by Catherine M. Haug, January 2011; updated 4/12/19 (image, right, from Wikimedia Commons)
Dietary choline is very important, even though the body can make some toward meeting our daily requirements. A constituent of lecithin, choline is:
- important for the structure of cell membranes, as precursor for acetylcholine (a neurotransmitter), and many more functions.
- essential for proper liver function. It is well established that a diet deficient in choline results in fat accumulation of fat (triglycerides) in the liver, a condition known as “fatty liver.”
One of the most common dietary sources is eggs (especially the lecithin in the yolks), as pictured above, but is also abundant in many seeds including soy and sunflower. However, it’s important that the soy be sprouted to avoid toxic substances in the seed, and that the soy be non-GMO. See USDA article (2) for extensive list of choline-containing foods, and amounts; a much smaller version is provided in a chart, below.
- Includes:1. Choline and the liver; 2. Minimum daily requirement; 3. Choline in foods, including 3b. Whole milk and 3c. Butter
- See also: 1. Diet & Health Menu; 2.
Choline and the liver
One of the liver’s functions is to package up fatty acids (primarily made from excess glucose in the blood) into triglycerides and then into VLDL cholesterol particles for transport in the blood to fat tissue (adipose) for storage. A critical component of VLDL is phosphatidyl choline, which is made in the liver from choline. If there is a deficiency in choline (or its precursor, methionine), the fats remain in the liver as fatty liver deposits (4B), rather than being shipped out in VLDL particles or excreted via bile and digestive waste.
(Note: NAFLD or non-alcoholic fatty liver disease happens when fatty liver deposits are at a level harmful for the liver. Fatty liver disease caused by too much regular consumption of alcohol – alcoholism – is also harmful to the liver, but the cure involves giving up alcohol consumption and sufficient choline.)
Increased dietary protein, especially that containing methionine (a sulfur-containing amino acid predominantly from animal sources), and increased dietary choline can all protect against fatty liver and the resulting inflammatory damage to the liver that eventually leads to increased liver enzymes in the blood, similar to that caused by excess alcohol intake. (4C)
One thing is becoming clear to me: excess dietary fat and/or sugar and starch can lead to the production of triglycerides in the liver. If there is sufficient choline and methionine in the diet, those triglycerides are exported from the liver to the adipose tissue. If there is insufficient choline and methionine, the triglycerides remain in the liver and can lead to dangerous inflammation of the liver, if there is also excess dietary polyunsaturated fats (PUFA), especially Omega-6 PUFA such as that from corn and soy oils (4C).
So in addition to needing sufficient choline and methionine, we also need to minimize excess carbs and polyunsaturated oils such as corn, soy and canola if we want to minimize stored fat (both in adipose and in liver tissue). That is, unless the excess fatty acids are excreted with bile in the stool, rather than conversion to triglycerides.
Minimum daily requirement of choline
FDA recommendations (AI) for daily dietary choline are: 425 mg for women, and 550 mg for men.
But many believe these recommendations are too low. The tolerable upper limit of daily choline intake is 3500 mg. Amounts in excess of this can result in runny stool, low blood pressure, and fishy body odor. (Source “9” is lost).
According to Chris Masterjohn (4A), one of the reasons it is difficult to pin down the minimum daily requirement of choline is because that minimum depends on the dietary intake of certain other nutrients involved in the methylation cycle (part of the liver’s detox and protein synthesis pathways); namely folate, B12, B6 and betaine intake.
As Chris so aptly points out (4A), the metabolism of choline (and choline’s role in liver metabolism) is very complex. Methionine, which can be made from choline via betaine for use in the methylation cycle, is also used by the liver to make choline. The critical enzyme here is PEMT (phosphatidylethanolamine-N-methyltransferase), The making of PEMT is controlled by a specific gene; “The presence of at least one defective copy of this gene is extremely prevalent in the population, and it dramatically raises our chances of developing fatty liver on a low-choline diet.” (4B)
Choline in foods.
Note that the amounts of food listed are not necessarily a single serving. For example, it is highly unlikely that one would eat 3 cups of cooked brown rice in a single meal. (Chart from Wikipedia (1). See also the following for more detail/longer lists of foods:
- USDA Database for Choline Content in Common Foods (2);
- Chris Masterjohn’s Choline Database (new 4/17/19) (4D); includes instructions on how to use the database.
By far, the richest source of choline is organ meets (liver, heart, etc.). The most common supplemental form of choline is as a component of soy lecithin, but I prefer sunflower lecithin because sunflower seeds are not as toxic as soy, and have not yet been altered by GMO.
It is well known that raw, whole milk contains more choline than heat-treated milk such as pasteurized milk with 1% fat listed in chart above: 173 mg choline in 1 quart (equates to 43 mg in an 8-oz glass). But I’ve not been able to find out just how much more, primarily because our government frowns on the consumption of raw milk for “sanitary” reasons.
Pasteurized whole (3.25% fat) milk contains 14.2 mg per 100 gram (3.5 oz) serving (2); this is equivalent to 32 mg choline in 1 cup of whole pasteurized milk.
According to 1944 data from Pet Milk company (5), “fresh” milk provides 131-169 mg choline per liter of milk. This is equivalent to 31 – 40 mg choline per cup of fresh milk. (“Fresh” is the old term for “raw” milk).
Salted butter contains 18.8 mg choline per 100 grams (2), which equates to 5.3 mg choline per ounce or 2.7 mg choline per Tablespoon salted butter.
- Wikipedia on choline: en.wikipedia.org/wiki/Choline
- USDA Database for Choline Content in Common Foods; Original link no longer valid. Try this pdf instead: ars.usda.gov/ARSUserFiles/80400525/Data/Choline/Choln02.pdf
- WHFoods: choline: whfoods.com/genpage.php?tname=nutrient&dbid=50
- Chris Masterjohn:
- (4) on dietary choline: blog.cholesterol-and-health.com/2010/12/meeting-choline-requirement-eggs-organs.html
- (5) on choline deficiency and fatty liver: blog.cholesterol-and-health.com/2010/11/does-choline-deficiency-contribute-to.html
- (6) on choline and fatty liver: blog.cholesterol-and-health.com/2010/11/sweet-truth-about-liver-and-egg-yolks.html
- Choline Database: chrismasterjohnphd.com/2019/04/17/the-choline-database/
- (7) Choline in fresh milk (1944): jn.nutrition.org/content/29/2/137.full.pdf