Effect & symptoms of a deficiency - all about choline
There are nutrients that cannot be categorised as either vitamins or minerals - yet they are essential for the human organism. Find out here when it is advisable to take choline supplements in capsule form and what role the nutrient plays in weight loss.
What is choline?
Choline is a vital nutrient that is necessary for various functions in the body and has an effect in various processes. It is also thought to have an effect on maintaining the health of various organs and muscles, regulating metabolism and for various brain functions [1].
It belongs to the water-soluble "vitaminoids" and plays an important role in the formation of cell membranes and the transmission of signals between nerve cells. The term vitaminoid is used to describe certain substances that have similar properties to vitamins, but do not correspond to the characteristics of vitamins in the strict sense. This is because vitamins are organic compounds that the body needs in small quantities to maintain metabolic processes, but which it cannot produce in sufficient quantities itself. Vitaminoids, on the other hand, are substances that the human body can produce itself in small quantities, but which still have to be supplied via the diet because the quantities that the body can synthesise itself are not sufficient [1].
Choline is also a precursor of acetylcholine, a neurotransmitter that is responsible for communication between nerve cells in the brain and body. Acetylcholine, in turn, is a precursor of lecithin, a type of fat molecule. Lecithin is found in all animal and plant cells. Therefore, a lack of lecithin carries the risk of affecting the proper functioning of cells and organs, most notably the liver [2].
What is the difference between choline and phosphatidylcholine?
They are related substances, but there are some important differences between them: The main difference is that choline is a single nutrient that has a variety of functions in the body, while phosphatidylcholine is a specific form in which choline is present in combination with other molecules, particularly phosphatidyl groups. Phosphatidylcholine acts as a major component of cell membranes and is also an important component of lipoproteins that transport fats in the body. Phosphatidylcholine can also be taken as capsules or other supplements to increase choline intake, as it is an easily absorbed form of the vitamin oxide.
What is choline good for?
The vitaminoid is important for a variety of vital tasks:
Healthy brain function: It is a building block of acetylcholine, a neurotransmitter that is important for memory, learning and other cognitive functions [3].
Cell membrane integrity: The vitaminoid is a component of phospholipids (lecithin), which are contained in the structure and integrity of cell membranes and exert their effect there [4].
Liver health: It plays a role in the regulation of fat metabolism, supports detoxification functions and thus the health of the organ [5].
Muscle movement: Acetylcholine is a neurotransmitter that controls muscle contraction. It therefore plays a role in muscle movement and function [6].
Fat metabolism: It has an effect on the emulsification of fats, which supports the digestion and absorption of nutrients [7].
What role does choline play in various metabolic processes?
It plays an important role in the body's metabolism and in the formation of important molecules.
Fat metabolism: It is important for the transport of fat from the liver. It supports the emulsification and transport of fats and lipids, which is necessary for the digestion and absorption of nutrients. Choline ensures that fat molecules can be transported in a water-soluble form, as it is a component of phospholipids, which in turn are components of lipoproteins [7].
Cell membrane structure: As a component of phospholipids, it contributes to the structure and integrity of cell membranes. It plays a crucial role in the formation and maintenance of healthy cells [4].
Neurotransmitter production: Choline is a precursor of acetylcholine, a neurotransmitter that is important for signalling between nerve cells in the brain and body. This influences various neurological processes such as memory, learning and muscle contraction [8].
Involvement in other metabolic processes: It is involved in the methylation reaction in the body. Methylation is an important biochemical process that plays a role in the production of DNA, the regulation of gene expression and other metabolic processes [9].
How does choline help with weight loss?
The vitaminoid may have an indirect effect on weight loss, although it is not a direct weight loss agent. Its effect is based more on its role in metabolism and fat processing [10].
Fat metabolism: It supports the transport of fats from the liver, which is important for emulsifying fat molecules and making them available for energy production. A balanced fat metabolism can help the body burn fats more efficiently and potentially reduce the storage of fat [7].
Metabolic activity: It is involved in metabolic processes, including the methylation reaction. A well-regulated metabolism can help the body process nutrients and produce energy more efficiently [9].
Muscle activity: It has an effect on the function of the neurotransmitter acetylcholine, which is involved in muscle contraction. Optimal muscle activity can increase calorie consumption and support the burning of fat [6].
Which foods contain a lot of choline?
The average choline requirement can usually be easily covered by the diet. Different foods contain different amounts of choline. The following foods are good sources: Eggs, liver (especially beef liver), beef, chicken, pork, fish (especially salmon, tuna and cod) and dairy products. Including a variety of these foods in your diet can help ensure you get sufficient amounts of the vitamin. It is important to note that the exact amount in each food may vary.
How do you notice a choline deficiency?
A choline deficiency can cause various symptoms, although such a deficiency is relatively rare as the requirement is normally well covered by the diet. The symptoms can be non-specific and have other causes, so it can be difficult to diagnose a choline deficiency. Nevertheless, the following symptoms may indicate a possible choline deficiency:
Memory problems or cognitive impairment: difficulty learning, memory problems or concentration problems [11].
Muscle problems: such as muscle tremors or muscle weakness [12].
Liver problems: Liver disease or inadequate liver function may indicate a deficiency [13].
It is important to note that these symptoms can also be caused by other nutritional or health factors. Diagnosis is usually not based on symptoms alone, but also requires laboratory tests to check choline levels in the blood.
What is the daily requirement for choline?
The recommended daily requirement varies depending on age, gender and other factors. The Recommended Dietary Allowances (RDA) have not yet been standardised and may vary depending on the source.
The following guideline values for daily choline intake are based on the recommendations of the Institute of Medicine (IOM) in the USA [14]:
- Infants (0-6 months): 125 milligrams per day
- Infants (7-12 months): 150 milligrams per day
- Children (1-3 years): 200 milligrams per day
- Children (4-8 years): 250 milligrams per day
- Children (9-13 years): 375 milligrams per day
- Adolescents (14-18 years): 400-550 milligrams per day (depending on gender)
- Adults (19 years and older): Men 550 milligrams per day, women 425 milligrams per day
- Pregnant women: 450 milligrams per day
- Breastfeeding women: 550 milligrams per day
It is important to note that these values are guidelines and individual needs may vary. However, most people in developed countries tend to consume less than recommended through their diet. Foods such as egg yolks, meat and fish (pulses and nuts to a lesser extent too) are good natural sources and can help to meet requirements.
Does choline have side effects?
Side effects are rare, especially when the vitaminoid is obtained from natural sources in the diet. However, some people may be at risk of diarrhoea, nausea or stomach problems when taking very high doses in the form of food supplements or preparations (usually as capsules) or medication. It is important not to exceed the recommended dosage of capsules or medication, as high doses can lead to undesirable side effects.
People who suffer from a choline metabolism disorder or have a hypersensitivity to the vitaminoid should be careful and consult a doctor before taking capsules, medication or other preparations.
Pregnant women should also be careful when taking choline supplements (e.g. capsules), as the effects of high doses and possible side effects on the unborn child have not been sufficiently researched.
In general, the side effects are rare and usually only occur with excessive intake of dietary supplements. It is advisable to stick to the recommended dosages and consult a doctor if in doubt.
Is too much choline harmful to the liver?
There is some evidence that excessive doses can potentially affect the liver, especially in people who already have liver disease or are more susceptible to liver problems. Extremely high doses taken via supplements could theoretically overload the liver, especially if it is already damaged or stressed. This could lead to the liver having difficulty processing these additional amounts [15].
Sources:
[1] https://www.ncbi.nlm.nih. gov/pmc/articles/PMC2782876/
[2] https://www.tandfonline.com/doi/abs/10.3109/00365517809104931
[3] https://www. ncbi.nlm.nih.gov/pmc/articles/PMC7352907/
[4] https://pubmed.ncbi.nlm.nih.gov/16636297/
[5] https://www. ncbi.nlm.nih.gov/pmc/articles/PMC3729018/
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7400816/
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113756/
[8] https://www.sciencedirect. com/science/article/abs/pii/S1385299X9600013X
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4825771/
[10] https://www. ncbi.nlm.nih.gov/pmc/articles/PMC4096089/
[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570899/
[12] https://uncnri.org/2017/06/01/know-your-neurotransmitters-acetylcholine/
[13] https://lpi.oregonstate.edu/mic/other-nutrients/choline
[14] https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
[15] https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/#h16