Nutrition focus: Choline

Choline is a vital nutrient that can be made in our bodies but is best obtained from the diet.  It was officially recognized as an essential nutrient by the Institute of Medicine in 1998.

Choline's primary function in our body is help with production of the neurotransmitter, acetylcholine.  Acetylcholine causes muscle contraction, activates pain responses and regulates endocrine and REM sleep functions. Deficiencies in acetylcholine can lead to neurological problems such as myasthenia gravis, which is characterized by muscle weakness.  Choline is needed for cell membrane signaling.  Choline's main form in the body is as phosphotidylcholine (a phospholipid also known as lecithin) which forms the outer layer of every cell in our body. Phospholipids play a key role in determining what enters and exits every cell.  Choline is important in fat (lipid) transport in the body.  Finally, it is important in detoxification pathways utilizing methylation to reduce inflammation.

Choline is particularly important in fetal brain and spinal cord development.  There is a high rate of transfer of choline from mom to baby via placental blood flow.  This often leads to depletion of maternal choline stores so intake of choline needs to be higher during pregnancy and lactation.  Choline deficiencies, along with folate deficiencies, are associated with neural tube defects such as spina bifida.  Choline is also particularly relevant for the development of memory and learning structures in the brain such as the hippocampus.  In humans, the hippocampus develops in pregnancy and reaches an approximate adult structure around age 4 years.

Rodent studies indicate that adequate levels of choline during pregnancy, especially during the later stages of pregnancy, has beneficial sustained life time effects on learning and memory.  It is possible that choline in adequate amounts may protect against age related memory loss and may be part of a strategy to prevent Alzheimer's dementia.  A 2013 study showed that adequate maternal choline intake during pregnancy was associated with better memory function in children at 7 years of age v. mothers who only took in about 50% of the recommended intake of choline. There is evidence that choline is protective against the prenatal effect of alcohol on a fetus suggesting a way to help treat babies affected by fetal alcohol syndrome. Human studies on choline's effect are ongoing.

There are significant genetic variations leading to different choline daily requirements. About 50% of humans carry genetic variations that require increased intake of choline to meet biological needs. Choline intake is inadequate in many older children, adult men and women and critically, in pregnant and lactating women.  Human milk is high in choline due to the high transfer of choline from maternal blood to breast milk.  Soy formulas have less choline than breast milk and cow's milk based formulas.  Deficiency of choline leads to a fatty liver, atherosclerosis due to impaired lipid metabolism, increased inflammation due to poor methylation and detoxification and muscle pain. Choline deficiency may play a role in neurologic disorders such as Alzheimer's dementia. 

Daily needs for choline

Men >19y:  550 mg/day
Women >19y:  425 mg/day
Pregnant women: 450 mg/day
Lactation:  550 mg/day

Foods with choline

Chicken liver, cooked 3oz                      247mg
Soy flour, defatted                                  201mg
Salmon, sockeye, smoked 3oz            187mg
Egg, 1 large                                              125mg
Quinoa, uncooked, 1/2 c.                       60mg
Milk, nonfat, added vit. A, 8oz               38mg
Cauliflower, 1/2 c.                                   24 mg
Broccoli, 1/2 c.                                         15mg 
Bacon, 2 pieces                                       20mg

Choline is found in lots of foods.  Adding one egg to the diet each day increased the number of pregnant women meeting the daily intake guidelines from only 10% to greater than 50%. Most physicians are not aware of choline needs and thus don't discuss it. Only 6% of obstetricians, who are seeing pregnant patients with the highest choline needs, recommend foods high in choline to their patients. Much work needs to be done to improve awareness of this critical nutrient for healthy babies and adults!

Nutrition and Yoga for Gut Health Workshop takes place on April 14th from 10:30am to 11:30am.  Join us for this informative and unique workshop intertwining nutritional strategies with yoga to improve the health of your digestive system.  To learn more and register, go to www.wholekidspediatrics.com/yoga-and-wellness.

Are you overwhelmed by medicine and natural remedy choices?  Download our wonderful resource, The Wholistic Medicine Cabinet for free for guidance on what to keep in a well stocked medicine cabinet to care for your family.  Enter your email at www.wholekidspediatrics.com/yoga-and-wellness and you'll get the download.  In addition, you will recieve a 25% discount for use on one class or workshop at Whole Yoga & Wellness.