Choline was officially acknowledged as a necessary nutrient by the Institute of Medicine in 1998 (FNBIOM, 1998). The Food and Nutrition Board, of the Institute of Medicine, considers choline to be an important nutrient (i.e., a nutrient that must be acquired from the diet). It is found in a wide variety of foods, although animal products are the wealthiest sources.
Choline is a micronutrient that is essential for proper functioning of the liver, normal brain development, the functioning of nerves, movement of muscles, enhancement of energy levels and sustaining a healthy metabolism. Choline is present in the form of phosphatidylcholine, a compound that forms the structural component of fat and thus can be found in different varieties of foods that contain certain fats. Choline plays a role in many significant processes within the body that takes place every single day.
Choline is a water-soluble nutritious element that has relation with other vitamins, such as folate and the ones in the B vitamin complex family. Just like B vitamins, choline plays a similar role in terms of supporting energy and brain function, as well as keeping the metabolism active.
There is another compound, betaine which is involved in the choline story. The body has the capacity to turn choline into betaine, and betaine is also found in a range of foods. Obtaining plenty of betaine in your diet can to some extent bring down the requirement for choline.
Choline has a number of functions:
- Choline is used for the conglomeration of phosphatidylcholine, the major phospholipid in cell membranes (Hollenbeck, 2010).
- Along with betaine, choline does its activity as a methyl donor. Like many other elements including folate, vitamin B12, and s-adenosylmethionine (SAMe), methyl donors are responsible for keeping homocysteine levels low, among many other activities.
- Choline is essential to synthesize low-density lipoproteins (LDL).
- Choline is important to synthesize the neurotransmitter, acetylcholine.
Figure 1: Metabolic pathway of Choline
The importance for choline was realized when some people were found to have fatty livers. The fatty livers rectified upon adding choline to the feeding procedure (Buchman, 1995). The fatty livers were caused by a buildup of triglycerides as a result of the liver’s incapacity to synthesize and release very-low-density lipoprotein (VLDL) particles because of a declined synthesis of phosphatidylcholine (Hollenbeck, 2010).
Daily recommended amount of Choline
Our bodies have the capacity to generate small concentrations of choline on their own in the body. Rest of the required amount is obtained from various food sources. Choline is found in foods including eggs, liver, beef, salmon, cauliflower, Brussel sprouts and breast milk. In fact, eggs are often named as “brain food” because they are considered to have highest concentrations of choline (Holmes, 1996)
Choline was actually only added to the Nation Academy of Science’s (NAS) essential nutrients list in 1998, making it one of the latest additions of all nutrients. There is now proof that current choline recommendations may be suboptimal for a large percentage of the population. Women appear to rely upon an amalgam of dietary choline absorption and high concentrations of endogenous estrogen-induced biosynthesis of choline to be able to carry a normal pregnancy (Zeisel, 2006).
Zeisel (2006) reported that the amounts listed below are sufficient for producing optimal benefits without causing any damage:
- Infants and babies: 125 – 150 mg
- Children ages 1-8: 150 – 250 mg
- Teens ages 8-13: 250 – 375 mg
- Women above age 14: 425 – 550 mg
- Men above age 14: 550 mg
- Pregnant women: 450 -550 mg
- Women who are breastfeeding: 550 mg
Signs and Symptoms of Choline Deficiency
There is some proof that there are people who don’t get enough choline in their diets, even after eating choline-rich foods, because some choline is not ingested. So it has been found that there are certain factors which make choline sometimes hard to absorb even when they eat choline-rich foods and studies have shown that an average person does not have amounts of choline present within their body that meet the daily recommendation (Zeisel, 2009).The reason for this is that different people have different genetic makeup that creates an increased need for choline For example, as per the researchers, 50% of the population possess genes that increase dietary methyl needs, and since choline is a rich source of methyl processes, this can result in choline deficiency.
The debate on as to how much choline should be recommended to the public is still going on among the researchers and there has not been any agreement as the topic continues to remain difficult as there is a wide range of requirements for choline, with some of the population requiring much more than others. Therefore it’s hard to agree on an average amount.
Symptoms of choline deficiency may possibly include:
- Low energy levels or fatigue
- Loss of memory
- Decline in cognitive ability
- Learning disabilities
- Muscle aches
- Damage to the nerves
- Mood swings and changes in behavior
People having a condition called “fatty liver” have a higher risk of choline deficiency and facing negative symptoms. Fatty liver, also known as fatty liver disease (FLD), is actually a reversible condition where triglyceride fat builds up in liver cells. It mostly develops in people who consume excessive alcohol, are suffering obesity, diabetes and have some other diseases that influence fat metabolism.
A choline deficiency also leads to cognitive decline, memory loss and Alzheimer’s disease. This is because choline plays a role in neurotransmitter maintenance and, as someone grows old, nerve signaling may decrease and signs of dementia become visible (Zeisel, 2009).Eating a variety of foods rich in choline is the best way to get rid of its deficiency. Choline is mostly present in animal products, so vegetarians and vegans are at higher risk of experiencing a choline deficiency.
One more element called folate has a part in the body’s tendency to make and use choline — as the two nutrients share a strong relationship and depend on one another to do their activities. According to a recent research, the quantity of folate you take may dictate as to how much choline the body makes and requires from food sources, so if someone obtains more folate from leafy green vegetables and certain grains will require fewer levels of choline from food (Wood, 2001).
Top 9 Health Benefits of Choline
Builds DNA and Cell structures
Choline helps the body to absorb fats, which create cell membranes and structures. In the absence of adequate choline in our bodies, our cells cannot function properly and signal messages to other parts of the body (Secades and Frontera, 1995). Choline is also required to create DNA that is responsible for constructing out entire body structure. Choline and folate are notable for being key nutrients associated with the methyl group processes, which the body utilizes to create genetic matter that helps build every system inside the body.
Supports Central Nervous System
Choline is crucial for nerve functioning, nerve signaling and maintaining the membranes of brain cells.Choline also helps in the formation of a tissue in the nervous system that has a role in brain development and growth. Choline improves signaling tendencies of nerves, support their structural integrity, and shields vital neuronal membranes (Poly et al, 2011). Choline acts like a forerunner to certain important neurotransmitters, including acetylcholine, which is used in healthy nerve and muscle function. Neurotransmitters are chemical symptoms of communication used throughout the body continuously to relay information from system to system and play an important role in memory and learning (Zeisel, 1994).
Maintains healthy liver function
Choline is essential to properly transport fat from the liver to cells in the entire body. Choline cleanses the liver by keeping the liver clear from fat build-up that can build up and cause damage. Choline transports both cholesterol and triglycerides, two forms of essential fats, from the liver to other parts of the body where they are required.
In people who have low concentrations of choline present within their body, they are more at risk of liver damage and even liver failure. Choline also prevents LDL cholesterol within the liver (Zeisel, 1992).
Helps protect memory and loss of brain function
Choline helps to keep the brain sharp because it’s an element of cell membranes and neurotransmitters that are used in nerve signaling. Choline also plays a role in safeguarding memory and preventing dementia, memory loss and other signs of cognitive decline as we grow older.
Choline helps in retaining brain elasticity by maintaining levels of acetylcholine, which naturally reduces into old age. Some research has proved that low levels of acetylcholine may lead to cognitive decline, including Alzheimer’s disease and senile dementia. Patients who develop Alzheimer’s at times show reduced levels of acetylcholine, and some medications used to treat Alzheimer’s actually mimic choline’s effect of expanding this neurotransmitter’s effects (Wood. 1992).
Helps to improve physical activity and muscle function
Choline improves mental energy, focus and concentration, which are all important for physical tasks and athletic performance (Zeisel, 2000).
Choline is also helpful in maintaining energy levels, your mood, sleep cycles and recovery time following exhaustive activity. Additionally, choline facilitates muscle nerve functioning and helps in combating fatigue and muscle pains following any physical exercise. Every time a muscle moves within the body, choline is required to trigger the neurotransmitter acetylcholine, which passes chemical signals to muscles and makes them mobile.
Maintain heart health
Choline and folate foster conversion of homocysteine, which averts the body from accumulating too much fat and may be useful in declining down on the risk of having a heart attack (da Costa, 2005). Homocysteine is an amino acid that finds its way in the body from protein sources, normally meat, and high levels of homocysteine have been correlated with the development of heart and blood vessel diseases. Choline and lecithin can help to bring down blood cholesterol and risk for heart disease. Still, more research is needed before doctors will begin to prescribe choline for its tendency to lower LDL (“bad”) cholesterol and triglycerides (da Costa, 2005)
Supports a healthy pregnancy
Pregnant women are in need of more choline than anyone else because choline is utilized in huge amounts by fetuses while their brains, cell structures and nerve channels are taking shape. Choline ensures sharp brain functioning and a lower risk of brain deformities (Llcol, 2002). Other studies show that pregnant women with low levels of choline are at higher risk for having children with neural tube defects and developmental issues.
Choline is also naturally found in breast milk since it’s important for a newborn’s growth and proper development. This is the reason it’s added to most infant formulas. Neuron synapses are being formed in the brain of fetuses and infants at a very rapid rate, so choline plays a major part in helping to build the foundation of the brain’s structure (Zeisel, 2004).
Choline is also important during pregnancy because of its relationship with folate. Choline, folate and B vitamins all work together to keep levels of one another in check. Choline is one of the methyl donors in the body — which means that when folate, a vital nutrient needed for fetal development, is low, that choline is able to help fill in and carry out body functions where folate is needed but is missing.
Essential for children’s growth and development
Neuron plasticity refers to the brain’s ability to build new neuron connections, and choline is thought to be very important for supporting brain elasticity and plasticity (Poly et al, 2011).
As children grow older, choline is needed to help develop brain function since it plays a role in learning, remembering, concentration abilities and logical thinking. Children need to acquire choline to form neurotransmitters channels in their brain that will help with information retention, verbal abilities, creative thinking, mathematical skills, social cues, and more (Zeisel, 2000).
In fact, choline is important for forming new brain connections between neurons called synapses, which is the chemical reaction required for memories to form in the brain. Some reports even show that choline can help avert learning disorders, including ADHD (Attention-deficit/hyperactivity disorder, and can improve concentration in children and teens.
Lowers the risk of breast cancer
One of the most amazing things about choline is its benefit for reducing the risk of breast cancer. A new study of more than 3,000 adult women found a 24 percent lowered risk of developing breast cancer in women with the highest consumption of choline compared to women with the lowest intake. Women in the group with the highest choline intake averaged 455 mg a day or more, which mostly came from eggs and skim milk. Women with the lowest intake gobbled a daily average of only 196 mg. The study, from the University of North Carolina, was aided by a grant from the National Institutes of Health (NIH) (Zeisel, 2010).
Best natural sources of choline (food)
Below is the table showing selected food sources of choline (milligrams per serving)
Source: USDA Database for the Choline Content of Common Foods, Release Two, January 2008; USDA National Nutrient Database for Standard Reference, Release 20.
Chiuve et al (2007) in his study reported that some experts suggest getting even higher levels of choline in order to augment brain function and to perpetuate memory. Some reports have shown that people having damaged liver suffer from choline deficiency as choline is processed partially in the liver. If you decide to take choline supplements, it’s best to purchase one that is made from whole food sources and is of very high quality. There are several options available for different types of choline supplements. This has to do with how your body converts choline into the molecule acetylcholine, which plays a role for many of choline’s health benefits. Different types of choline also differ in their ability to cross the blood-brain obstacle once swallowed.
Soy lecithin is commonly utilized as a food additive that contains choline. Lecithin can also be taken as a supplement. However, lecithin contains only 10–20% phosphatidylcholine.Phosphatidylcholine can be taken as a pill or a powder supplement, yet choline consists of only about 13% of the weight of phosphatidylcholine.
Experts recommend CDP-choline also called as Citicoline, or Alpha GPC choline as the common and best choline used by the body and these are potent types of choline being very beneficial for the body because these mimic choline actions found naturally in food sources
Side effects and concerns of choline
Choline is a safe and essential nutrient but can cause toxicity and some harmful effects if taken in excess.
One of the common side effects of excessive choline is a fishy odor. The bad body odor is triggered by the excessive secretion of trimethylamine, a metabolic by-product of choline. The good part is that this can be resolved and reversed easily by reducing the amount of choline taken or by stopping its use, which will quickly rectify this side effect.
Individuals who are allergic to choline or lecithin should simply avoid consuming choline. An allergic reaction is considered to be a serious medical condition and symptoms include a rash or hives causing itching and swelling on tongue, facial areas and even throat, along with heaviness in the chest and breathlessness. People who have any of these symptoms should stop taking choline.
Excessive amounts of choline can result in diarrhea, high blood pressure, sweating, fatigue and nausea. So it’s always advisable to read about the recommended intake of any choline supplement you take. One should consult a doctor first about doing otherwise.
Other Side Effects
Other side effects due to excessive intake of choline include high body temperature, increased sweating as well as reduced salivation. Some symptoms also include loss of appetite. Reducing the amount of choline taken or stopping its use will also rectify these side effects. Excessive intake of choline may also result in dizziness, hypertension and abnormal electrocardiogram.
Natural Ways and Ideas to add more Choline into Your Diet
Choline is found naturally in a variety of food items and consuming these items on daily basis will help to balance choline levels essential for our body (Jensen, 2007).
One yolk of an egg consists of about 115 mg of choline. In some ancient cultures, women used to eat 5-7 egg yolks daily during pregnancy. Pastured eggs should be consumed whenever possible, as they have a superior nutrient account. The egg yolk can be added as extras into scrambled eggs, in homemade ice-creams or custard, and even in smoothies.
Raw liver is rich in choline content and 5oz of raw liver has 423 mg of choline. Liver has to be grass-fed and should be from a trusted source. Liver can be had with pate or sautéed with some onions and some butter. Some people can consume desiccated liver in the form of some capsules or even powder.
Grass fed raw dairy
Other rich sources of choline in daily consumable foods include 8oz of fresh milk, fresh yogurt, and some kefir that have about 40 mg choline. Raw dairy products are richer in choline since they are not subjected to pasteurization, which helps in keeping the fragile nutrients undefiled.
Soaked nuts and legumes
Garbanzo beans, lentils and some Legumes are rich in choline having about 70 mgs of choline per cup. Some other sources include sunflower and pumpkin seeds and also some almonds which contain about 60 mgs of choline per cup. Nuts and legumes need to be eaten moderately, though.
Cruciferous veggies including cooked bok choy, broccoli, cauliflower and cabbage consist of about 65 mg of choline per cup.The best way to consume these veggies is to steam them and add lot of butter or grass fed ghee to facilitate nutrient absorption.
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