Choline

Choline Supplement Benefits

Choline is a quaternary ammonium cation that is naturally available in many foods and dietary supplements. The benefits of a dietary choline supplement are similar to those of B vitamins and some vitamins and minerals products. Like other vitamins or minerals, choline is an essential nutrient that is beneficial for our good heart health, brain functions during pregnancy, and neural tube defects. 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.

Various food sources may increses choline levels in our body while a deficiency may cause many health problems. The main dietary sources of choline in people are animal-based food products such as meat, poultry, fish, dairy products, eggs, etc.

Choline is a water-soluble organic compound that has the chemical formula [(CH₃)₃NCH₂CH₂OH]⁺. It is a component of different phospholipids such as phosphatidylcholines and sphingomyelins. As a component of phospholipids, it is generally involved in the formation of membrane structure and lipid transport.

Sources of Choline

The human body produces phosphatidylcholine endogenously in the liver. However, the amount that is synthesized naturally is not sufficient to meet their daily needs. Therefore, a certain level of choline must also be needed from various food sources to maintain various biological functions in the human body.

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. However, the choline content of breast milk may increase when a breastfeeding mother takes a choline supplement 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 the average requirement (EAR). Therefore, the Food and Nutrition Board (FNB) established adequate intake (AI) levels. The recommended Al for adult men is 550 mg/day while for women it is 425 mg/day.

However, 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 sets 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 generally does not cause any adverse effects in the human body. However, excessively high doses may be harmful to our bodies. Therefore, a high intake causes fishy body odor, vomiting, excessive sweating and salivation, low blood pressure (hypotension), and liver toxicity.

Choline consumption has been increasing the production of a substance (TMAO) 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. It helps to make the membrane structure that surrounds the cells of our body. It also helps in fat transport and metabolism, DNA synthesis, and cell messaging in our body.

Structural Integrity of Cells

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 in maintaining the structural integrity of cell membranes.

Fat transport and metabolism

Choline 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 also plays an important role in the early stage of brain development.

Choline can control our brain and nervous system by regulating memory, mood, muscle, and other functions in the body

DNA synthesis

Choline plays an important role in DNA synthesis. It may also modulate gene expression in the human body.

Cell Signaling

This biomolecule may also be important for the formation of various biological compounds that help in cell membrane signaling.

Choline Supplement

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

For the best benefits, we need to take a dietary supplement containing choline only or also in combination with B vitamins, and in some vitamins and minerals products. The best dietary supplements containing a range from 10 mg to 250 mg are choline bitartrate, phosphatidylcholine, and lecithin.

Benefits of Choline

Choline is beneficial for various biological functions of the body. The main health benefits of this nutrient, obtained from foods or taking a supplement, 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. However, various studies suggest that it may increase the risk of cardiovascular disease (CVD).

Homocysteine is an amino acid that enters our body from various protein sources. Along with B vitamins, 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 decrease the risk of stroke.

Choline may also negatively impact your heart. It is generally converted in our body by gut bacteria into a byproduct called trimethylamine (TMA). TMA is also 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 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 from foods or from a supplement may be beneficial for learning and understanding during adulthood and childhood.

Some studies also 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 influences neural tube closure and lifelong memory and learning functions. A lower intake of this nutrient during pregnancy raises 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 generally to transport fat from the liver to our body cells. Therefore, it is beneficial for cleaning harmful fats from our liver.

It also plays an important role 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 generally 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 such biomolecules in our daily diet to preserve the structural integrity of our cells.

It is also involved in a critical step for making DNA that generally 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 thought to be the main causes of carcinogenesis. It happens 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 cancer.

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 reduces the risk of neural tube defects (NTD).

Choline and folate interact with vitamin B₁₂ and act as methyl donors to homocysteine to form methionine. It can then form SAM (S-adenosylmethionine), a substrate that generally 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 causes 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 also plays a role in preventing 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 signs 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 developed generally 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 also uses for the quantitation of choline, betaine, acetylcholine, glycerophosphocholine, cytidine diphosphocholine, phosphocholine, phosphatidylcholine, and sphingomyelin in the liver, plasma, various foods, and brain.

Choline Supplement During Pregnancy

Yes, a choline supplement is safe during pregnancy because it is beneficial for maternal and fetal health. During pregnancy, the demand for it significantly increases because it is required for neural tube formation, brain development, and the synthesis of lipoproteins in your baby.

Getting enough choline during pregnancy can help your baby’s brain and spinal cord development. For the best benefits, always consult a doctor or healthcare provider before taking a choline supplement because they can adjust the dosage that is safe for you.