Home Medicinal Chemistry Vitamins Choline


What is Choline?

Choline is a quaternary ammonium cation that is naturally available in many foods and dietary supplements. The dietary supplements of choline obtain mainly with B vitamins and some vitamins and minerals products. Like other vitamins or minerals, choline is an essential nutrient that is beneficial for humans and many other animals for maintaining various biological activities.

Choline supplement with B-complex vitamin, food sources, functions, and benefits in human health

It is a water-soluble organic compound that has the chemical formula [(CH3)3NCH2CH2OH]+. When our diet is deficient in methyl-donor vitamins such as folic acid (folate) and vitamin B12 the requirement of dietary choline rises because it is the primary methyl donor in such conditions.

Choline is a component of different phospholipids such as phosphatidylcholines and sphingomyelins. As a component of phospholipids, it is involved in the formation of membrane structure and lipid transport.

Sources of Choline

Humans body can produce choline endogenously in the liver in the form of phosphatidylcholine but the amount synthesizes naturally is not sufficient to meet their daily needs. Therefore, a level of choline must be needed from various food sources to maintain various biological functions in the human body.

Choline sources in the 10 best animal and plant foods supplements with benefits and deficiency

It occurs in foods as a free molecule and in the form of phospholipids or phosphatidylcholine. Human breast milk is rich in choline which provides 120 mg per day for your baby. The choline content of breast milk may increase when a breastfeeding mother intakes more choline in her diet.

Choline Content in Foods

The main dietary sources of choline in the United States peoples are animal-based food products such as meat, poultry, fish, dairy products, and eggs. The other dietary sources of choline may include nuts, seeds, whole grains, cruciferous vegetables, and certain beans.

Animal-based foods Plant-based foods
Meats Amount (mg/100 g) Vegetables Amount (mg/100 g)
Bacon, cooked 124.89 Bean, snap 13.46
Beef, trim-cut, cooked 78.15 Broccoli 40.06
Beef liver, pan fried 418.22 Cabbage 15.45
Chicken, roasted, with skin 65.83 Carrot 8.79
Chicken, roasted, without skin 78.74 Cauliflower 39.10
Chicken liver 290.03 Cucumber 5.95
Shrimp, canned 70.60 Pea 27.51
Pork loin cooked 102.76 Spinach 22.08
Eggs & Dairy products (cow) Grains & Fruits
Egg, hen 251.00 Oat bran, raw 58.57
Butter, salted 18.77 Rice, brown 9.22
Cheese 16.50–27.21 Wheat bran 74.39
Cottage cheese 18.42 Apple 3.44
Milk, whole/skimmed 14.29–16.40 Avocado 14.18
Yogurt, plain 15.20 Banana 9.76
Sour cream 20.33 Orange 8.38

Infant formulas may or may not contain enough choline but in the EU and the US, it is mandatory to provide at least 7 mg per 100 kilocalories (kcal) of every infant formula.

Dietary recommendations

Insufficient data have been available when estimating choline by average requirement (EAR). Therefore, Food and Nutrition Board (FNB) established adequate intakes (AIs) levels. The recommended Al for adults men is 550 mg/day and for women is 425 mg/day.

The European Food Safety Authority (EFSA) and the National Academy of Medicine (NAM) recommended milligrams per day (mg/day) for EU countries and the United States. EFSA does not set any upper limits for intake but NAM set upper limits for intake.

Choline recommendations (mg/day)
Age Groups EFSA adequate intake US NAM adequate intake US NAM tolerable upper intake levels
Infants 0–6 months NA 125 NA
7–12 months 160 150 NA
Children 1–3 years 140 200 1000
4–6 years 170 250 1000
7–8 years 250 250 1000
9–10 years 250 375 1000
11–13 years 340 375 1000
Males 14 years 340 550 3000
15–18 years 400 550 3000
19+ years 400 550 3500
Females 14 years 340 400 3000
15–18 years 400 400 3000
19+ years 400 425 3500
If pregnant 480 450 3500
If breastfeeding 520 550 3500

Excess intake of Choline

A normal dose or high dose of choline may not cause any adverse effects but excessive high doses may be harmful to the human body. A high intake can cause fishy body odor, vomiting, excessive sweating and salivation, low blood pressure (hypotension), and liver toxicity.

Choline consumption has been increasing the production of TMAO, a substance that has been linked to a higher risk of cardiovascular disease in adults.

Functions of Choline

Choline is an essential nutrient that is synthesized in our body and used to maintain various biological functions. The main functions of choline are:

  • Cell structure: All plants and animals need choline to preserve the structural integrity of their cells because it helps to synthesize phosphatidylcholine and sphingomyelin. These two phospholipids are major components to maintain the structural integrity of cell membranes.
  • Fat transport and metabolism: It is an important component in lipid transport and metabolism. Therefore, it is a biological component that prevents the accumulation of fat in the liver. It promotes the synthesis of phospholipids and lipoproteins. It also helps in the disposal of triacylglycerols from the liver.
  • Nervous system: Choline is a precursor for the synthesis of acetylcholine which is required for the transmission of nerve impulses. It plays an important part in the early stage of brain development.
  • DNA synthesis: It plays important role in DNA synthesis and modulating gene expression.
  • Cell messaging: It may also be important for the formation of various biological compounds that help in cell membrane signaling.

Choline Supplements

Humans can synthesize small amounts of choline by converting the phospholipid and phosphatidylethanolamine to phosphatidylcholine via de novo synthesis. It is not enough to meet our metabolic needs. Therefore, we need to consume it from our daily foods and supplements to maintain our good health.

It is available in dietary supplements containing choline only or in combination with B vitamins, and in some vitamins and minerals products. Typical amounts in best dietary supplements range from 10 mg to 250 mg in the forms of choline bitartrate, phosphatidylcholine, and lecithin.

Benefits of Choline

It is beneficial for various biological functions of our body. The main health benefits of choline may include the following:

  • Maintain heart health
  • Brain development during pregnancy
  • Regulating brain function
  • Maintains healthy liver function
  • Formation of DNA and cell structures
  • In Cancer
  • Neural Tube Defects

Maintain Heart Health

Choline is a nutrient that may maintain your heart health. Various studies also suggest that it may increase the risk of cardiovascular disease (CVD).

  • Homocysteine is an amino acid that enters our body from various protein sources. Choline along with B vitamin folate can lower homocysteine levels in your blood by converting it to methionine. High homocysteine levels are a risk factor for high blood pressure and stroke. Therefore, it may reduce your blood pressure and decreases the risk of stroke.
  • It may also negatively impact your heart. Choline is converted in our body by gut bacteria into a byproduct called trimethylamine (TMA). It is then converted in your liver to trimethylamine-N-oxide (TMAO) which is a risk factor for cardiovascular disease (CVD).

Regulating Brain Function

It is an essential precursor for the synthesis of the neurotransmitter acetylcholine. Acetylcholine is an important neurotransmitter needed for the synthesis of the two most abundant phospholipids (phosphatidylcholine and sphingomyelin) in the brain.

These neurotransmitters may help nerve cells to communicate with each other. Therefore, acetylcholine is important for regulating memory and mood. Some studies have shown that higher choline intake may improve learning and understanding during adulthood and childhood age.

Some studies suggest that low levels of acetylcholine may cause cognitive decline and memory loss including Alzheimer’s disease and senile dementia.

Brain Development During Pregnancy

Choline is not only obtained from our daily diet but also from de novo synthesis. It is an important nutrient for fetal brain development because it influences stem cell proliferation and apoptosis.

During pregnancy, it can influence neural tube closure and lifelong memory and learning functions. A lower intake of this nutrient during pregnancy may raise the risk of neural tube defects in unborn babies. Therefore, pregnant women need more choline to help their babies grow and mental development.

Maintains Healthy Liver Function

Choline is an important factor that is used to transport fat properly from the liver to our body cells. Therefore, it is beneficial for cleaning harmful fats from our liver.

It plays a part in transporting cholesterol and triglycerides from the liver to other parts of our body where they are needed. Some studies suggest that low levels of choline may increase the risk of liver damage or even liver failure.

Formation of DNA and Cell Structures

Choline is an essential nutrient that is involved in the synthesis of phospholipids and other structural components of cell membranes to maintain good health. Therefore, we need sufficient amounts of chlorine in our daily diet to preserve the structural integrity of our cells.

It is also involved in a critical step for making DNA that is needed to maintain healthy cells and organ systems of our body.

Choline in Cancer

Disruption of DNA methylation and impaired DNA repair in one-carbon metabolism are thought to be the main cause of carcinogenesis. It may happen due to a deficiency of methyl donors such as folate, choline, betaine, and methionine. Therefore, dietary choline may reduce the risk of some types of cancers.

The deficiency can cause fatty liver disease which increases the risk of cancer. Some studies suggest that higher intakes of choline and betaine may reduce the risk of lung cancer.

Neural Tube Defects

A deficiency may increase the risk of neural tube defects because a higher maternal intake of choline can cause better neurocognition/neurodevelopment in children. A study published in the American Journal of Epidemiology suggests that a high intake of choline and betaine may reduce the risk of neural tube defects (NTD).

Choline and folate can be interacting with vitamin B12 and act as methyl donors to homocysteine to form methionine. It can then form SAM (S-adenosylmethionine), a substrate that almost controls all methylation reactions in mammals. A study suggested that disturbed methylation via SAM could be responsible for neural tube defects (NTD).

Choline Deficiency

The deficiency in healthy and nonpregnant individuals is very rare because some parts of this nutrient can be synthesized endogenously in healthy humans. In most cases, choline deficiency may be observed due to certain genetic disorders and pregnancy.

The deficiency can cause various health problems such as muscle damage, liver damage, and nonalcoholic fatty liver disease (NAFLD or hepatosteatosis). Recent reports suggest that the metabolism of this nutrient may also play a role to prevent diabetes, cancer, and cystic fibrosis.

Symptoms and Signs

There is no definitive clinical test that can be used to identify persons who are choline deficient but it can be identified by deficiency symptoms and signs. The most common sign and symptoms may include:

  • fatty liver disease (FLD)
  • low energy levels or fatigue
  • cognitive decline
  • memory loss and Alzheimer’s disease
  • learning disabilities
  • mood changes or disorders
  • nerve damage
  • muscle aches

Simple, rapid, and sensitive ultra-high-performance liquid chromatography–ultraviolet-mass spectrometry (UHPLC-UV-MS) and gas chromatography/isotope dilution mass spectrometry (GC/IDMS) methods are developed for the quantitative determination of choline in liver, plasma, various foods, and brain.

The liquid chromatography/electrospray ionization-isotope dilution mass spectrometry (LC/ESI-IDMS) method is also used for the quantitation of choline, betaine, acetylcholine, glycerophosphocholine, cytidine diphosphocholine, phosphocholine, phosphatidylcholine, and sphingomyelin in the liver, plasma, various foods, and brain.