Choline is one of the nutrients that has risen in ranks very quickly. The Institute of Medicine declares choline as an ‘essential nutrient’. There are many complex roles performed by this nutrient in the body.
While humans do produce choline in their bodies, the quantities are mostly insufficient. It is hence important to also obtain choline from the foods you eat. Choline acts like amino acids and facilitates various processes to function seamlessly.
It is not easy to decide on the global recommended values for choline intake. Certain genetic changes increase or decrease a person’s choline needs. We will discuss more of this in the genetic section.
Why Do You Need Choline?
Here are some of the important functions of choline in the body.
Helps in making fats that holds together cell membranes
Choline is useful in producing acetylcholine. This is a basic neurotransmitter (messengers that transmit signals from one cell to another)
Helps with DNA synthesis (the production/creation of DNA molecules)
The History Behind Choline
In the middle of the 19th century, a large number of researchers were analyzing the chemical composition of tissues of living organisms.
During the 1850s and 1860s, several scientists were working on a new molecule at the same time in different parts of the world.
In 1850, Theodore Gobley, a pharmacist in Paris extracted this new molecule from the tissues of the brain and named it ‘Lecithin’. The word meant egg yolk in Greek.
In 1862, Adolph Strecker, a German scientist extracted lecithin from bile and then heated it. The result was a new chemical named Choline.
In 1865, another expert named Oscar Liebreich identified a new chemical found in the brain and named it neurine.
It was later proven that choline and neurine were the same substances.
It was only in the 1930s that scientists proved fatty liver could be cured with choline supplemented food.
In 1998, choline was added to the list of essential nutrients needed for human survival.
Choline At The Molecular Level - Getting Technical
De Novo Synthesis - De Novo synthesis of choline is the production of choline inside the body. The phosphatidylethanolamine N-methyltransferase (PEMT) is an enzyme that helps convert certain kinds of lipids called phospholipids into phosphatidylcholine.
An enzyme called Phospholipase D converts phosphatidylcholine into phosphatidic acid. In this process, choline is released, which then enters circulation.
Absorption from food - Once you eat choline-rich foods, different forms of choline enter the small intestine and then choline gets stored in the liver. The liver then passes on the choline to the bloodstream and this reaches all the cell membranes.
While this would be enough to match bare requirements, you will need to match up with the right foods to get your complete recommended levels of choline.
How Genes Influence Choline Needs
The PEMT gene is responsible for making phosphatidylcholine in the body. Phosphatidylcholine is eventually converted into choline. Extreme cases of choline deficiency can lead to liver damage. For some individuals, variations in the PEMT gene can result in an increased risk of liver damage, obesity, and abdominal fat build-up.
The C allele of the rs12325817 SNP causes increased risk of liver problems when you consume inadequate amounts of choline.
The C allele of the rs7946 SNP increases PEMT activity in the body. This leads to excess choline production and increased risks of obesity. The T allele however results in normal PEMT activity and normal choline levels. The risk of obesity is also low.
The MTHFD1 gene helps in activating folic acid into forms usable by the body. Certain variations in the MTHFD1 gene affects the choline levels in the body too.
The A allele of the rs2236335 SNP causes folate deficiencies. When your choline intake is also low, you can develop serious signs of choline deficiency like fatty liver. The G allele however does not cause folate deficiencies. The body is able to handle a low-choline diet better without resulting in extreme symptoms.
Non-genetic Factors Affecting Choline Levels
Pregnancy and lactation - About 95% of pregnant and lactating women consume less choline than what’s needed. Women who do not consume folic acid supplements during pregnancy are at a greater risk for choline deficiency. Talk to your gynecologist to know if you should change your diet pattern during pregnancy.
Menopause - Estrogen is an important hormone that helps produce choline internally in the body. During menopause, estrogen levels come down and so do choline levels.
Alcoholics - Alcoholics have higher needs for choline. When they do not have a healthy diet regime, the chances of them developing choline deficiency is very high.
Athletes and high endurance trainers - If you are physically very active, regular workouts and training sessions can cause a fall in the choline levels. Supplements can help stabilize the levels
Symptoms Of Choline Deficiency
Since choline is also produced internally in the body, choline deficiency is rare. However, it does happen in the below categories of individuals.
- Pregnant women
- People with genetic polymorphisms that prevent absorption of choline
- Individuals who are intravenously fed
People with choline deficiency develop Nonalcoholic Fatty Liver Disease (NAFLD). This condition usually resolves when the person is supplemented with choline. Here are some of the conditions associated with NAFLD.
- Insulin resistance
- Increased risks of liver damage, liver cancer and liver cirrhosis
Recommendations For Healthy Choline Levels
- For healthy adults, it is better to meet your nutritional requirements with only food sources. Make sure you include unprocessed meat, grains, egg yolk, and dairy products adequately to maintain your choline levels.
- Get your genetic testing done to see if you will need excess choline to stay healthy.
- If you are at a risk for choline deficiency because of genetic or non-genetic reasons, then do consider supplements and choline fortified foods.
- If you are pregnant or lactating, talk to your doctor about matching your increased needs for choline.
- Choline is an essential nutrient that is not given the importance it deserves.
- Though choline deficiency is considered rare, a lot of people don’t get enough choline from the foods they eat.
- Changes in certain genes can make few people require more choline than others.
- Unless you have extreme choline deficiency or require more choline than recommended amounts, you do not have to worry about choline supplements. Including choline-rich foods is enough.
- For people struggling with extreme side effects of choline, supplements can help.