Choline, which is water soluble, plays a key role in the basic cellular functioning of the body. It is essential for liver function, normal brain development, nerve function, and muscle movement. It supports energy levels and helps maintain a healthy metabolism. Choline is a key nutrient in the production of phosphatidylcholine, an important structural building block of living cells, and it is an essential part of the process of methylation, which is needed to create DNA. Choline is also a crucial component of the neurotransmitter acetylcholine. Without acetylcholine, muscles cannot contract—the heart is unable to beat and the gastrointestinal track is unable to move along the food that has been consumed.
Choline is an essential component of the phospholipids found in cell membranes throughout the body. Choline is widely distributed in foods and can also be synthesized in limited amounts in the liver. However, this synthetic pathway alone cannot meet the body’s needs, especially during times of increased physiologic stress. Diets low in choline may result in low body stores of choline and liver dysfunction, thus ample dietary intake is important.
The National Academy of Sciences added choline to the list of required nutrients in 1998. While it is relatively new to the list of human vitamins, choline is considered to be a nutrient that should be part of everyone’s everyday diet. Although it was previously thought that the body could make its own choline, that is no longer believed to be true. Researchers now advise people that choline should be obtained from an outside source, such as the diet or a supplement.
Food Sources of Choline
Choline is found in food additives such as soy lecithin, a widely used emulsifying agent that helps to keep oil and water-soluble ingredients from separating in packaged foods. Choline is sold in tablets and capsules by itself or, most often, with inositol, also known as vitamin B8. It may also be found in multivitamins.
|Food name||Weight (g)||Choline (mg)||DV%|
Recommended Intake for Choline
In 1998, the Food and Nutrition Board of the U.S. Institute of Medicine established adequate intake levels for choline. Lactating women and males who are 14 years old or older should take in 550 mg per day, while pregnant women should take in 450 mg per day. Females who are 19 years or older should take in 425 mg per day, while females who are between 14 and 18 years should take in 400 mg per day. Children between the ages of 9 and 13 years should take in 375 mg per day, while children between the ages of 4 and 8 years should take in 250 mg per day. Children between the ages of one and three years should take in 200 mg per day; infants between the ages of 6 and 12 months should take in 150 mg per day; and infants up to the age of six months should take in 125 mg per day. It also established a tolerable upper intake level of 3.5 g per day for most adults.
Health Benefits of Choline
Above we have discussed about choline, here we will know its health benefits in detail:
- Healthy pregnancy
In a randomized, placebo-controlled clinical trial published in 2013 in the American Journal of Psychiatry, researchers based in Colorado tested the ability of a dietary supplement known as phosphatidylcholine, which converts into choline in the body, to help prevent a child’s future development of schizophrenia. While schizophrenia does not generally manifest symptoms until late adolescence or adulthood, it is believed to be caused by a combination of genes and the environment that are present during pregnancy. The researchers initially recruited 100 healthy pregnant women; at the beginning of their second trimester, they were placed on either the supplement or a placebo. Every day, the pregnant women on the supplement took the equivalent of the amount of choline in three large eggs. After delivery, the infants of the mothers on choline were placed on choline supplementation for 12 weeks. Neither the mothers nor the infants experienced any side effects from the choline. Although seven women dropped out of the study, the remaining 93 women had notable results. Testing administered after the infants were born found that the infants of the mothers on choline were far less likely to have physiologic factors associated with the future development of schizophrenia, such as responses to a pair of clicking sounds and the presence of a specific genotype. The researchers recommended the longer-term follow-up of the children who received the supplement.
- Sharpens memory
In a study published in 2011 in the American Journal of Clinical Nutrition, researchers based in Boston examined the association between dietary intake of choline and memory. The dementia-free cohort included 1,391 subjects between the ages of 36 and 83 years from the Framingham Offspring population. Between 1991 and 1995, the subjects completed food frequency questionnaires, and between 1998 and 2001, they had neuropsychological evaluations and brain MRIs. The researchers found that the men and women in the top quarter of choline intake performed better on the memory tests than those on the bottom quarter. And people who had lower intakes of choline were more likely to be on a pathway toward mental decline than their counterparts with higher intakes. Moreover, the subjects with higher choline intake at the outset of the trial were less likely to show areas of “white-matter hyperintensity” in their MRI scans. These areas are believed to be an indication of blood vessel disease, which may signal a heightened risk of stroke or dementia. The researchers concluded that “in this community-based population of non-demented individuals, higher concurrent choline intake was related to better cognitive performance.”
- Lowers the chances of Breast cancer
In a case-control study published in 2013 in the journal Cancer Science, researchers based in China investigated the association between intake of choline and risk of breast cancer among Chinese women. The cohort consisted of 807 women with confirmed breast cancer and 807 matched controls. To improve the statistical power of the study, the researchers recruited a second set of cases and controls. This time there were 369 cases and 369 controls. Dietary assessments were made with face-to-face interviews and validated food frequency questionnaires. The main sources of choline were eggs, chicken, and while milk. The researchers learned that the intake of total choline was inversely related to breast cancer in a dose-response manner. Thus, higher intakes of choline were associated with lower risks for breast cancer. “The mean dietary choline intake in the control group of the present study was 173 mg/day, which shows the potential deficiency of choline in the current study population.”
In a study published in 2008 in FASEB Journal, researchers from New York City and Chapel Hill, North Carolina, wanted to examine the association between intake of choline and incidence of breast cancer. The cohort consisted of a population-based study, the Long Island Breast Cancer Study Project, of 1,508 cases and 1,556 controls. The participants ranged in age from 20 to 98 years. The researchers found an association between the highest intake of choline consumption and a reduced risk of breast cancer. By eating high amounts of dietary choline, women reduced their risk of breast cancer by 24 percent. According to the researchers, “Choline metabolism may play an important role in breast cancer etiology.”
- Lower the risk of Nonalcoholic Fatty Liver Disease
In a study published in 2014 in The Journal of Nutrition, researchers from Nashville, Tennessee, and China wanted to determine if there was an association between dietary intake of choline and nonalcoholic fatty liver disease in the general population. Nonalcoholic fatty liver disease is associated with several medical problems, including insulin resistance, dyslipidemia, cardiovascular disease, some cancers, and liver-related morbidity and mortality. The cohort consisted of 56,195 Chinese men and women between the ages of 40 and 75 years, who drank no alcohol or negligible amounts of alcohol. All of the participants completed food frequency questionnaires and had at least one liver ultrasound examination. Their primary sources of dietary choline were eggs, soy foods, red meat, fish and shellfish, and vegetables. The researchers learned that choline intake was inversely associated with fatty liver in middle-aged and older normal weight women. This association did not exist for overweight or obese women.
- Prevent onset of Pancreatic cancer
In a study published in 2016 in the journal Cancer Epidemiology, Biomarkers & Prevention, researchers from Pittsburgh, Pennsylvania, and Singapore examined the association between the intake of several nutrients, including choline, and the risk of pancreatic cancer “among the most deadly malignancies in the world.” The cohort initially consisted of 63,257 men and women, between the ages of 45 and 74 years, enrolled in the Singapore Chinese Health Study. All the participants were residents of Singapore. Nutrient assessments were made using a food frequency questionnaire. During an average follow-up of 16.3 years, there were 271 incident cases of pancreatic cancer. The mean age at cancer diagnosis was 72 years for males and 71.6 years for females. In the final analysis, which included 60,298 subjects, the researchers found that higher intakes of choline were associated with statistically significant decreases in the risk of developing pancreatic cancer. This association was more apparent in men than in women.
- Cell membrane structure
Choline is a precursor for several phospholipids. Phosphatidylcholine (also known as lecithin) accounts for about half of the phospholipids in cell membranes. Phospholipids contribute to the flexibility of cell membranes and allow for the presence of both water- and fat soluble compounds in cell membranes. With its role in cell membrane structure, choline is important for the health of every cell and particularly for the health of brain tissue, where it is present in high levels.
- Nerve functions and Brain development
Choline is part of acetylcholine, a neurotransmitter associated with attention, learning, memory, muscle control, and many other functions. Sphingomyelin, a choline-containing phospholipid, is part of the myelin sheath that insulates nerve cells. As already mentioned, brain tissue is particularly high in choline. During pregnancy, the concentration of choline in amniotic fluid is high, supplying choline to the developing brain of the fetus. Animal studies demonstrate that choline deficiencies during pregnancy lead to poor brain development, learning ability, and memory. The AI for choline is increased during pregnancy and breastfeeding to assist in proper brain development.
- Liver function
As part of phospholipids, choline is a component of lipoproteins, which carry lipids through the blood. Choline deficiencies in animals and humans lead to decreased production of lipid transport proteins, such as very low density lipoproteins (VLDL). The inability of the liver to export fat to the rest of the body leads to the buildup of fat in the liver. A small amount of fat in the liver is normal, but excess fat leads to scarring of the liver tissue and eventual dysfunction. Fatty liver is a common cause of cirrhosis.
The roles of choline in lipid transport and homocysteine metabolism have implicated the nutrient in the prevention of cardiovascular disease. However, research has also raised some concerns about possible negative effects of choline on cardiovascular disease risk. Recent findings have shown that metabolism of dietary phosphatidylcholine, from foods such as eggs, by the intestinal microbiota produces an atherosclerosis-promoting compound that has been associated with an increased risk of major adverse cardiovascular events.
- Improve Glaucoma symptoms
Glaucoma is a disease which is caused by pressure behind optic nerve which could result in blindness. Study has shown that with CDP choline, it significantly improved symptoms of Glaucoma. It suggest that choline treatment complement to other treatments for Glaucoma.
- Prevent lipid metabolism in intestines
Phosphatidylcholine is required for lipid metabolism with intestines. Choline is must for forming phosphatidylcholine, low level of choline could limit production. Study conducted in lactating rats showed that low level of choline result to high level of unmetabolized lipids in intestines. It is resulted that low level of choline results in low absorptive intestinal surface area.
What happens with deficiency or excess presence of Choline in the body?
While most people probably consume adequate amounts of choline in their diets, it may not be properly absorbed. And some people simply have higher requirements for choline. Symptoms of choline deficiency include nerve damage, learning problems, memory loss, cognitive decline, low energy levels, and mood changes. People with a condition known as “fatty liver,” in which triglyceride fat accumulates in the cells of the liver, are at increased risk of choline deficiency. People who drink excessive amounts of alcohol and those who are obese or have types 2 diabetes are also at increased risk for choline deficiency. Some believe that choline deficiency may play a role in age-related cognitive decline, including Alzheimer’s disease.
Excessive amounts of choline supplementation may be toxic. Symptoms of choline toxicity include changes in blood pressure, diarrhea, nausea, fatigue, excessive sweating, and a fishy odor of the skin.
What are the increasing chances of deficiency?
- Regular alcohol intake increases turnover of choline in the liver and can lead to depletion of body stores.
- A low dietary intake of folate sharply increases choline requirements. Risk of choline deficiency is increased in conditions of impaired folate status, including use of many common drugs (antibiotics, aspirin, oral contraceptive pills), chronic illnesses (liver disease, alcoholism, anemia), and vitamin B12 deficiency.
- Pancreatic or intestinal disorders cause poor absorption of dietary choline and may lead to deficiency.
- AIDS increases risk of choline deficiency.