Maybe you’ve never heard of choline. You’re not alone. The DRI wasn’t even established until 1998, and the choline content of foods could not be measured until recently. Small amounts of choline are made in your body, but you get most of it in the foods that you eat. Foods like:
- Fish and shellfish: salmon, Atlantic cod, shrimp, scallops
- Wheat and wheat germ
- Kidney beans
- Navy beans
- Milk and milk products
- Brussels sprouts
- Shiitake mushrooms
- Nuts and seeds
It is an essential nutrient because it’s used by every cell in your body. It’s also necessary for the creation of a neurotransmitter involved in muscle control, circadian rhythm, mood, and memory (acetylcholine), is involved in the metabolism and transport of lipids, and is essential for kidney function.
Men and post-menopausal women need more choline than premenopausal women, and about half of us are genetically susceptible to deficiency. You have to have adequate amounts of an amino acid (methionine) and folate to use the choline that you consume. When choline is limited, the need for folate increases, and vice versa.
Deficiency of choline can lead to the development of fatty liver disease and muscle damage. Up to 65% of overweight people and 90% of obese people have fatty liver disease already, which can lead to cirrhosis, liver failure, and liver cancer. Because choline is vital for transporting lipids out of the liver, a deficiency will result in accumulation of lipids in the liver. Both the fatty liver disease and muscle damage appear to resolve once choline is reintroduced into the diet.
If a pregnant woman is deficient in choline, her baby is at risk for birth defects of the brain and spinal cord. Ninety percent of pregnant women don’t get enough choline. In one study, those pregnant women in the lowest quartile for intake had four times the risk of giving birth to a baby with neural tube defect compared to those women in the highest quartile.
Choline might be necessary for preventing the memory loss associated with aging. However, it does not seem able to reverse the cognitive decline that has already occurred. Supplementation with citicoline, which is a choline derivative may help to limit neurologic damage in stroke patients.
Citicoline is used in many traumatic brain injury (TBI) regimens because it is believed to possible quicken the resorption of cerebral edema and improve the recovery of consciousness and neurologic disorders in severe cases. It might also limit memory deficits and how long someone experiences headaches, dizziness, and attention disorders following TBI. Research is mixed, though, and in an extensive study recently completed on 1,213 patients with mild-to-severe TBI, citicoline supplementation did not have any benefit for 90 days or 180 days.
Things get tricky when you talk about choline with heart disease. In very brief summary of what would otherwise be an extremely long explanation: some research initially showed that choline might be good for the heart, but newer research seems to indicate that the opposite might be true.
What would happen if you developed choline toxicity from taking too many supplements? You would produce a fishy body odor, vomit, have diarrhea, salivate a lot, sweat a lot, and develop low blood pressure. Oh, yeah, and you might develop heart disease. The tolerable upper intake level for adults is 3,500 mg/day.
I think that all of this boils down to:
- Try to eat choline-rich foods every day.
- If you’re pregnant or a vegetarian, a supplement might be especially useful for you.
- Do not take mega-doses of choline supplements.