Choline is important for liver metabolism
Choline is a nutrient that was first found about 150 years ago in the bile. It is very important as it helps to make the cell membranes and also plays a part in liver fat metabolism. It is involved in making a molecule called acetylcholine which is found in brain and muscles as a neurotransmitter.
Everybody is thinking these days about sustainability as well as improving their health. We have all heard about the benefits of a vegetarian diet which seem to be undoubtedly true. Reducing the amount of meat and fish intake is associated with longer life spans. A major reason for this is probably due to eating less saturated fat with associated decrease in risk of heart disease and inflammatory conditions.
We used to think that the body could make its own choline and unlike vitamins there is no known choline deficiency disease.
About 30 years ago the first suggestion that maybe we could not make enough choline came about. Volunteers were given diets almost completely deficient in choline or with extra-choline added. Those who were deficient in choline started accumulating fat in their livers and as soon as they switched to the choline enriched diet the livers got better.
It turns out that choline is produced in high quantities in breast milk and in the placenta. It is therefore clearly important for babies; it may well be important for adults as well as we do not appear to make enough in our own bodies.
Sources of choline
The main source of choline is red meat and eggs. It is also made in fatty fish like salmon. As far as vegetarian sources are concerned it is found in quite small amounts in almonds, broccoli, baked beans and in very tiny amounts in white rice. The problem with a vegetarian diet is it is almost impossible to eat enough choline to meet the recommended daily intake or 500 mg a day for men and 425 mg a day for women.
Choline in multi-vitamin tablets
It would be nice to be able to get a multi-vitamin that has enough choline in it. To get the entire daily dose would require a very large tablet so one would need to take two or three smaller tablets to get the total dose that is needed.
Choline and fatty liver
There is an intriguing question as to whether choline deficiency may be part of the reason we are seeing a rise in fatty liver syndrome these days. It is certainly not proven but it is an interesting hypothesis. There is also a question as to whether choline supplements might reduce the risk of getting dementia but again more work is needed. It is certainly an area to watch however.
Should I be taking choline supplements?
Most vitamin supplements are probably of no use and some of them may be positively dangerous. Mega doses of vitamin C can cause kidney stones. Taking too much calcium can increase the risk of heart disease. No-one yet knows whether taking choline supplements will turn out to be a good or a bad thing, but it is certainly an area to keep watching.
So what should I do now?
Nutrition is complex. There is no single answer that fits everyone. If you would like to discuss your nutritional issues with one of our Gastroenterologists or Dietitians please feel free to make an appointment.
Please note that our primary focus is dealing with people who are ill not giving general nutritional advice.