Choline: Everything you need to know

Choline is a nutrient which supports different body functions including cell growth and metabolism. The body produces some choline but most of it comes from food sources.

In 1998 choline was formally recognised as an important nutrient by the Institute of Medicine. Some research, however, indicates most people don’t get enough of it.

Continue to read this article to learn more about choline, including the recommended daily intake, its origins and how it can support the overall health of individuals.

What is choline?

Nuts and seeds are good sources of choline.
Nuts and seeds are good sources of choline.

Choline is an important nutrient which supports vital body functions and overall health of individuals. While some choline is made by the body, people need to add choline-rich foods into their diet to get enough of it.

Choline serves various important functions in the body including:

  • Cell maintenance: The body uses choline to produce fats that make up cellular membranes.
  • DNA synthesis: Choline, along with other nutrients such as folate and vitamin B-12, can affect gene expression.
  • Metabolism: Choline helps metabolize fats.
  • Nervous system functioning: The body converts choline into a neurotransmitter that affects the nerves and plays a role in regulating automatic bodily functions, such as breathing and heart rate.

Choline exists both as water-soluble molecules and as fat-soluble ones. Choline is processed by the body and consumed differently depending on its form.

Water-soluble molecules of choline go into the liver, where they are converted into a form of fat called lecithin.

Fat-soluble choline typically originates from food sources, and it is consumed by the body in the gastrointestinal tract.

Benefits

Choline supports several vital bodily functions and may offer a wide range of other health benefits, such as:

Improving memory and cognition

Choline is a nutrient important to brain growth.

In one retrospective study of 2,195 participants aged 70–74 years, those with higher choline rates had greater cognitive function than low choline participants.

The 2019 retrospective study showed low levels of choline, vitamin C and zinc in older men were associated with impaired working memory.

Protecting heart health

The authors of a 2018 study found an association between increased choline dietary intakes and a lower risk of ischemic stroke.

The research looked at almost 4,000 participants from African American countries, with an average follow-up duration of 9 years.

Boosting metabolism

Many work found that choline plays a part in the metabolization of fats.

The authors of a small 2014 study found that there were lower body mass indexes (BMIs) and leptin rates among female athletes who took choline supplements than control group. Leptin is a hormone responsible for regulating body fat.

Reducing the risk of pregnancy complications

Choline can affect the development of the fetus, and can affect the outcomes of pregnancy. For example, in one 2013 study women received 480 milligrams (mg) or 930 mg of choline per day in their third trimester of pregnancy.

Those who took higher doses of preeclampsia had decreased markers. Symptoms of preeclampsia include elevated blood pressure, extreme headaches and swelling.

Improving cystic fibrosis symptoms

One 2018 study showed that choline supplementation enhanced lung function in 10 adult males with cystic fibrosis and decreased symptoms of fatty liver disease.

Deficiency

The precise amount of choline a person needs depends on the following factors:

  • pregnancy or lactation
  • biological sex
  • genetics
  • age

The following table lists the approximate adequate choline intake (AI) based on age, biological sex, pregnancy status and lactation status:

Daily AI for choline
AgeMaleFemalePregnancyLactation
0–1 year125–150 mg/day125–150 mg/day
1–3 years200 mg/day200 mg/day
4–8 years250 mg/day250 mg/day
9–13 years375 mg/day375 mg/day
14–19+ years550 mg/day400–425 mg/day450 mg/day550 mg/day

However, most people do not meet the recommended AIs for choline.

Most people however don’t meet the required choline AIs.

Males aged 20–59 consume an average of 406–421 mg of choline per day, while females in the same age group consume around 290–303 mg per day, according to the United States Department of Agriculture.

Pregnant women, lactating individuals, and individuals with genetic abnormalities that increase the body’s demand for choline may also be at higher risk of choline deficiencies.

Although some people think vegetarians and vegans can run the risk of choline deficiencies, there is only mixed evidence to support this.

Some foods with the highest choline content currently include soybeans, potatoes, and mushrooms. Eating a balanced diet based on whole foods would be adequate to avoid deficiencies.

Lack of choline can lead to the following health conditions:

  • cardiovascular disease
  • neurological conditions, such as Alzheimer’s disease
  • nonalcoholic fatty liver disease
  • neural tube irregularities
  • muscle damage

Although choline deficiencies can lead to adverse health effects, too much choline can also cause problems, including:

  • hypotension
  • sweating
  • vomiting
  • excessive salivation
  • liver toxicity
  • a fishy body odor

The National Institutes of Health (NIH) provide the following upper intake levels for choline based on age:

  • children aged 1–8: 1 gram (g) per day
  • children aged 9–13: 2 g per day
  • teenagers aged 14–18: 3 g per day
  • adults aged 19 or older: 3.5 g per day

Sources

People can obtain choline from different dietary sources. Throughout the first few months of life, infants need tons of choline, much of which they receive from breast milk or fortified formula.

Most people are getting choline out of their diet after infancy.

Dietary sources of choline include:

  • proteins, such as beef, soybeans, fish, poultry, and eggs
  • vegetables, including broccoli, potatoes, and mushrooms
  • whole grains, such as quinoa, rice, and whole wheat bread
  • nuts and seeds

Some multivitamins and dietary supplements can contain choline in the form of lecithin, as well as prepackaged and fortified foods.

People can consider supplements that only contain choline, too. The exact amount of choline available varies so it’s important for people to read labels before taking any dietary supplements.

Choline supplements can be sold in pharmacies, in natural food stores.

Testing

Healthcare professionals can test choline levels of a individual by taking a blood sample and analyzing how much choline is present.

However, the authors of one 2018 article note that the choline content in blood samples may be influenced by various test procedures.

Blood tests may therefore not be a reasonable indicator of whether a person is getting enough choline or not.

Summary

Choline is an important nutrient that controls critical body functions, such as the formation of cell membranes and aiding neuronal communication.

The body does not contain enough choline alone so people need to get it from food sources like meat, eggs, and vegetables.

Current research findings indicate that choline can enhance memory and cognition, and minimize ischemic stroke risk.

To newborn babies, choline promotes brain development and growth. Evidence also indicates choline may reduce the risk of preeclampsia and congenital abnormalities.

While the recommended choline intake is fairly small (125–550 mg daily), most people do not get enough.

Deficiency of choline can cause muscle and liver disease and lead to cardiovascular disease, dementia and abnormalities of the neural tube in children.

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