Bortz of Balchem, summarizing day one’s focus on pregnancy and early life and previewing day two’s focus on the latest choline research targeting adult nutrition. (1:03)The next guest on our roster is Dr. Mark Manary, a professor of pediatrics at the Washington University School of Medicine. Mark’s symposium talk discusses choline and food aid. Food aid products are specially designed to address needs from crisis situations. These specialized food aid products are standardized to meet great deficiency or inadequacy needs. On the most extreme side, there is a product called ready-to-eat therapeutic food for children who are starving to death. Other food aid products include those for severely underweight children. Dr. Manary’s research consists of clinical trials in sub-Saharan Africa that include different nutrients in food aid to see if there are improvements in children’s responses. One trial with the inclusion of DHA found a 6-15 IQ point difference by adding fish oil or DHA. Mark hypothesizes that a doubling of that effect will be observed when choline is added. (6:42)Dr. Rima Obeid from Saarland University Hospital in Homburg, Germany, joins us next. Her symposium presentation focused on choline and pregnancy outcomes. Their research group has found that low or insufficient amounts of choline in the mother’s diet during pregnancy are associated with a higher risk for serious birth defects in babies and that the liver health of the infants is also negatively affected by low choline intake of the mother during pregnancy. Rima’s future research includes investigating the impacts and interactions of folate and choline consumption during pregnancy on neural tube defects such as spina bifida. In another study, she will focus on the relationship between the severity of congenital heart defects compared to neural tube defects. In particular, they wish to look at the association with low choline in the blood of the children, the mother and the father, because a pilot study suggests a family pattern, which could be due to some genetic background. (17:18)Our next guest is Dr. Susan Smith, Deputy Director of the University of North Carolina Nutrition Research Institute. One of her presentations centered on choline genetics and cognition. Her research has found genetic variation in choline uptake from the diet. One research question was, “Are there choline variants that affect how powerful that choline is in treating a disease condition?” In particular, Dr. Smith was investigating if choline could be used to treat children who have brain damage from prenatal alcohol exposure, and the answer is yes, it’s very helpful. Then, they evaluated if some children benefit more than others and found that there is a gene variant that affects how efficiently choline is absorbed from the diet. Children with the variant that reduced choline uptake benefitted the most from supplemental choline. In addition, there was an impact of the gene variant on cognitive function regardless of prenatal alcohol exposure. Children who carried one or two copies of this particular variant had reduced cognitive performance as compared to those children who were lucky enough to be born with the other variant. While we still don’t have a blanket recommendation for how much choline pregnant women should consume, Dr. Smith’s message to pregnant women is that eating enough choline lets your baby achieve its full potential. (23:32)Dr. Isis Trujillo-Gonzales and Dr. Evan Paules, both with the University of North Carolina Nutrition Research Institute join us. Isis focuses on choline and brain/eye development, while Evan focuses on choline and metabolic health. Dr. Trujillo-Gonzales’s research has found that the neurons in the eye that receive light and connect to the r