Choline – A critical nutrient for physical and cognitive health.

Have you heard of or paid much attention to choline? Referred to as a brain boosting nutrient, choline is essential to our health, nervous system and cognitive function.

After receiving an email from Dr Lara Biden, a naturopathic doctor, highlighting a relatively new study on the subject, I was intrigued and I decided to do more research. This study by the Arizona State University (2023) found that ‘choline deficiency impacts brain and body health, contributing to Alzheimer’s markers like amyloid plaques and tau tangles.’ It can also impact the heart or liver.

Let’s take a closer look.

What is Choline?

Choline is classified as an organic compound, rather than a mineral or vitamin. It is often grouped with the B Vitamins – historically classified as Vitamin B4 – as it shares similar characteristics, food sources and functions including its role in metabolic processes.

The human body can synthesise choline in the liver from the amino acid methionine in a 3-part methylation process, resulting in phosphatidylcholine which is then converted into choline. However, this is not sufficient to meet the body’s needs, thus it is necessary for us to consume it through our diet. For that reason, choline is seen as a conditionally essential nutrient, and this is why Adequate Intake (AI) guidelines have been established.

Why is Choline so important?

Choline carries many vital functions and is used to make the neurotransmitter acetylcholine as well as the phospholipid lecithin. The latter is a fundamental part of the cell membranes, maintaining structural integrity and flexibility. Adequate dietary choline reduces levels of the amino acid homocysteine, a neurotoxin contributing to neurodegeneration.

Key functions include:

Constitutes a precursor to acetylcholine – a neurotransmitter involved in mood, memory, muscle control and other vital functions of the brain and nervous syste
- Note: acetylcholine signals satiety by increasing at the end of a meal, suppressing further eating and reducing motivation to eat
Plays important roles in lipid transport and metabolism, serving as a source of methyl groups required for a variety of metabolic processes
Helps to build cell membranes and is involved in cell membrane signalling
- Specifically, the body uses choline to make phosphatidylcholine and sphingomyelin, which are two key phospholipids essential for healthy (brain) cell membranes
Supports the regulation of gene expression and gene activity, especially in liver function and brain development
Critical for fetal brain development during pregnancy and may enhance cognitive abilities in children.

Choline food sources.

According to the research by Arizona State University (2023), ‘new lines of evidence imply that the established recommended daily intake of dietary choline’ for adult women or men ‘may not be optimal for proper brain health and cognition’.

Choline is naturally present in some foods; it is also available as a supplement. Note – a plant-based diet may be low in naturally occurring choline sources.

Animal sources

Egg yolk – one of the most concentrated sources
Beef, chicken, fish
Dairy products.

Plant based sources

Cruciferous vegetables such as broccoli, cauliflower or brussels sprouts
Potatoes and some type of beans including soybeans
Whole grains and wheat germ
Seeds and nuts, in particular peanuts.

Choline intake guidelines.

Current established intake recommendations for choline, as determined by the Institute of Medicine, were based on evidence preventing fatty liver disease in men.

Adequate Intakes (AI) for choline for adults:

Women – 425mg/day (different during pregnancy or lactation)
Men – 550mg/day

To give you an idea:

1 large hardboiled egg contains 147 mg/serving
1 large red potato, baked including skin, contains 57mg/serving
½ cup of broccoli, chopped, boiled and drained contains 31 mg/serving

Note the Upper Level of intake (UL) for choline according to eatforhealth.gov.au for adults (both women and men) is 3.5000mg/day. The UL of a nutrient intake is the highest amount that appears to be safe, beyond this point it can become toxic.

Other considerations.

Estrogen – stimulates the gene responsible for choline biosynthesis, so women may require less dietary choline than children or other adults
Folate – if your diet is deficient in folate (Vitamin B9), which acts as a methyl donor, the requirement of choline dietary intake is higher due to choline becoming the primary methyl donor (for metabolic processes).

Insulin Resistance

Choline has a complex and potentially inverse relationship with insulin resistance:

Higher intake is typically associated with lower insulin resistance, particularly in women, and when combined with betaine, a derivative of choline, found in foods like sugar beets or spinach
However, excessive supplementation can also promote hepatic insulin resistance (affecting the liver cells).

Heart Health

Similarly, the relationship with heart health is multifaceted; while there may be protective effects, there are also associated risk factors:

Choline helps to regulate blood pressure and to reduce homocysteine levels, a risk factor for cardiovascular disease
However, gut bacteria can convert it into TMA (trimethylamine), which is then processed by the liver into TMAO (trimethylamine-N-oxide) – elevated TMAO levels are linked to an increased risk of cardiovascular disease.

A word of caution.

Like with anything, moderation and balance are key! Everyone has different needs and I am by no means suggesting that you rush out and purchase a choline supplement.

This article is intended for awareness and educational purposes and not deemed as advice. Please conduct further research to and/or consult with your GP or a qualified healthcare professional to ensure the approach you select is tailored and right for you. If you are taking choline supplements, it’s important to consult with a healthcare professional before significantly changing your intake, as high doses can have adverse effects and risks.

How can Kinesiology help?

I am not a naturopath and thus not qualified to give advice on supplementation. However, through Advanced Kinesiology treatments, I am able to work with you and your system to identify and balance potential stresses related to choline, including its functions, levels, synthesis, absorption or other underlying or relevant aspects.

You can email me, call or book online.

Sources

Arizona State University. (2023, February 5). Choline: An essential brain‑boosting nutrient that most Americans are lacking. Retrieved from https://scitechdaily.com/choline-an-essential-brain-boosting-nutrient-that-most-americans-are-lacking/
National Institutes of Health, Office of Dietary Supplements. (n.d.). Choline – Fact sheet for health professionals. Retrieved from https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
National Health and Medical Research Council. (n.d.). Choline: Nutrient reference values. Australian Government, Eat for Health. Retrieved from https://www.eatforhealth.gov.au/nutrient-reference-values/nutrients/choline
Whitney, E., et al. (2019). Understanding nutrition (4th Australian & New Zealand ed., p. 357). Cengage Learning Australia Pty Limited.