Choline

It’s not often talked about and you won’t find it on food packaging. Five years ago, a survey across the US showed that 15% of the general population was not aware of it. But if you want to have a healthy diet, choline should be in your mind and on your plate. Here’s what you need to know about it.

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Best known for: Keeping your cells, brain and liver healthy.

Good sources: Meat, eggs, poultry, nuts, whole grains and seeds.

Adequate intake (AI): 400 mg/day for healthy adults; 480 mg/day for pregnant and 520 g/day for lactating women. The tolerable upper intake level (UL) is 3.5 g /day.

Good to know: Although it gets less popularity than folic acid, choline is equally important for the normal development of the baby. Choline supplementation during pregnancy can also help prevent neural tube defects, pre-eclampsia and premature birth.

What is choline?

Choline is sometimes referred to as vitamin B4. Although it shares structural and functional similarities with the B-complex vitamins, choline isn’t technically a vitamin, because your body can synthesise it. That’s also the reason choline started being seen as an essential nutrient only recently, in 1998, when it became clear that the amounts synthesised by our livers aren’t sufficient to meet our needs.

Functions of choline in your body

Choline is involved in several important functions in your body, including:

  • Maintaining the structural integrity of your cells. Choline is needed for the synthesis of two major phospholipidsPhospholipids are major components of cell membranes. The two phospholipids choline helps synthesise are phosphatidylcholine and sphingomyelin., found in all cell membranes.
  • Ensuring the normal functioning of your brain and nervous system. Your body requires choline to make acetylcholine, a neurotransmitterA neurotransmitter is a chemical released by nerve cells as a way to transfer signals to other cells throughout the nervous system. involved in essential brain functions such as memory and mood regulation. Next to that, acetylcholine is also important for muscle control and other nervous system functions.
  • DNA synthesis and gene expression.
  • Supporting the movement and metabolism of lipids in the body. Without sufficient choline, fat and cholesterol build up in the liver and can disrupt its normal function.
  • Development of the infant brain. Sufficient choline intake during pregnancy, lactation and the first years of a child’s life are key for the optimal development of memory and cognitive functions.

How much choline do you need?

For healthy adults, 400 mg choline/day is considered an adequate intake. During pregnancy and lactation, the body requires more choline – 480 mg/day and 520 mg/day, respectively.These amounts reflect the adequate intake (AI) established by the European Food Safety Authority (EFSA). It’s not difficult to meet the AI – a 100-gramme portion of beef liver already has you covered for the day.

FolateSource: Jake and choline intakes are closely interrelated. Both nutrients provide a methyl group necessary for numerous metabolic reactions. As a result, if you’re not getting enough of either of these nutrients, your body will require more of the other to ensure normal metabolic processes.

Choline in foods

You can find choline in a variety of foods. Particularly rich sources are meat, poultry, dairy, eggs and fish. Other foods that can help you get your choline are beans, nuts, whole grains and seeds.

Here are some of the top sources of choline:

FoodAI (%)*Choline (mg)
Beef liver (85 g)89%356
Egg, hard-boiled (1 whole)37%147
Soybeans, roasted (100 g)27%107
Mushrooms, shiitake, cooked (40 g)15%58
Kidney beans, canned (90 g)11%45

* Based on the adequate intake (AI) established by EFSA for healthy adults (400 mg/day)

What if you’re not getting enough choline?

Choline deficiency is very rare and, in fact, in Europe there’ve been no reports of deficiency in the general population. However, if it does occur, choline deficiency can lead to muscle and liver damage. More specifically, without sufficient choline, fat starts to accumulate in your liver – a condition known as non-alcoholic fatty liver disease (NAFLD). NAFLD can increase the risk of further liver diseases, including inflammations and cirrhosisCirrhosis is a liver condition characterised by disruption of the liver function and the replacement of normal liver tissue with scar tissue..

Despite the rarity of choline deficiency, these groups remain at risk:

  • Pregnant women: Especially in the absence of folate supplements, pregnant and lactating women may be at a greater risk of becoming choline deficient. Insufficient choline in their diet can raise homocysteine Homocysteine is an amino acid commonly present in your blood. However, abnormally high levels of homocysteine can be a risk factor for several diseases affecting the heart and liver. levels in the blood, which is a risk factor for preeclampsia, premature birth and very low birth weightSource: Nutrition Reviews. Next to that, choline has been shown to have a protective effect against neural tube defectsSource: The British Journal of Nutrition, similar to folic acid.
  • People with conditions affecting the DNA sequence of genes responsible for choline and folate metabolism.
  • Endurance athletes: During prolonged endurance exercises, levels of choline in the body drop significantlySource: European Journal of Applied Physiology and Occupational Physiology.
  • Postmenopausal women: The hormone oestrogen is important for choline production in the body. Oestrogen levels drop significantly after menopause, which increases the risk of choline deficiencySource: The American Journal of Clinical Nutrition.

How much choline is too much?

High intakes of choline can cause a fishy body odour, low blood pressure and symptoms such as excessive sweating and salivation. Due to lack of sufficient data, the EFSA hasn’t established a tolerable upper intake level (UL) for choline. The UL set by the US Institute of Medicine is 3.5 g choline/day. Consuming this much choline from food would be very difficult. However, if you’re taking a lot of supplements, it’s possible to reach that level of intake.

Take-aways

These are the things worth remembering about choline:

  • It’s an essential nutrient. Even though your body can make some, it’s not sufficient to meet your needs and you need to get choline from your diet.
  • Choline is important for your cells, brain and nervous system function, as well for the metabolism and movement of lipids in your body.
  • Pure choline deficiency is rare, but if you’re pregnant or an endurance athlete, you’re at a higher risk.
  • Too much choline can cause low blood pressure, excessive sweating and give your body a fishy smell. To avoid these side effects, make sure you’re not getting more than 3.5 g choline/day.