Choline is an essential nutrient that plays a vital role in various bodily functions. It is naturally present in some foods and available as a dietary supplement. This article explores the importance of choline, its functions, dietary sources, deficiency symptoms, and recommended intakes.
What is Choline?
Choline is a water-soluble nutrient that is crucial for optimal health. It serves as a building block for phosphatidylcholine and sphingomyelin, two major phospholipids essential for cell membranes. Therefore, all plant and animal cells need choline to preserve their structural integrity. In addition, choline is needed to produce acetylcholine, an important neurotransmitter for memory, mood, muscle control, and other brain and nervous system functions.
While humans can produce choline in the liver, the amount synthesized is insufficient to meet the body's needs. As a result, it is essential to obtain choline from the diet.
Functions of Choline in the Body
Choline participates in several crucial processes in the body:
- Cell Structure: Choline is required for synthesizing phosphatidylcholine and sphingomyelin, which are vital for maintaining the structural integrity of cell membranes.
- Neurotransmission: It is a precursor to acetylcholine, a neurotransmitter involved in memory, mood, muscle control, and other nervous system functions.
- Lipid Metabolism: Choline, especially phosphatidylcholine, is essential for transporting lipids from the liver.
- Methylation: Choline plays a role in methylation, a chemical process in DNA that influences how cells read and use genetic information. Methylation is also involved in detoxification.
Dietary Sources of Choline
Many foods contain choline, with the main dietary sources in the United States being animal-based products such as meat, poultry, fish, dairy products, and eggs. About half the dietary choline consumed in the United States is in the form of phosphatidylcholine. Lecithin, a substance rich in phosphatidylcholine, is also a common food additive used as an emulsifying agent in processed foods.
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Here is a list of foods rich in choline:
- Organ Meat: Organ meat like liver and kidneys are some of the best sources of choline. Just 3 ounces (85 grams) of cooked beef liver provides 359 mg, or 65% of the daily value (DV) of 550 mg for this nutrient.
- Fish: Seafood, including fish like salmon, tuna, and cod, is a good source of choline. For example, 3 ounces (85 grams) of salmon provide 187 mg, or 34% of your daily needs.
- Caviar: Fish roe, or caviar, is an excellent source of choline. Just 3 ounces (85 grams) of mixed-species caviar contains 285 mg, or 52% of the DV.
- Beef: A 3-ounce (85-gram) serving of cooked beef contains 116 mg, which fulfills 21% of the DV for this nutrient.
- Chicken and Turkey: Both provide 72 mg per 3-ounce (85-gram) serving, or 13% of the DV.
- Whole Eggs: One egg provides 169 mg of choline.
- Cottage Cheese: One cup (210 grams) of plain cottage cheese contains 39 mg, or 7% of the DV for choline.
- Shiitake Mushrooms: One cup (145 grams) of cooked shiitake mushrooms provides 116 mg, or 21% of your daily needs.
- Soybeans: One cup (93 grams) of roasted soybeans contains 214 mg, or 39% of the DV.
- Wheat Germ: Just 3 ounces (84 grams) of toasted wheat germ packs 153 mg of choline, or 28% of the DV.
- Cruciferous Vegetables: One cup (160 grams) of cooked cauliflower packs 72 mg, or 13% of your daily choline needs, while the same amount of cooked Brussels sprouts and broccoli each provide about 31 mg and 30 mg respectively, or approximately 5% of your daily needs.
- Almonds: Eating 1 ounce (28 grams) of almonds provides about 15 mg of the nutrient, which covers 2.5% of your daily needs.
- Lima Beans: A 1-cup (170-gram) serving of cooked immature lima beans contains 75 mg of choline, which covers 14% of your daily needs.
- Red Potatoes: One large (299-gram) red potato contains 57 mg of choline, which fulfills 10% of your daily needs for this nutrient.
- Kidney Beans: One cup (177 grams) of cooked kidney beans provides 54 mg of the nutrient, which equates to 10% of the DV.
- Quinoa: One cup (185 grams) of cooked quinoa has 43 mg of the nutrient, or 8% of the RDI.
Choline Intake Recommendations
Intake recommendations for choline are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) of the Institute of Medicine. Since there was insufficient data to establish an Estimated Average Requirement (EAR) for choline, the FNB established Adequate Intakes (AIs) for all ages based on the prevention of liver damage.
The amount of choline that individuals need is influenced by various factors, including the amount of methionine, betaine, and folate in the diet; gender; pregnancy; lactation; stage of development; ability to produce choline endogenously; and genetic mutations that affect choline needs.
Here are the recommended daily allowances for choline:
- 0-6 months: 125 mg
- 7-12 months: 150 mg
- 1-3 years: 200 mg
- 4-8 years: 250 mg
- Females 14-18 years: 400 mg
- Males 14+ years: 550 mg
- Females 19+ years: 425 mg
- Females who are pregnant: 450 mg
- Females who are lactating: 550 mg
Choline Deficiency
Choline deficiency can lead to muscle damage, liver damage, and nonalcoholic fatty liver disease (NAFLD). Symptoms of low choline may include muscle aches, memory and cognitive problems, moodiness, tiredness, and tingling caused by nerve damage.
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Approximately 90%-95% of pregnant women consume less choline than the AI. Some evidence suggests that lower plasma or serum choline levels are associated with an increased risk of neural tube defects.
Health Implications of Choline
Cardiovascular Health
Choline is involved in functions that overlap with those of folate and other B vitamins. Some researchers have suggested that choline might protect cardiovascular health by reducing blood pressure, altering lipid profiles, and reducing levels of plasma homocysteine. However, other research suggests that higher dietary choline might increase cardiovascular disease risk because some choline and other dietary ingredients, such as carnitine, are converted to trimethylamine (TMA) by intestinal bacteria.
Neurological Disorders
People with Alzheimer’s disease have lower levels of the enzyme that converts choline into acetylcholine in the brain. Some experts have theorized that consuming higher levels of phosphatidylcholine could reduce the progression of dementia in people with Alzheimer’s disease.
Nonalcoholic Fatty Liver Disease (NAFLD)
Choline, especially phosphatidylcholine, is essential for transporting lipids from the liver. In choline deficiency, fat accumulates in the liver, which can result in NAFLD.
Choline Supplements
Choline is available in dietary supplements containing choline only, in combination with B-complex vitamins, and in some multivitamin/mineral products. Typical amounts of choline in dietary supplements range from 10 mg to 250 mg. The forms of choline in dietary supplements include choline bitartrate, phosphatidylcholine, and lecithin.
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It's important to note that not everyone needs choline supplements. A balanced diet rich in choline-containing foods is usually sufficient. However, vegetarians, vegans, postmenopausal women, pregnant or breastfeeding women, and people with certain medical conditions may benefit from supplementation.
Precautions and Considerations
High intakes of choline are associated with a fishy body odor, vomiting, excessive sweating and salivation, hypotension, and liver toxicity. The FNB has established Tolerable Upper Intake Levels (ULs) for choline from food and supplements based on the amounts of choline that are associated with hypotension and fishy body odor.
People with bipolar disorder and depressive disorders should avoid high amounts of choline from supplements, as it can worsen depression. If you are pregnant or breastfeeding, talk to your doctor before taking a choline supplement.