Choline: Sources, benefits and deficiency

Choline is a water-soluble compound that is essential for human health. It is neither a vitamin nor a mineral. The body uses choline for a number of important functions, including metabolism and the synthesization of some of the fatty compounds that form cells, according to the National Institutes of Health (NIH).

While there’s still some uncertainty around everything choline does in the body, research indicates that it helps in the production of neurotransmitters involved with memory, as well as modulating DNA. There is also increasing evidence that it is important for early brain development in the womb. 

Choline: Benefits

Choline plays a role in the synthesis of phosphatidylcholine and sphingomyelin — phospholipids that make up a large part of the structure of cell membranes, Dr. Deborah Lee, a medical writer for Dr Fox Online Pharmacy in the U.K., told Live Science. Phospholipids are a type of fatty compound that form part of human cell membranes, controlling what goes in and out of the cell. 

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A 2021 review in the journal Frontier in Physiology found that these phospholipids are linked to lifespan and aging, with a reduction in phospholipids appearing to be a general feature of aging in humans. The review also suggested that different phospholipid molecules are involved in regulating healthspan and lifespan, although more research is needed on their potential mechanisms. 

Choline has other functions in the body. “Choline is also needed for the synthesis of acetylcholine – a major neurotransmitter or chemical messenger,” Lee said. This neurotransmitter is involved in memory, learning, attention and involuntary muscle movement, according to a National Center for Biotechnology Information publication.

A 2023 study in the journal Aging Cell found links between dietary choline deficiency and Alzheimer's disease in mice. The researchers found that those with deficiencies had increased levels of the proteins amyloid-beta and tau ⁠— markers for Alzheimer’s ⁠— and altered hippocampal networks, responsible for learning and memory. The mice with choline deficiency also had liver damage, enlarged hearts, increased body weight and impaired motor functions. However, more research is needed to establish any link between choline and Alzheimer’s disease in humans.

Choline: Sources

Choline is found in a wide variety of foods, said Roxanna Ehsani, a registered dietitian in Florida. 

Some of the best sources of choline include: 

• Beef
• Poultry
• Fish
• Dairy products, such as milk, yogurt and cottage cheese
• Eggs
• Cruciferous vegetables, such as broccoli, cauliflower and cabbage
• Shiitake mushrooms
• Soybeans and kidney beans
• Peanuts and sunflower seeds
• Whole grains, such as quinoa and brown rice

The body does produce a small amount of choline in the liver, Ehsani said, but it's not enough to meet the body’s needs, so dietary sources are needed too.

While supplementing choline is possible, the NIH says that the most commonly available forms of choline in supplements (choline bitartrate, phosphatidylcholine and lecithin) need to be researched in more detail to confirm their effectiveness and safety. Anyone thinking of adding a supplement to their diet should consult a doctor first. 

Choline: Deficiency

Intake recommendations for choline and other nutrients are provided by the Institute of Medicine’s Food and Nutrition Board (FNB). However, there is insufficient data to establish an estimated average requirement for choline, so the FNB instead set adequate intakes (AIs) based on the prevention of liver damage as measured by serum alanine aminostransferase levels. For adults age 19 and older, this is 550 micrograms (mg) per day of choline for men and 425 mg for women, according to the NIH. Pregnant or lactating women require 450 mg and 550 mg, respectively.

A serving of beef contains around 356 mg of choline, while a hard boiled egg contains 147 mg. A serving of broccoli or Brussels sprouts contains 31 mg. 

Choline deficiency can have a negative impact on liver health, a 2013 review in the journal Current Opinion in Clinical Nutrition and Metabolic Care found. The report also suggested that choline requirements vary from person to person due to genetic polymorphisms (a difference in an individual’s DNA sequence) that increase their demand for choline. 

Lee also noted that choline deficiency can lead to health problems. “An inadequate intake of choline results in organ failure with muscle breakdown and non-alcoholic fatty liver disease,” Lee said. “Choline deficiency may also accelerate atherosclerosis, because of its effects on lipoprotein metabolism, and hence exacerbate the risk of cardiovascular disease.” Atherosclerosis is a buildup of plaque on artery walls, which can restrict blood flow to major organs. This arterial plaque consists primarily of fats and cholesterols. 

Research also suggests that choline deficiency can impact fetal brain development. A 2012 prospective study in the journal PLOS One measured choline levels in the blood of women at 16 and 36 weeks of gestation, while infant neurodevelopment was assessed at 18 months of age. Researchers found that there was a positive association between infant cognitive test scores at 18 months and the mothers’ choline levels at 16 weeks of gestation. They concluded that choline status in the first half of pregnancy is associated with cognitive development among healthy term gestation infants. The study suggests more work is needed on the potential limitation of choline in the diets of pregnant women.

This article is for informational purposes only and is not meant to offer medical advice.