What is choline?

Choline is a molecule that’s essential for various aspects of cellular function. It is not considered a vitamin because the body can produce a small amount in the liver, but humans do not make sufficient amounts to support metabolic demands (1). Thus, we must consume adequate choline from the diet to meet the body’s needs.

What Does Choline Do?

Choline plays many vital roles in health and metabolic function. It is an essential component of the most ubiquitous neurotransmitter in the body, acetylcholine (2), making it essential for all forms of movement and nervous system communication.

Phosphotitylecholine and sphingomyelin are cellular membrane molecules that require choline for their production, making it an essential building block for every cell of the body (3, 4).

Like folate, betaine, and B12, choline is an important methyl donor that helps recycle the inflammatory molecule homocysteine. When these other nutrients are low in the diet or impaired due to genetic mutations, choline becomes the primary methyl donor to regulate homocysteine levels (4).

Choline is also crucial for cellular signaling, lipid transport, gene expression, and metabolic processes and is especially vital for brain and nervous system development during fetal developments and infancy (5).

Essentiality of Dietary Choline

Despite being an essential nutrient for health, choline currently has neither a Recommended Dietary Allowance (RDA) nor an Estimated Average Requirement (EAR). At current, there only exists an Adequate Intake (AI) level based on the amount required to prevent liver disease (1).

This is problematic in terms of health optimization because the AI only tells us how much is needed to prevent overt disease, as opposed to how much is optimal or even sufficient for maintaining health in 50%- 98% of healthy populations, as is the case with the EAR and RDA, respectively (5).

The AI is currently set at 425mg/day for women and 550 mg/day for men older than 19 years (6).

During pregnancy and lactation, the AI for women increases to 450 mg/d and 550 mg/day, respectively.

Steady maternal choline intake throughout gestation and intake during infancy has been shown to improve various outcomes of neurological development in children. It’s great for women too. 930mg/day of choline during pregnancy showed improved placental health and function and reduced the risk of preeclampsia (7).

Cognitive function in children whose mothers took either 930 mg/d during the third trimester or 480mg/day throughout the entire pregnancy was better than those whose mothers consumed less choline (8). There appears to be an accumulation of choline throughout gestation and infancy that greatly contributes to optimal brain and nervous system development up into the early school years of childhood (5).

Because the AI of choline is just enough to prevent liver disease, the AI should be regarded as the minimum daily intake amount rather than the target. It is estimated that only 10% of Americans are meeting the AI of choline. More concerning, only 8% of pregnant women are meeting the AI (9).

The average American consumes only about 300 mg/d. Vegans and vegetarians have the lowest intake, averaging 192 mg/d (5).

Researchers have also identified several genetic mutations that increase individual choline intake needs (10). For those with these genetic mutations, the AI may be insufficient for preventing liver disease. Menstruating women who are not meeting the AI may not present with liver destruction as the first sign of deficiency because estrogen enhances choline synthesis in the liver (11). Thus, liver health is not a totally reliable indicator of choline intake.

While liver damage appears to be one of the first presentations of choline deficiency in man, other studies have also observed muscle damage (12) and triglyceride accumulation (13) also increase with deficiency.

Choline From Food

The NIH states that “The amount of choline that individuals need is influenced by 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” (6).

In 2018, the Scientists presented at the Choline Science Summit called for greater knowledge and education on the vital role of choline in health. In their call to action, they emphasize the need for continued education for dieticians, obstetricians and gynecologists as an ideal place to start, further underscoring the significance of choline intake during pregnancy.

Eggs (with the yolks) are an excellent source of choline. Beef and chicken liver provide the most amount of choline per serving than any other food. Other cuts of beef are also good food sources of choline, as well as chicken, fish, soybeans, potatoes (with skin), milk, Brussels sprouts, almonds, broccoli, and wheat germ (5, 6).

Choline comes as both fat-soluble and water-soluble forms from food sources. Fat-soluble choline is the most abundant dietary source; it include phosphatidylcholine and sphingomyelin. Water-soluble sources from food include phosphocholine, glycerophosphocholine, and free choline (14).

Currently, there is no research on which forms are best absorbed or most bioavailable to cells.

Choline Supplements

Krill oil is an excellent whole-food-based-supplement source of choline. The primary form of choline present in krill oil is phosphatidylcholine, one of the most abundant food sources. Phosphatidylcholine makes up 44-99% of the phospholipids in krill oil, and krill oil itself is anywhere from 40-80% phospholipids – a substantial concentration of choline (15).

What’s more, krill oil is also an excellent source of omega-3s. Some studies have shown omega-3s from krill oil to be more bioavailable than those from fish oil (16). This may, in part, be due to choline’s ability to enhance cellular transport and integration of DHA (17, 18).

Krill IQ is an excellent supplement for supplying vital omega-3s and supporting optimal choline intake. Beef Liver IQ is another exceptional option for those who prefer not to consume live in their diet. Our beef liver is undefatted and freeze-dried to retain all of the fat- and water-soluble nutrients, including choline.

Focus IQ also contains two choline analogs. The first is alpha-GPC (glycerophosphocholine), a metabolite of choline and a direct precursor to acetylcholine. Alpha-GPC has been shown to enhance various areas of cognitive function (19) and physical performance (20). Studies have demonstrated its ability to reduce cognitive decline in individuals with dementia and Alzheimer’s (21).

DMAE-bitartrate in Focus IQ is a direct precursor to choline and can support the body’s endogenous choline production. It has also been shown to have free radical scavenging actions to reduce oxidative stress (22).

Regardless of how you get your choline, aiming for no less than the AI for your gender and age range should be at the top of anyones health checklist. Given the ubiquitous nature of this molecule and numerous roles it plays in health, human physiology only stands to benefit from ensuring optimal choline intake.