Choline: An Essential Nutrient for Public Health that we’re not getting enough of in our diet

[David PS]

We were discussing choline at page 4 of another thread and we thought it was worthy of its own thread.

According to the National Institutes of HealthTrusted Source, choline is an essential nutrient found in many foods. The brain and nervous system use it to regulate functions that include memory, mood, and muscle control. Choline is also needed to form the membranes that surround your body’s cells.

Although the body produces some choline in the liver, most of the choline we need comes from the food we eat. For some people with genetic snips that prevent them from making their own choline, all of the choline in the body comes from the diet.

source

source

The source for the requirements in the chart can be found in the free version of Chapter 12 at
Choline - Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline - NCBI Bookshelf

With such a widespread deficiency and with all of the dietary confusion, are you feeling lucky?

“Because of its wide-ranging roles in human metabolism, from cell structure to neurotransmitter synthesis, choline-deficiency is now thought to have an impact on diseases such as liver disease, atherosclerosis and possibly neurological disorders. Choline is found in a wide variety of foods. Egg yolks are the most concentrated source of choline in the American diet, providing 680 milligrams per 100 grams. “

Choline: An Essential Nutrient for Public Health

The Adequate Intake (AI) is a calculated “target value” to achieve for optimal health. The Tolerable Upper Intake Level (UL) is the value a healthy individual should not exceed. As you can see in this table, the spread between AI and UL for choline. The AI is only 22.2% of the UL and so there appears to be a large safety margin. The body seems to be very forgiving. It is as though choline is so important that it will tolerate overdoing it for a few days. Theoretically, I could eat 27eggs per day and still be under the UL for my age and sex.

source

My interest in choline is for its long term protection of my brain. The brain shrinkage associated with Alzheimer's may be the result of a long term (meaning lifelong) deficiency of choline and acetylcholine. We have known about the benefits of choline for decades. However, I doubt that studies will ever be conducted.
A Brief History of Choline
Could we be overlooking a potential choline crisis in the United Kingdom? | BMJ Nutrition, Prevention & Health

 

[LLight]

Thanks @David PS

Choline could be useful regarding digestion because the gallbladder muscles seem to be under the control of cholinergic pathways and choline seems useful regarding bile production.

---

The role of dietary choline in the beneficial effects of lecithin on the secretion of biliary lipids in rats - PubMed

Earlier studies showed that dietary soybean lecithin increases biliary lipid secretion, which mainly comes from the contribution of high density lipoprotein (HDL) and hepatic microsomal pools of phosphatidylcholine and cholesterol. In addition, a lecithin diet enhances bile secretion and...

pubmed.ncbi.nlm.nih.gov

Rats were fed either a control diet (CD), a choline diet (ChD) or a lecithin-enriched diet (LD) for 2 weeks. Results showed that like LD, ChD induced an increase in bile flow and bile acid secretion rate when compared with the control diet.

---

Review article: control of gall-bladder motor function - PubMed

Muscular contraction of the gall-bladder is the primary determinant of bile delivery into the duodenum. Where bile goes following its secretion by the liver depends upon a co-ordinated series of pressure interrelations between the hepatic secretory pressure at the entrance to the biliary system...

pubmed.ncbi.nlm.nih.gov

Agonists like cholecystokinin and acetylcholine cause contraction of gall-bladder smooth muscle through signal transduction, which increases intracellular calcium levels and so initiates the contractile machinery. Cholecystokinin also acts on the sphincter of Oddi via pre-ganglionic cholinergic nerves to release vasoactive intestinal polypeptide and nitric oxide, and so lower tone. These events are co-ordinated with motility and secretory events in the upper gastrointestinal tract, delivering bile at appropriate times into the duodenum.

---

Effect of cholinergic agonists and antagonists on gallbladder volume in fasting man - PubMed

The effect of direct cholinergic stimulation and blockade on gallbladder volume, determined by real-time ultrasonography (RUS), was evaluated in twenty normal, fasting subjects. Eleven subjects received atropine sulphate or placebo and 9 subjects a series of 3 injection of prostigmine...

pubmed.ncbi.nlm.nih.gov

It is suggested that cholinergic mediation is involved in maintaining fasting tone in the gallbladder and that cholinergic stimulation causes contraction of the gallbladder by a direct effect.

 

[LLight]

If you have dry eyes (or retina issues), choline could be useful.

Role of Choline in Ocular Diseases

Choline is essential for maintaining the structure and function of cells in humans. Choline plays an important role in eye health and disease. It is a precursor of acetylcholine, a neurotransmitter of the parasympathetic nervous system, and it is involved ...

www.ncbi.nlm.nih.gov

Choline is essential for maintaining the structure and function of cells in humans. Choline plays an important role in eye health and disease. It is a precursor of acetylcholine, a neurotransmitter of the parasympathetic nervous system, and it is involved in the production and secretion of tears by the lacrimal glands. It also contributes to the stability of the cells and tears on the ocular surface and is involved in retinal development and differentiation. Choline deficiency is associated with retinal hemorrhage, glaucoma, and dry eye syndrome. Choline supplementation may be effective for treating these diseases.

 

[Spartan300]

I'm curious on this. For a number of years after exercising for decades I have lost most of my capacity to tolerate exercise and recover.
Around the same time this decline started I have also had to start treatment for high intra-ocular pressure, the precursor to glaucoma.

Are there any reasonable supplement options as consuming more than a half dozen eggs a day isn't always practical?

 

[LLight]

I'm curious on this. For a number of years after exercising for decades I have lost most of my capacity to tolerate exercise and recover.
Around the same time this decline started I have also had to start treatment for high intra-ocular pressure, the precursor to glaucoma.

Are there any reasonable supplement options as consuming more than a half dozen eggs a day isn't always practical?

Not sure it really answers your question but eating foods high in betaine (aka Trimethylglycine or TMG) might lower the need for choline.

 

[David PS]

Common genetic polymorphisms affect the human requirement for the nutrient choline (2006)​

Figure 2.Study design. Healthy men and women were fed abaseline diet containing the choline Adequate Intake concen-tration for 10 days. They were then switched to a low choline diet (<50 mg choline) until they developed signs of organdysfunction associated with choline deficiency or for up to 42 days. Subjects who developed signs of organ dysfunction wererepleted with graded amounts of choline at 10 day intervals until their symptoms disappeared; those without signs of organ dysfunction were fed the 100% choline diet for at least 3 days before being discharged from the study.

Some subjects were given a folic acid supplement (400 g per day) during the depletion and repletion phases, but this did not affect their susceptibility to choline deficiency (from da Costa et al.,Am J. Clin. Nutr., in press).

 

[David PS]

Are there any reasonable supplement options as consuming more than a half dozen eggs a day isn't always practical?

I am focused on getting my choline from food sources.

https://www.researchgate.net/profile/Steven-Zeisel/publication/15251760_Choline_and_Human_Nutrition/links/00463522603a36807a000000/Choline-and-Human-Nutrition.pdf

This table suggests that eggs and liver may be the best way to rack up the choline in the diet. Directly supplementing with Phosphatidycholine is another option. I do not know if that is considered to be a reasonable option.

Incidently, old-time bodybuilders consumed large quantitied of eggs. Watch Rocky demonstrate a practical method to quickly incorporate eggs into the diet in this video clip.

 

[Blossom]

Great thread, thank you so much!

 

[David PS]

Not sure it really answers your question but eating foods high in betaine (aka Trimethylglycine or TMG) might lower the need for choline.

I agree. In addition, betaine supplements may help with fatty liver.

Betaine for Nonalcoholic Fatty Liver Disease: Results of a Randomized Placebo-Controlled Trial

 

[David PS]

Great thread, thank you so much!

You are welcome. It is nice to see your face.

 

[Peatness]

I posted these on the head injury thread recently

Choline May Help Improve Cognitive Function Following Brain Injury – Neurologic Rehabilitation Institute

Choline - Nutrition and Traumatic Brain Injury - NCBI Bookshelf

A timely thread thanks @David PS

 

[Vanset]

I'm curious on this. For a number of years after exercising for decades I have lost most of my capacity to tolerate exercise and recover.
Around the same time this decline started I have also had to start treatment for high intra-ocular pressure, the precursor to glaucoma.

Are there any reasonable supplement options as consuming more than a half dozen eggs a day isn't always practical?

Eating a few eggs a day or even a few dozen is not going to help you with this, don't get your hopes up.

 

[David PS]

I posted these on the head injury thread recently

Choline May Help Improve Cognitive Function Following Brain Injury – Neurologic Rehabilitation Institute

Choline - Nutrition and Traumatic Brain Injury - NCBI Bookshelf

A timely thread thanks @David PS

Thanks I did not know about cholines role in brain repair. The eye is considered to be nuerologically part of the brain. So it could help with eye issues as well.

source

 

[Ismail]

Wow this is amazing! Thank you for such a great thread.

I remember I used to get acne type breaks on my scalp, I’m assuming it was due to low choline and/or NAFLD.

Once I started taking choline bitartrate (stopped now as apparently it increase TMAO levels etc.) my scalp cleared up, and so did my skin!

Wish I could continue taking choline bitartrate

It’s not easy to get enough choline through diet everyday.

How can one test for these genetic polymorphisms to do with choline?

Thank you again, will read through these studies more thoroughly once I get a moment.

 

[Peatness]

I'm curious on this. For a number of years after exercising for decades I have lost most of my capacity to tolerate exercise and recover.
Around the same time this decline started I have also had to start treatment for high intra-ocular pressure, the precursor to glaucoma.

Are there any reasonable supplement options as consuming more than a half dozen eggs a day isn't always practical?

Have you seen these threads?

Glaucoma likely a metabolic disease, treatable by pyruvate and/or niacinamide

About a year ago, a publication came out that demonstrated therapeutic effects of raising the (mitochondrial) NAD/NADH ratio in glaucoma patients. That study used niacinamide (NAM) and suggested that the "irreversible" changes in eye structure seen in glaucoma patients are in fact nothing more...

raypeatforum.com

Vitamin B3 (Niacinamide) Shows Promise For Glaucoma Patients In Clinical Trial

"Results of the trial, led by Professor Jonathan Crowston and Dr. Flora Hui at the Center for Eye Research Australia, are published today in Clinical and Experimental Ophthalmology. They show "significant improvement" in the visual function of glaucoma patients who received a daily high dose of...

raypeatforum.com

Niacinamide + pyruvate may treat glaucoma (human study)

Some excellent results from a human clinical trial. Namely, a combination of 3g niacinamide and 3g (calcium) pyruvate daily demonstrated significant therapeutic effect in patients with already established glaucoma. I can't access to actual study link on JAMA, but I suspect the mechanism of...

raypeatforum.com

From old notes - sorry I don't have references but they are filed under ray peat

Because of their stress-like effects, coffee and tobacco should be avoided in glaucoma. The nutrients that are especially involved in the adrenal stress reaction should be used: ascorbic acid, pantothenic acid, riboflavin, vitamin A, magnesium, and vitamin E.

Progesterone (natural form) is a diuretic and also is a precursor for the anti-stress hormones, and sometimes helps glaucoma. The nutrients mentioned above promote its synthesis. Estrogen blocks its actions, so it would seem desirable to "avoid estrogen, and to use the nutrients which oppose estrogen. The eye itself has especially high requirements for vitamins A, B2, and niacin, and coenzyme Q.

Salt and water metabolism involve vitamins B6, pan-tothenic acid, A, C, E, and niacin (see R.J. Kutsky, Handbook of Vitamins and Hormones, p. 263), and various minerals (other than sodium) including magnesium, potassium and zinc. Because of the role of carbon dioxide in circulation, vitamins B1, B6, and biotin, and zinc, should also be con-sidered. Choline is now known to stimulate acetylcholine synthesis, and so might help to promote a normal parasympathetic innervation.

 

[Peatness]

Thanks I did not know about cholines role in brain repair. The eye is considered to be nuerologically part of the brain. So it could help with eye issues as well.

View attachment 40021source

Thanks.

This thread is useful

Incomprehensive/ble Notes On Choline

..and why avoiding eggs due to a couple grams of PUFAs might not be a good idea. They're not the only source, but are by far the best since livers aren't ideal for regular consumption. Finding pastured eggs locally and online - Toxinless These were all over of the places. I figured it could be...

raypeatforum.com

USDA Database for the Choline Content of Common Foods Release Two

 

[redsun]

I'm curious on this. For a number of years after exercising for decades I have lost most of my capacity to tolerate exercise and recover.
Around the same time this decline started I have also had to start treatment for high intra-ocular pressure, the precursor to glaucoma.

Are there any reasonable supplement options as consuming more than a half dozen eggs a day isn't always practical?

Eating half a dozen eggs is actually the most practical way to do this. Supplements are not as useful and will not be as helpful for recovery since they lack the nutrients in eggs. You dont necessarily need a ton of eggs. 3 to 4 may be enough but this would need to be with at least a half pound of meat or more to add to your choline intake. Milk, yogurt also have a little which can add up with a few servings a day.

Your tolerance to exercise will improve pretty quickly once your choline intake goes up again. Lack of choline will lead to very poor tolerance to exercise since acetylcholine is required for contractions of your muscles. You will be physically weak and also lack endurance.

Eating a few eggs a day or even a few dozen is not going to help you with this, don't get your hopes up.

Way to be a debbie downer. If his choline intake has been low for a long time due to lack of eggs and also lack of meat which are the major sources of choline in most people's diet then it absolutely will. Even if you ate a ton of meat, with no eggs in the diet you would struggle to reach the minimum. The important of choline for exercise cannot be overstated. This is especially an issue with men since we have less estrogen to induce PEMT as effectively as women. And if you are also european you likely have genetic mutations which further reduce PEMTs effectiveness to produce choline. Men, especially european men, are much more dependent on dietary choline to maintain choline levels in the body. And if they don't deliberately obtain more choline with the right foods, eggs being the most convenient and effective way, they get plagued with liver, organ dysfunction, cognitive dysfunction, low muscle tone and overall muscle weakness.

 

[Vanset]

Eating half a dozen eggs is actually the most practical way to do this. Supplements are not as useful and will not be as helpful for recovery since they lack the nutrients in eggs. You dont necessarily need a ton of eggs. 3 to 4 may be enough but this would need to be with at least a half pound of meat or more to add to your choline intake. Milk, yogurt also have a little which can add up with a few servings a day.

Your tolerance to exercise will improve pretty quickly once your choline intake goes up again. Lack of choline will lead to very poor tolerance to exercise since acetylcholine is required for contractions of your muscles. You will be physically weak and also lack endurance.


Way to be a debbie downer. If his choline intake has been low for a long time due to lack of eggs and also lack of meat which are the major sources of choline in most people's diet then it absolutely will. Even if you ate a ton of meat, with no eggs in the diet you would struggle to reach the minimum. The important of choline for exercise cannot be overstated. This is especially an issue with men since we have less estrogen to induce PEMT as effectively as women. And if you are also european you likely have genetic mutations which further reduce PEMTs effectiveness to produce choline. Men, especially european men, are much more dependent on dietary choline to maintain choline levels in the body. And if they don't deliberately obtain more choline with the right foods, eggs being the most convenient and effective way, they get plagued with liver, organ dysfunction, cognitive dysfunction, low muscle tone and overall muscle weakness.

I more or less know the mechanism and I appreciate your response, I simply speak from experience. He is free to experiment and post his results in this thread. Crack ten eggs daily and eat the yolks raw. I highly doubt this is his problem.

 

[David PS]

Your tolerance to exercise will improve pretty quickly once your choline intake goes up again. Lack of choline will lead to very poor tolerance to exercise since acetylcholine is required for contractions of your muscles. You will be physically weak and also lack endurance.

Thanks for your insight. For the record, it is not bro science.
Choline: An Essential Nutrient for Skeletal Muscle

 

[Blossom]

You are welcome. It is nice to see your face.

Thanks, that’s from last night so it’s how I truly look these days.

3 to 4 may be enough but this would need to be with at least a half pound of meat

I can definitely handle that rather than 7 yolks. :)