Choline was once considered Vitamin B4, though it lost that status when it was discovered that our liver makes some choline and thus we do not need to get all of our choline from food.

However, choline has been recognized as an essential nutrient by the Institute of Medicine since 1998, because our endogenous choline is not usually enough to meet our body's needs.

Some forms of choline are fat-soluble, meaning that they are absorbed with and stored in fat, while others are water-soluble. Choline's dietary forms tend to be of the fat-soluble variety.

Choline is used by the body to synthesize phosopholipids that are necessary for creating cell membranes, as well as to create acetylcholine, a neurotransmitter essential for proper muscle function, learning and memory, motivation, arousal, attention, regulation of REM sleep cycles, and regulating the endocrine system.

Choline also plays a part in gene expression, fat metabolism, early brain development, DNA synthesis, and cell membrane signaling.

Though animal-based foods like eggs, beef, chicken, dairy products, and fish are your prime sources of choline, smaller amounts are found in vegan foods like cruciferous vegetables, soybeans, nuts, seeds, and whole grains.

You can also get your choline from a common food additive called "lecithin," but since lecithin tends to come with other spookier ingredients and in highly processed foods, this may not be your best bet.

Additionally, choline is found in some, but not all, multivitamins and supplement blends, as well as in breast milk and most baby formulas.

Most people actually consume less than the recommended AI (adequate intake) of choline, but this is still not enough to cause a clinical deficiency; these are actually quite rare in most healthy individuals.

One exception to this rule is athletes, who may deplete their body's choline stores with frequent intense exercise. High alcohol intake also seems to increase choline requirements, as do deficiencies of other nutrients like folate, since choline will take on the roles of the missing nutrient as well as its usual tasks.

Since pregnant women need more choline than usual, they may also need to be more aware of their choline intake. Low choline levels during pregnancy have been tentatively associated with an increased risk of neural tube defects, lifelong memory deficits and other cognitive defects in the baby.

Low choline levels have also been associated with other pregnancy complications like preeclampsia, premature birth and low birth weight, while higher choline intake during mothers' pregnancies was associated with better memory in their children.

Choline defiency may also increase the risk of liver disease in those receiving parenteral nutrition (those who must be fed intravenously), leading experts suggest that the nutrient should be included in parenteral nutrition formulas.

One last group of people who may be at risk for a choline deficiency is menopausal women. Since estrogen increases production of choline and the estrogen levels of these women tends to drop, they may need to get more choline from their diet.

This is especially worrisome given the severity of damaged that could result from defiency. Menopausal women with lower choline intakes suffer from a greater risk of non-alcoholic liver disease, and another study of normal weight Chinese women revealed similar results.

Additionally, one small study found that 77% of men, 80% of postmenopausal women and 44% of premenopausal women experienced liver and/or muscle damage after going on a choline-deficient diet.

However, these symptoms disappeared as soon as they began getting enough choline, and supplementing with estrogen has also been found to decrease the risk of choline deficiency in postmenopausal women.

To make sure your choline intake is on track, check out this handy-dandy list of adequate intakes for people of different ages, genders, and maternity conditions.

  • 0–6 months: 125 mg per day
  • 7–12 months: 150 mg per day
  • 1–3 years: 200 mg per day
  • 4–8 years: 250 mg per day
  • 9–13 years: 375 mg per day
  • 14–19 years: 400 mg per day for women and 550 mg per day for men
  • Adult women: 425 mg per day
  • Adult men: 550 mg per day
  • Breastfeeding women: 550 mg per day
  • Pregnant women: 450 mg per day
Then do a little calculation using this list of some popular choline-rich foods! (Note that not all of these foods are appropriate for the 123Diet)

Egg, hard boiled

Serving Size: 1 large egg

Choline Content: 147 mg

Beef top round, separable lean only, braised

Serving Size: 3 ounces

Choline Content: 117 mg

Soybeans, roasted

Serving Size: ½ cup

Choline Content: 107 mg

Chicken breast, roasted

Serving Size: 3 ounces

Choline Content: 72 mg

Beef, ground, 93% lean meat, broiled

Serving Size: 3 ounces

Choline Content: 72 mg

Fish, cod, Atlantic, cooked, dry heat

Serving Size: 3 ounces

Choline Content: 71 mg

Mushrooms, shiitake, cooked

Serving Size: ½ cup pieces

Choline Content: 58 mg

Potatoes, red, baked, flesh and skin

Serving Size: 1 large potato

Choline Content: 57 mg

Wheat germ, toasted

Serving Size:  1 ounce

Choline Content: 51 mg

Beans, kidney, canned

Serving Size:  ½ cup

Choline Content: 45

Quinoa, cooked

Serving Size: 1 cup

Choline Content: 43 mg

Milk, 1% fat

Serving Size: 1 cup

Choline Content: 43 mg

Yogurt, vanilla, nonfat

Serving Size: 1 cup

Choline Content: 38 mg

Brussels sprouts, boiled

Serving Size: ½ cup

Choline Content: 32 mg

Broccoli, chopped, boiled, drained

Serving Size: ½ cup

Choline Content: 31 mg

Cottage cheese, nonfat

Serving Size: 1 cup

Choline Content: 26 mg

Fish, tuna, white, canned in water, drained in solids

Serving Size: 3 ounces

Choline Content: 25 mg

Peanuts, dry roasted

Serving Size: ¼ cup

Choline Content: 24 mg

Cauliflower, 1” pieces, boiled, drained

Serving Size: ½ cup

Choline Content: 24 mg

Peas, green, boiled

Serving Size: ½ cup

Choline Content: 24 mg

Sunflower seeds, oil roasted

Serving Size: ¼ cup

Choline Content: 19 mg

Rice, brown, long-grain, cooked

Serving Size:  1 cup

Choline Content: 19 mg

Bread, pita, whole wheat

Serving Size: 1 large (6½ inch diameter)

Choline Content: 17 mg

Cabbage, boiled

Serving Size: ½ cup

Choline Content: 15 mg

Tangerine (mandarin orange), sections

Serving Size: ½ cup

Choline Content: 10 mg

Beans, snap, raw

Serving Size: ½ cup

Choline Content: 8 mg

Kiwifruit, raw

Serving Size: ½ cup sliced

Choline Content: 7 mg

Carrots, raw, chopped

Serving Size: ½ cup

Choline Content: 6 mg

Apples, raw, with skin, quartered or chopped,

Serving Size: ½ cup

Choline Content: 2 mg

Of course, too much choline also has its downsides—among them, fishy body odor, vomiting, excessive sweating and salivation, hypotension, and liver toxicity. It can also raise your risk of heart disease by increasing your concentration of a harmful metabolite called TMAO.

While you're unlikely to reach these upper limits if you stick to high-choline foods, it may be quite possible to get there if you overdo it with the supplements.

Meanwhile, TMAO may be one factor in the convoluted link between choline intake in heart disease. Higher consumption of certain forms of choline are associated with a higher risk of heart disease.

Yet another found that higher choline intake was not associated with the risk of heart disease, but it did seem to lead to lower mortality from heart disease, perhaps by reducing inflammation and other cardiace risk factors. Other studies found no significant association between choline and heart disease at all!

Choline may also do quite a lot for your brain! It has been found to protect against memory deficits in aging rats and to improved visuomotor performance in humans.

In groups of elderly non-dementia patients, higher choline levels were associated with better cognitive performance, while another associated lower choline levels with worse performance. Choline supplementation also improved verbal memory in aging patients suffering from mild cognitive decline.

On the mental health side, low choline levels have been tentatively linked to anxiety, while depression was actually linked with increased choline concentrations in certain brain areas. Choline has also been seen to reduce the symptoms of bipolar disorder in a cohort of rapid-cycling patients.

Choline has also been hypothesized as potentially reducing the symptoms of neurological disorders like tardive dyskinesia, Huntington chorea, Tourette's syndrome, and Friedreich ataxia has been hypothesized.

Higher consumption of choline has also been associated with a lower risk of breast cancer in women, and test tube studies suggest that it may fight cancer.

Choline treatment may also lead to improvement in glaucoma patients or slow their disease's progression, as well as reduce the symptoms of ischaemic optic neuropathy.

Choline has also been found to improve lung function in cystic fibrosis patients, and to lead to lower stroke risk in African-American patients.

Finally, a study done on young female athletes trying to slim down to make it into their desired weight class in taekwondo or judo found that the girls who received choline supplementation lost more weight.

It's unknown whether this benefit would translate to non-athletes or dieters of different ages than genders, but it's a good incentive to keep choline in mind!

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