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Choline

choline-containing foods Choline is not a vitamin or a mineral, but it is an essential nutrient. Although the body can create choline in small amounts, it cannot make enough to maintain health. Choline must be consumed in the diet.

Choline is a component of acetylcholine, a neurotransmitter that is involved in functions such as muscle movement, and memory formation.

Most of the body's choline is found in phospholipids, which are fat molecules. The most common of these is phosphatidylcholine, better known as lecithin.

Functions

Choline's functions include:

Helping to maintain the structure of the cell membrane
Aiding in the transmission of nerve impulses
Playing a role in the conversion of homocysteine to methionine—elevated levels of homocysteine have been associated with a higher risk of cardiovascular disease
Helping to transport fat and cholesterol out of the liver

Dietary Intake

Age group	Adequate intake (milligrams)
Age group	Females	Males
0-6 months	125 mg	125 mg
7-12 months	150 mg	150 mg
1-3 years	200 mg	200 mg
4-8 years	250 mg	250 mg
9-13 years	375 mg	375 mg
14-18 years	400 mg	550 mg
19 and older	425 mg	550 mg
Pregnant, all ages	450 mg	n/a
Lactating, all ages	550 mg	n/a

Choline Deficiency TOP

Although the body can make choline, it cannot make enough to maintain proper health and functioning. Therefore, it is possible for your choline levels to become too low if your diet does not contain enough. Because choline is essential for the transport of fat from the liver, deficiency symptoms include:

Fatty accumulation in the liver
Liver damage

Choline Toxicity TOP

The tolerable upper intake level (UL) for choline from dietary sources and supplements combined is:

Age group	Upper intake (milligrams)
Age group	Females	Males
0-6 months	Undetermined	Undetermined
7-12 months	Undetermined	Undetermined
1-3 years	1000 mg	1000 mg
4-8 years	1000 mg	1000 mg
9-13 years	2000 mg	2000 mg
14-18 years	3000 mg	3000 mg
19 and older	3500 mg	3500 mg

Symptoms of choline toxicity include:

Fishy body odor
Vomiting
Increased salivation
Increased sweating
Lightheadedness

Major Food Sources TOP

Very little information is available on the choline content of foods; however, some good sources of choline include:

Beef liver
Wheat germ
Egg
Atlantic cod
Brussels sprouts
Broccoli
Shrimp
Salmon
Milk
Peanut butter
Milk chocolate

Health Implications TOP

Populations at Risk for Choline Deficiency

The following populations may be at risk for a choline deficiency and may benefit from a supplement:

Strict vegetarians—A choline deficiency may result if you do not eat animal products, including milk or eggs.
Endurance athletes—Studies have shown that some choline may be lost during intense training.

Choline and Alzheimer's Disease

Because choline is a precursor to the neurotransmitter acetylcholine, which is important in learning and memory, it has been studied for a possible role in Alzheimer's disease. Studies have been conducted, but a review of clinical trials found no benefit of supplementation with lecithin in the treatment of people with dementia.

Tips for Increasing Your Choline Intake TOP

To help increase your intake of choline:

At breakfast, spread a little peanut butter on your bagel or toast in place of butter or cream cheese.
Hard boil an egg and grate it onto a salad at lunchtime.
For dinner, drink a glass of milk instead of soda.
Try sprinkling granular lecithin on top of your cereal, oatmeal, salad, or stir-fry. Just a few teaspoons is all you need.
If you are taking a multivitamin/mineral supplement, make sure that it contains choline or lecithin.

RESOURCES:

American Society for Nutrition
http://www.nutrition.org

Eat Right—Academy of Nutrition and Dietetics
http://www.eatright.org

CANADIAN RESOURCES:

Dietitians of Canada
http://www.dietitians.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

Choline. Linus Pauling Institute at Oregon State University website. Available at:
...(Click grey area to select URL)
Updated January 2015. Accessed June 23, 2016.

Dietary reference intakes: vitamins. Institute of Medicine website. Available at:
...(Click grey area to select URL)
Accessed June 23, 2016.

Higgins JP, Flicker L. Lecithin for dementia and cognitive impairment. Cochrane Database Syst Rev. 2003;(3):CD001015.

Ralf J, Purpura M, Kingsley M. Phospholipids and sports performance. J Int Soc Sports Nutr. 2007;4:5.

Zeisel SH. Choline: needed for normal development of memory. J Am Coll Nutr. 2000;19(5 Suppl):528S-531S.

Last reviewed June 2016 by Michael Woods, MD
Last Updated: 6/23/2016

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