Choline: An Essential Nutrient With Many Benefits

Introduction

Choline is an essential nutrient similar to the B Vitamins which is required for healthy physiological and metabolic functioning of the body. The human body is capable of synthesizing choline in small amounts but it is recommended to supplement the intake of choline through diet to avoid deficiency. This nutrient is found in foods such as nuts, seeds, dairy products, eggs, beans, meat, fish, vegetables, etc.

Since choline is an essential nutrient, it is required for many vital functions of the body, like the maintenance of a healthy nervous system, liver function, muscle movement, etc.

Choline is neither a mineral nor a vitamin. However, choline is often grouped together with the vitamin B complex due to its similarities with the B vitamins. It is a water-soluble organic compound with an amino-acid-like metabolism.

Dosage of choline:

Even though choline is classified as an essential nutrient, its intake should not exceed a certain limit but it should also be consumed in enough amounts so the body is able to function properly. The daily intake of choline varies depending on factors like age, gender, and genetic constitution.

For adult males, the recommended dose of choline is 550 mg per day, whereas this number goes down to 425 mg per day for adult females. However, the daily intake of choline for pregnant women should be 930 mg while lactating women should consume about 550 mg of choline per day.

The dosage also varies across different age groups. For children below the age of thirteen years, the dosage varies from 125 mg to 350 mg per day whereas for teenagers the recommended dosage is between 375 mg to 400 mg per day.

These values are only approximations as it is difficult to determine the exact amount of choline required on a daily basis because its presence in different food items is relatively unknown.

What happens if choline intake is low?

Choline deficiency is rare but can prove to be very harmful. It can significantly impact liver functions, brain development and also cause muscle damage. Moreover, it is recommended for pregnant women to consume choline in higher amounts because low levels of choline can cause birth defects like neural tube defect in the developing fetus.

It can also lead to other complications in pregnancy like premature birth, preeclampsia, and low birth weight. Hence, in order to avoid these complications and maintain the healthy functioning of vital organs like the brain, liver, and muscles, it is important to maintain adequate levels of choline in the body.

What happens if too much choline is taken?

As it is said, excess of anything is bad so similarly, taking choline in excess amounts can cause choline toxicity. Too much choline consumption can lead to a drop in blood pressure, diarrhea, excessive sweating, vomiting, salivation, liver toxicity, and fishy body odor. This happens due to the formation of an organic compound called trimethylamine during the metabolism of choline.

Functions supported by choline in the body

Choline is responsible for maintaining the structural integrity of the cell membranes It is also used for the production of compounds that act as cell messengers. Choline is responsible for the formation of a substance that aids in the removal of fats and cholesterol from the liver. In other words, it supports the transport and metabolism of fats in the body.

Moreover, Choline forms an important component in the process of DNA synthesis along with other vitamins like B12 and folate. This nutrient is also essential for the production of acetylcholine, a vital neurotransmitter that is involved in the regulation of heartbeat, muscle movement, brain development, and good memory.

Dietary sources of choline

Choline is obtained from the diet as choline or in the form of choline phospholipids, like phosphatidylcholine. The richest food sources of choline include organ meats like beef liver and chicken liver, eggs yolks, fish like fresh cod and salmon, vegetables like cauliflower, broccoli, and fats like soyabean oil, etc.

Eggs and organ meats top the list of the richest sources of this essential nutrient. A single egg can account for 20-25% of daily dietary choline intake while a 3-ounce serving of beef liver or kidney can fulfil the daily requirement of choline for an adult female.

Choline in supplements

Food additives and supplements in the form of pills and powders contain phosphatidylcholine (a derivative of choline used by the body). Choline is present in soy lecithin which is a widely used food additive. Lecithin supplement is consumed in the form of powders and pills which contains about 10-20% usable choline.

Other supplements like CDP-choline and alpha-GPC contain higher amounts of choline than lecithin supplements. It is believed that choline helps in the reduction of body fat but there are no scientific studies to prove it yet.

Benefits

As mentioned earlier, choline is an essential nutrient that supports many vital functions in the body like liver functions, muscle movement, and increased cognitive performance. Choline helps to keep the nervous system healthy as it is required for the production of the neurotransmitter, acetylcholine which plays a significant role in the regulation and maintenance of memory, intelligence, and overall mood.

Choline directly impacts mental health and brain functions. Some observational studies link choline intake and blood levels to improved memory and better processing of information by the brain. Moreover, a few studies have also suggested that a higher intake of choline by pregnant women improved fetal brain development and reduced the risk of neural tube defect.

Data from a large observational study also suggest some link between non-alcoholic fatty liver disorder (NAFLD) and choline deficiency.

This study indicated an inverse relationship between dietary choline intake and risk of NAFLD i.e., people who consumed adequate amounts of choline through their diets were at a lower risk of suffering from NAFLD while people who did not obtain enough choline through diet had higher chances of developing NAFLD.

A link between choline and healthy functioning of the liver has been established but more research studies are needed to further clarify the role of choline in preventing and treating the non-alcoholic fatty liver disorder.

Choline has been found to be beneficial in the treatment of certain mental health conditions like anxiety and other mood disorders such as bipolar disorder. Some research studies have also indicated that women who consumed higher amounts of choline are less likely to develop breast cancer.

Although many large observational studies have been carried out to establish relationships between choline and vital body functions, these studies are not yet well established and there is no solid evidence to assess the efficacy of choline against cancer prevention or other diseases.

Side-Effects :

The side effects of choline can be seen when it is consumed in excessive amounts. Ideally, the daily intake should not go below the recommended dosage but it’s also very easy to go overboard with certain beneficial ingredients by increasing their intake through food additives and supplements.

Choline, even though an essential nutrient, should be consumed well within the prescribed daily limits i.e., the intake should not be more than 7.5 g daily. Consuming choline in amounts greater than 7.5 g daily can lead to choline toxicity which can adversely impact the health.

Too much choline intake can lead to low blood pressure (hypotension), diarrhea, nausea, heart rhythm problems, mood swings, and a distinct fishy body odor caused by the production of trimethylamine (TMA) during choline metabolism by the gut microbes.

Who is at risk of Choline deficiency/insufficiency?

Although choline deficiency is not very common, certain groups of people are still at a higher risk of developing it or having insufficient amounts of choline in their bodies.

  • Pregnant and lactating women

Studies have suggested that approximately 90-95% of pregnant and lactating women consume inadequate amounts of choline per day.

The daily recommended dose of choline for pregnant women is 930 mg per day while for lactating women it is 550 mg per day, and a reduced intake puts them at risk of choline deficiency.

This risk is greater in women who do not take folate and vitamin B12 supplements during their pregnancy which leads to an overall reduction in the amount of methyl groups present in the body required for the metabolism of choline.

  • People with genetic alterations

 Certain genes that are involved in the metabolism of choline, folate, and methionine (an essential amino acid) play an important role in the process of choline production and use within the body. The variations in the DNA sequences for these genes vary from individual to individual.

The genetic constitution can be a determining factor in the endogenous synthesis of choline. Thus, the dietary requirement of choline might be high or low depending on these genetic alterations.

  • Patients who need complete parenteral nutrition

As the studies are still ongoing, choline is not added to the commercial parenteral solution for adults and infants at present. Hence, patients who have been on total parenteral nutrition (TPN) for a long duration usually have low concentrations of choline in their plasma. This can lead to hepatic anomalies like NAFLD.

  • Postmenopausal women

 Postmenopausal women have low estrogen levels which can lead to choline deficiency as estrogen helps to synthesize choline in the body.

  • Athletes

 Athletes performing long-duration endurance exercises on a regular basis are also at a greater risk of developing choline deficiency. However, it is still not clear if increasing the intake of choline through supplements can improve their performance.

  • People with high alcohol intake

Alcohol consumption increases choline requirement and the risk of deficiency also increases if choline intake is already low. 

Frequently Asked Questions

Is it safe to consume choline?

Choline is generally a safe nutrient when taken by mouth in doses lower than 3.5 g daily. Consuming choline in doses lower than the recommended daily adequate intake can lead to deficiency while taking it in excessive amounts can cause choline toxicity. Thus, it is advised to maintain a balance when consuming this ingredient.

Is Vitamin B and choline same?

Although choline is usually grouped together with the B vitamins due to similarities in the properties of both. However, choline is not a mineral or a vitamin. It is a water-soluble organic compound with an amino-acid-like metabolism.

Can choline treat fatty liver?

There is very little evidence to suggest if choline can actually reduce or cure non-alcoholic fatty liver disorder as extensive studies and research have not been conducted for the same yet. However, certain observational studies have suggested a link between adequate intake of choline and a reduction in the risks of developing the non-alcoholic fatty liver disorder.

What are the symptoms of choline deficiency?

Since choline plays an important role in liver functioning, muscle movement, and nervous system development; low levels of choline can hinder these essential functions. Additionally, it can also impact mental health and cause mood swings or reduced cognitive performance in certain individuals.

What is the best source of choline?

The richest sources of choline include organ meats like beef and chicken liver, nuts, seeds, fish, egg yolks, vegetables like cauliflower and broccoli, etc. Additionally, choline requirements can also be fulfilled through supplements and food additives like soy lecithin.

Who should take Choline Supplements?

It is usually safe to take choline supplements if there are no underlying health conditions. However, it is recommended that the majority of the choline is derived from natural food sources instead of concentrated supplements. Pregnant women and people with underlying health problems should consult their health advisors before taking choline supplements.

Can choline be taken every day?

Choline is an essential nutrient and it is synthesized by the body in small amounts only. Hence it becomes necessary to take choline in adequate amounts through diet every day to maintain proper health.

Conclusion

Choline is a vital nutrient for the upkeep of a healthy body. Although extensive studies are still ongoing for this ingredient, there has been enough evidence to show that choline is indeed essential for the human body to maintain a healthy liver, and nervous system; support other significant functions like muscle mobility and improve cognition.

Thus, consuming choline in adequate amounts is paramount for the sustenance of optimal health in the long run. However, like everything else, choline also comes with its benefits and side effects, hence it becomes crucial to utilize this nutrient in a balanced way to reap its maximum benefits.

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