It’s been my experience that essentially no one has heard of choline unlike, say beta-carotene or thiamin (vitamin B1).
Choline however is very unappreciated. While not strictly a vitamin, it is absolutely essential for health. Although humans can make it in small amounts, choline must be consumed in the diet, in relatively large amounts, to maintain optimal health.
Choline. An Essential Nutrient for Public Health
Always a bridesmaid…
Poor choline. It’s true potential has yet to be appreciated. Always there to support it’s vitamin cousins, the B complex family, choline is pushed to the wings waiting for its turn in the nutritional/health spotlight. Choline is no slouch, it is crucial in so many ways and like all vitamins and minerals, choline wears many hats when it comes to its role in human health.
Choline’s many roles
Most of the body’s choline is found in specialized fat molecules called phospholipids with phosphatidylcholine [a mouthful I know], or lecithin, being the most common form. This gets a little technical but bear with me…
Neuronal function & cognition
Choline is a building block for acetylcholine, a very important neurotransmitter. Neurotransmitters are like the body’s chemical couriers carrying messages from one part of the body to another for its own communication needs. Acetylcholine is essential for muscle control, learning and consolidating memories – you’re using it right now!
Choline plays a critical role in brain health including ‘anti-aging’ benefits (1, 2, 3 & 4)
Lipid (fat) transport and metabolism
We get fat & cholesterol from two sources: our diet and some that’s made by the body; both are needed for the repair and maintenance of good health. These lipids need to move freely throughout the body and tissues.
Fat from your food is transported to the liver and fat and cholesterol that is made in the liver needs to be moved to other parts of your body. Without adequate amounts of phosphatidylcholine, [with choline as one of the building blocks] fat and cholesterol will accumulate in the liver which is why choline helps to prevent a fatty liver.
Choline Metabolism Provides Novel Insights into Non-alcoholic Fatty Liver Disease and its Prevention
Major source of methyl groups
Choline is metabolized to form a compound called betaine; a source of something called methyl (CH3) groups that are required for methylation reactions or the methyl cycle. Methylation does it all.
It is involved in reproduction ensuring DNA is copied properly, it is needed for efficient detoxification in the liver, it reduces homocysteine, a compound when elevated increases the risk for cardiovascular disease. Choline, via methylation, helps to reduce the risk of dementia cancer, converts folate, B12, and more into their active forms…the list goes on.
What may surprise most people is that approximately 66% of the population have gene mutations (MTHFR) that reduce their ability for effective methylation because they don’t convert dietary folate into its active form, 5-MTHF which impedes choline metabolism in part. MTHFR mutations are easily determined with My Blueprint by AOR, a simple genetic test using a saliva sample.
Choline is especially critical for healthy embryonic and fetal brain development during pregnancy. Studies have shown that women with the lowest blood levels of choline during mid-pregnancy are at an increased risk, 2.4 x greater risk, for neural tube defects. Choline works with folate (not to be confused with synthetic folic acid, they are not the same thing), B12 and B6 for healthy cognitive development.
A little fun for the science & nutrition peeps & nerds
How much choline do we need?
The Food and Nutrition Board (FNB) of the Institute of Medicine (IOM) established a recommended requirement for all ages.
Because choline is still the new kid on the block when it comes to establishing actual amounts needed for optimal health, the IOM established something called the Adequate Intake or AI, an amount assumed to be enough for healthy individuals. It doesn’t take into account possible needs for those with illnesses or genetic differences who may need more.
How much do we get?
Sadly not enough, in part because some of the most choline-rich foods have been demonized over the past few decades as being unhealthy and many of us were scared off of them for fear of developing heart disease – a sad and slow-to-die misconception.
Research has found that fewer than 10% of older children (9 and older), adult men, women, and pregnant women meet the recommended AI for choline. Some estimates put the number close to only 50 – 60% of the AI or about 275 to 330 mg per day for men [AI is 550 mg/day] and 213 to 255 mg for women [AI is 425 mg/day].
Food sources of choline
As you can see from the table below, it wouldn’t take much to fill the gap when it comes to getting more choline in your diet. Curiously though, those foods richest in choline aren’t promoted or leveraged like they could be for their choline content; making choline forever a bridesmaid.
It’s likely because choline is new to the nutritional conversation with distractions of kale, quinoa, goji berries or another superfood fad of the month stealing the spotlight. Will choline ever get the PR campaign it needs? With the smallest of effort, eating more choline is easy. Traditional foods like liver, eggs, fish, and seafood are the best sources.
Vegetarians are at greater risk for not getting enough choline but this resource can help Choline in vegetarian diets
For more detailed list of the choline content of various foods, check out Nutrition Data’s link.
Doug Cook RDN is a Toronto based integrative and functional nutritionist and dietitian with a focus on digestive, gut, mental health. Follow me on Facebook, Instagram and Twitter.