As a relatively newly understood essential nutrient, choline appears to impact human health in several ways.  Choline plays a role in memory function, in fetal brain development, kidney function and in the prevention of heart disease, fatty liver and neural tube defects, the latter through interactions with other key nutrients such as folate and vitamin B12.

Memory and Cognition

Choline is an essential building block for the memory-forming brain chemical, acetylcholine, which is used in the transmission of impulses between nerves, muscles and organs. In this role, choline and its metabolism are involved in cognition, long- and short-term memory and stimulus responses.

The importance of adequate choline intake during pregnancy and lactation has received special attention, in animal studies, since this is a period when maternal reserves of choline are depleted. During this period, the availability of choline for normal development of the brain is critical.  Prenatal choline deficiency may cause significant alterations to specific memory centers of the brain by reducing cell division, changing cell migration and increasing the number of cells that die prematurely. Other studies in animals suggest that adequate intake of choline during pregnancy and lactation may enhance an offspring’s lifelong cognition and memory.

Studies also show the importance of adequate choline intake during other life stages. It’s been determined that citicoline, a form of the nutrient choline, may be effective in treating elderly patients with cognitive deficits, inefficient memory, and early-stage Alzheimer’s disease. The therapeutic benefit of citicoline administered to stroke patients is also being investigated. A 2006 study conducted in Turkey determined that decreased serum choline concentrations, induced by coronary artery bypass surgery, is inversely associated with elevated levels of circulating cerebral injury markers, indicators of postoperative cognitive decline.

Adequate Intakes of Choline

The Food and Nutrition Board of the Institute of Medicine has established adequate intake levels for choline at 425 mg/day for adult women and 550 mg/day for adult men.  Due to choline’s important role in fetal cognitive development, adequate intake levels for women are increased during pregnancy and lactation to 450 and 550 mg/day, respectively.  

USDA Choline Database

In 2004, the Agricultural Research Service at USDA released a special interest database for the choline content of 434 common foods across 22 food categories. Since multiple choline compounds contribute to total choline concentration (choline, glycerophosphocholine, phosphocholine, phosphatidylcholine and spingomyelin), data are provided for these 5 choline compounds, total choline and betaine.    Betaine, a choline derivative is important because of its role in donating methyl groups to homocysteine to form methionine.   However, betaine is not included in the total choline value because the conversion of choline to betaine is irreversible.  According to the USDA data, the top food sources of choline include meat, nuts and eggs.

To access the Choline Database, go to

USDA Database for the Choline Content of Common Foods – 2004.

High blood homocysteine levels have been shown to increase the risk for heart attack, stroke, dementia and cancer. An epidemiological study, funded in part by the Agricultural Research Service and reported in the April issue of the American Journal of Clinical Nutrition, found that higher intakes of dietary choline and betaine were associated with lower plasma homocysteine concentrations in 1,960 participants in the Framingham Offspring Study. The findings were independent of other plasma homocysteine determinants, including intakes of folate and other B vitamins.

Until now, epidemiologic studies using food-frequency questionnaires (FFQ) relating choline and betaine intake with relevant outcomes have been sparse because of the unavailability of the choline database.  This study verifies the use of the FFQ and the choline database to determine the health effects of dietary choline.

Citation:
Dietary choline and betaine assessed by food-frequency questionnaire in relation to plasma total homocysteine concentration in the Framingham Offspring Study. Cho E, Zeisel SH, Jacques P, Selhub J, Dougherty L, Colditz GA, Willett WC. American Journal of Clinical Nutrition 2006 Apr;83(4):905-11.

To read the abstract, go to

Dietary choline and betaine assessed by food-frequency questionnaire in relation to plasma total homocysteine concentration in the Framingham Offspring Study.

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