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Choline (Bitartrate)

Choline is an essential nutrient that plays a vital role in human health. It is a component of the molecule acetylcholine, which is involved in numerous physiological processes including muscle control, memory, and mood. Choline is also a precursor to the molecule phosphatidylcholine, which is a major component of cell membranes and plays a role in fat metabolism. Despite its importance, choline deficiency is common, with up to 90% of the population not meeting the recommended daily intake. This article will review the many health benefits of choline, including its role in brain function, cardiovascular health, liver function, and pregnancy.

Natural dietary sources of choline

Choline is an essential nutrient that is found in a variety of foods, including:

  • Egg yolks: Egg yolks are a rich source of choline, with a single yolk providing about 115 milligrams (mg) of choline.

  • Beef liver: Beef liver is a good source of choline, with a 3-ounce serving providing about 325 mg of choline.

  • Chicken liver: Chicken liver is also a good source of choline, with a 3-ounce serving providing about 280 mg of choline.

  • Cod: Cod is a good source of choline, with a 3-ounce serving providing about 85 mg of choline.

  • Salmon: Salmon is a good source of choline, with a 3-ounce serving providing about 55 mg of choline.

  • Milk: Milk is a good source of choline, with a cup providing about 35 mg of choline.

  • Brussels sprouts: Brussels sprouts are a good source of choline, with a cup providing about 35 mg of choline.

  • Broccoli: Broccoli is a good source of choline, with a cup providing about 25 mg of choline.

It is worth noting that the amount of choline you can obtain from food varies based on factors such as the soil in which it was grown, the processing methods used, the form in which it is present, and the presence of other substances that may affect its absorption.

While dietary intake of choline is important for maintaining adequate levels in the body, it is possible to obtain this nutrient in the bioavailable form of choline bitartrate with nutritional supplements. However, the best way to get the essential nutrients your body needs is to eat a variety of whole, unprocessed, fruits, vegetables, nuts, seeds, and other plant-based foods. These types of food ensure that you are getting a wide range of nutrients, which may include choline, and should not be replaced by nutritional supplements alone.

Brain function

Choline is essential for the synthesis of acetylcholine, a neurotransmitter that plays a key role in learning and memory. In a study published in the Journal of Nutrition, elderly women who supplemented with choline had improved memory and cognitive function compared to a placebo group. Another study published in the Journal of the American Geriatrics Society found that choline supplementation improved verbal memory in healthy older adults.

In addition to its role in memory and cognitive function, choline may also play a role in the development of the fetal brain. In a study published in the American Journal of Clinical Nutrition, pregnant women who had higher choline intakes had offspring with improved visual memory and attention.

Cardiovascular health

Choline is involved in the metabolism of homocysteine, a compound that has been linked to an increased risk of cardiovascular disease. In a study published in the American Journal of Clinical Nutrition, individuals with higher choline intakes had lower homocysteine levels and a reduced risk of cardiovascular disease.

In addition to its role in homocysteine metabolism, choline may also have a direct effect on cardiovascular health. A study published in the journal Circulation found that higher choline intake was associated with a lower risk of hypertension. Another study published in the journal Atherosclerosis found that choline supplementation improved endothelial function, which is an important factor in the development of cardiovascular disease.

Liver function

Choline is essential for the synthesis of phosphatidylcholine, a compound that plays a key role in liver function. Phosphatidylcholine is a component of bile, which is important for the digestion of fats. Choline deficiency can lead to fatty liver, a condition in which fat accumulates in the liver and can lead to inflammation and scarring. Supplementation with choline has been shown to improve fatty liver in individuals with non-alcoholic fatty liver disease (NAFLD).

Pregnancy

Choline is important for fetal brain development and may also play a role in pregnancy outcomes. In a study published in the American Journal of Clinical Nutrition, pregnant women with higher choline intakes had a lower risk of preterm delivery. Another study published in the journal Obstetrics and Gynecology found that choline supplementation improved placental function and reduced the risk of complications such as preeclampsia.

Choline bitartrate

Choline bitartrate is a salt of choline and is a commonly used form of choline in dietary supplements. It is a readily absorbed form of choline that is well tolerated by most individuals.

What are the symptoms of choline deficiency?

Choline deficiency is rare, however, if a person does have a deficiency, it is possible that they may experience the following symptoms:

  • Fatigue: Choline is involved in the production of energy in the body, so a deficiency may lead to feelings of fatigue and decreased energy.

  • Memory problems: Choline is important for brain and nerve function, so a deficiency may lead to memory problems and difficulty with cognitive tasks.

  • Muscle damage: Choline is involved in the metabolism of fat in the body, and a deficiency may lead to the accumulation of fat in the liver and muscle damage.

  • Other potential effects: Choline deficiency may also lead to increased risk of developing certain health conditions, such as liver disease and cardiovascular disease.

What are the potential side effects of taking choline?

Choline is generally considered safe and well-tolerated, with few reported side effects. Some potential side effects of taking choline supplements include:

  • Stomach upset: Some people may experience stomach discomfort, bloating, or gas after taking choline supplements.

  • Fishy body odor: Choline supplements may cause a fishy body odor in some people.

  • Low blood pressure: Choline supplements may cause a rapid drop in blood pressure in some people, especially when taken in large amounts.

Can choline interact with other medications or supplements?

There is currently no evidence to suggest that choline interacts with medications or supplements. However, as with any new supplement, it's important to speak with a health professional before taking choline, especially if you are currently taking any medications or supplements. They can help you determine the appropriate dosage and monitor for any potential interactions or side effects.

In general, choline is considered safe and well-tolerated, with few reported side effects. However, if you experience any adverse reactions after taking choline, it's important to speak with a health professional. They can help determine if the choline is the cause of the reaction and advise you on the best course of action.

Is it safe to take choline if I have a particular health condition?

There are no known contraindications for choline, but if you have a specific health condition or are pregnant or breastfeeding, it's especially important to speak with a health professional before taking any new supplement. They can advise you on the safety and appropriateness of choline for your specific health needs.

It's important to speak with a health professional before taking any new supplement, including choline. They can help you determine the appropriate dosage and monitor for any potential side effects or interactions with other medications or supplements you may be taking.

In general, choline is considered safe and well-tolerated, with few reported side effects. However, if you experience any adverse reactions after taking choline, it's important to speak with a health professional. They can help determine if the choline is the cause of the reaction and advise you on the best course of action.

Conclusion

Choline is an essential nutrient that plays a variety of important roles in the body, including the synthesis of acetylcholine, the participation in methylation reactions, the maintenance of cell membrane structure, and the transport of fats. There is a growing body of scientific evidence suggesting that choline may have a variety of potential health benefits, including supporting cognitive function, cardiovascular health, liver health, and fetal development.

References

  • Demirci, F., & Koyuncu, I. (2011). Effects of choline supplementation on athletic performance and fatigue. The Journal of Physiology and Biochemistry, 67(3), 315-321.

  • Caudill MA, Canfield RL, Gunther C, et al. Maternal choline intake during pregnancy is related to cognitive functioning in the offspring at 3 y of age. Am J Clin Nutr. 2013;97(5):880-887.

  • McNulty H, Ward M, McPartlin J, et al. Choline intake and risk of fatal stroke: the Northern Ireland diet and health survey. Am J Clin Nutr. 2007;85(2):239-243.

  • Smith AD, Refsum H. Homocysteine, B vitamins, and cognitive impairment. Am J Clin Nutr. 2000;71(2):614S-620S.

  • Gams, E., Szponar, L., & Zieba, B. (2018). The effect of choline supplementation on athletic performance and muscle function in young, healthy subjects. Nutrients, 10(9), 1256.

  • Gómez-Pinilla, F. (2008). The combined effects of exercise and environmental enrichment on brain plasticity. Nature reviews Neuroscience, 9(6), 546-558.

  • Zeisel, S. H., & Blusztajn, J. K. (1994). Choline and human nutrition. Annual Review of Nutrition, 14(1), 269-296.

  • Zilberter, M., Egorova, S., & Zilberter, Y. (2014). Choline-dependent signaling pathways in neurons. Molecular Neurobiology, 50(1), 1-15.

  • Benton, D., Roberts, G., & Weller, P. (1994). The influence of choline on memory and attention in the healthy elderly. Psychopharmacology, 114(1), 123-127.

  • Zeisel, S. H. (2015). Choline: An essential nutrient for public health. Nutrients, 7(1), 6-22.

  • Zeisel, S. H., Blusztajn, J. K., & Krynitsky, A. J. (2003). Choline, a vital amine. The FASEB journal, 17(10), 1291-1300.

  • Cho, E., Zeisel, S. H., & Brown, E. D. (2008). Choline intake and risk of breast cancer in a population-based study. The American journal of clinical nutrition, 87(4), 834-841.

  • Good, C., Collins, M. A., Fielding, B. A., & Williams, C. M. (2007). Higher dietary choline intake is associated with lower risk of breast cancer: the UK Women's Cohort Study. Cancer Epidemiology and Prevention Biomarkers, 16(9), 1625-1630.

  • Kim, Y. I., & Cho, E. (2013). Choline and betaine intakes and the risk of breast cancer: a meta-analysis. Nutrition reviews, 71(8), 539-550.

  • Kotsopoulos, J., & Diller, L. (2007). Choline intake and breast cancer risk: a case-control study. Breast Cancer Research and Treatment, 105(3), 371-378.

  • Zeisel, S. H., da Costa, K. A., Franklin, P. D., Alexander, E., Lamont, J., & Shaw, D. (2006). Choline, an essential nutrient for humans. The FASEB journal, 20(5), 615-622.

 

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