British Journal of Nutrition

Full Papers

Dietary Surveys and Nutritional Epidemiology

Low fish intake is associated with low blood concentrations of vitamin D, choline and n-3 DHA in pregnant women

Brian T. Wua1a2, Roger A. Dyera1, D. Janette Kinga1 and Sheila M. Innisa1a2 c1

a1 Department of Paediatrics, Faculty of Medicine, Nutrition and Metabolism Program, Child and Family Research Institute, BC, Canada V5Z 4H4

a2 Department of Foods, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC, Canada V6T 1Z4


Several studies have investigated the potential health benefits, including those associated with neurological function, of the n-3 fatty acid DHA. This has arisen in part because of the association between higher intakes of fish, which is a major dietary source of DHA, and reduced disease risk. In addition to DHA, fish also provides choline and vitamin D. The objective of the present study was to assess whether women in the first half of pregnancy with low fish intake also had low blood concentrations of vitamin D, choline and DHA. A total of 222 pregnant women at 16 weeks of gestation were examined for dietary intake, erythrocyte (phosphatidylethanolamine PE) DHA, plasma free choline and 25-hydroxyvitamin D (25(OH)D). Women who consumed ≤ 75 g fish/week (n 56) compared to ≥ 150 g fish/week (n 116) had lower dietary intake of DHA, total choline and vitamin D (P< 0·001), and lower erythrocyte PE DHA (5·25 (sd 1·27), 6·83 (sd 1·62) g/100 g total fatty acid, respectively, P< 0·01), plasma free choline (6·59 (sd 1·65), 7·40 (sd 2·05) μmol/l, respectively, P= 0·023) and 25(OH)D (50·3 (sd 20·0), 62·5 (sd 29·8) nmol/l, respectively, P< 0·01). DHA intake was positively related to the intake of vitamin D from foods (ρ 0·47, P< 0·001) and total choline (ρ 0·32, P< 0·001). Dietary intakes and biomarkers of DHA, choline and vitamin D status were assessed to be linked. This raises the possibility that unidentified concurrent nutrient inadequacies might have an impact on the results of studies addressing the benefits of supplemental DHA.

(Received November 07 2011)

(Revised April 16 2012)

(Accepted April 24 2012)

(Online publication June 12 2012)

Key Words:

  • Dietary fish;
  • DHA;
  • Vitamin D;
  • Choline


c1 Corresponding author: S. M. Innis, fax +1 604 875 3597, E-mail:


  Abbreviations: 25(OH)D, 25-hydroxyvitamin D; PE, ethanolamine phospholipids