See additional information. Choline is not known to have any clinically relevant interactions with medications. However, the researchers did not identify choline as a contributor to disease severity in other groups of people. The daily upper limit for adults is 3,500 mg per day. Scientists have not identified how much choline can reverse fatty liver disease. (5) Results showed that rats who had received the choline inositol supplementation had significantly less liver fat than the control group. Luckily fatty liver is reversible. History of changes to this fact sheet, U.S. Department of Health & Human Services, Division of Program Coordination, Planning, and Strategic Initiatives, Strengthening Knowledge and Understanding of Dietary Supplements, My Dietary Supplement and Medicine Record, Analytical Methods and Reference Materials (AMRM), NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Computer Access to Research on Dietary Supplements (CARDS) Database, Dietary Supplement Ingredient Database (DSID), ODS Participation in NIH Funding Initiatives, Administrative Supplements for Research on Dietary Supplements, Administrative Supplements for Validation Studies of Analytical Methods, Frequently Asked Questions About ODS Grants & Co-funding, Resources for Investigators Submitting Natural Products Research Grant Applications, Staff Bios, Publications, and Presentations, Federal Working Group on Dietary Supplements, NIH Dietary Supplement Research Coordinating Committee, Food Labeling: Revision of the Nutrition and Supplement Facts Labels, Nutrient Intakes from Food and Beverages: Mean Amounts Consumed per Individual, by Gender and Age, What We Eat in America, NHANES 2013-2014. Some B-complex vitamins even contain added choline. In a cross-sectional study of 664 adults and children from the Nonalcoholic Steatohepatitis Clinical Research Network, postmenopausal women who had nonalcoholic steatohepatitis (an extreme form of NAFLD involving liver inflammation and fibrosis) and a choline intake less than 50% of the AI had more severe fibrosis, but the results showed no relationship between choline intake and degree of liver steatosis [48]. DRIs is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. [. Here are 5 ways to achieve this: 1. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Clin Nutr 1993;12:33-7. However, requirements may vary depending on the individual. Therefore, a deficiency of either nutrient can result in an accumulation of homocysteine in your blood. The daily average requirement for choline intake each day, as established by the National Institutes of Health Office of Dietary Supplements with theU.S. Department of Health and Human Services,ranges from about 450 milligrams for women to 550 milligrams for men. N Engl J Med 2013;368:1575-84. Many foods contain choline [4]. Several food sources of choline are listed in Table 2. Am J Hum Genet 2002;71:1207-15. The biggest offenders are sugar and foods made of white flour; they need to be avoided completely. These Science-Backed Tips Can Help You Lose Weight Sustainably. Getty Images Georgia Noble's heart started pounding when her doctor's name popped up on her phone. Milk thistle, in combination with other supplements, might improve the symptoms of indigestion. Another older study of 664 individuals with NAFLD or NASH found that postmenopausal women with deficient choline intake had worse fibrosis. Usually, NAFLD is a silent disease, so people may have few or no symptoms. Nonalcoholic fatty liver disease What happens if I dont get enough choline? Most people in the United States consume less than the AI for choline. Aside from eating foods high in inositol and choline, there are numerous ways in which you can support healthy choline and inositol levels in the body without having to add dietary supplements that risk raising inositol and choline levels above the healthy range. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Choline also plays important roles in modulating gene expression, cell membrane signaling, lipid transport and metabolism, and early brain development [1,2]. A few nutrients are either difficult or impossible to get in adequate amounts from plant foods. Due to a lack of available evidence, a Reference Daily Intake (RDI) for choline has not been determined. The thicker the blood, the less oxygen there is for the liver. Corbin KD, Zeisel SH. They can tell you if the dietary supplements might interact with your medicines or if the medicines might interfere with how your body absorbs, uses, or breaks down nutrients such as choline. Whey protein, shown to reduce liver fat by up to 20%. Cochrane Database Syst Rev 2003:CD001015. 2023 Healthline Media UK Ltd, Brighton, UK. [, Naber M, Hommel B, Colzato LS. This may be due to the hydrolysis of membrane phospholipids, a source of choline, to maintain plasma choline concentrations above this minimal level, or to endogenous synthesis [2]. Choline is a source of methyl groups needed for many steps in metabolism. Some research indicates that women who eat a lot of choline may have a lower risk of breast cancer (53, 54, 55). It is also found in foods such as meats, fish, nuts, beans, vegetables, and eggs. Genes involved in the metabolism of choline, folate, and methionine play a role in the pathways for choline production and use [24,25]. In: Erdman JW, Macdonald IA, Zeisel SH, eds. Choline is a nutrient that is found in many foods. [, Finelli C, Tarantino G. Non-alcoholic fatty liver disease, diet and gut microbiota. Low plasma vitamin B-12 is associated with a lower pregnancy-associated rise in plasma free choline in Canadian pregnant women and lower postnatal growth rates in their male infants. Choline status is not routinely measured in healthy people. Prog Mol Biol Transl Sci 2012;108:159-77. da Costa KA, Kozyreva OG, Song J, Galanko JA, Fischer LM, Zeisel SH. However, because inositol is produced through natural biological functions and is also abundantly found in food sources, supplementation is likely not necessary. Some studies have found a link between higher intakes of choline (and higher blood levels of choline) and better cognitive function (such as verbal and visual memory). People can consume choline in animal protein and plant sources. Common genetic polymorphisms affect the human requirement for the nutrient choline. Ankylosing Spondylitis Pain: Fact or Fiction, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), highest choline intake of 412 milligrams (mg), https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/alcohol-related-liver-disease/#information-for-the-newly-diagnosed, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8779168/, https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/, https://lpi.oregonstate.edu/mic/other-nutrients/choline, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302364/, https://pubchem.ncbi.nlm.nih.gov/compound/L-methionine, https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/nonalcoholic-steatohepatitis-information-center/nash-definition-prevalence/, https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash, https://journals.lww.com/nutritiontodayonline/fulltext/2018/11000/choline__the_underconsumed_and_underappreciated.4.aspx, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4230213/, Heart attack may speed up cognitive decline, study finds, New treatment strategy for stroke-related brain bleed could save thousands of lives. Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects. Many foods contain choline. Adequate choline intake is needed for proper liver function and to prevent NAFLD, but more research is needed to further clarify the role of choline in preventing or treating NAFLD [50]. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. In addition, a single 3-ounce (85-gram) serving of beef kidney or liver can supply all of a womans daily requirement and most of a mans (23). NAFLD is a common liver disorder among people who have more weight or obesity. All rights reserved. There is not enough data to establish a Recommended Dietary Allowance for choline. Average daily recommended amounts are listed below in milligrams (mg). Berberine, which lowers blood sugar. Choline is a macronutrient that's important for liver function, normal brain development, nerve function, muscle movement, supporting energy levels and maintaining a healthy metabolism. J Am Diet Assoc 2010;110:1198-206. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. It explains different types of fatty liver disease and how a person may manage them. The daily upper limits for choline include intakes from all sourcesfood, beverages, and supplementsand are listed below. Nevertheless, requirements differ according to genetic makeup and gender (7, 8, 9). The biggest benefit of choline for the liver is that it helps remove fat from the liver which in turn may help prevent non alcoholic fatty liver disease (NAFLD) and liver damage (8, 10). What kinds of choline dietary supplements are available? For more information on food sources of choline: For more advice on choosing dietary supplements: For information about building a healthy dietary pattern. Your brain and nervous system need it to regulate memory, mood, muscle control, and other functions. Choline. Improved human visuomotor performance and pupil constriction after choline supplementation in a placebo-controlled double-blind study. A polymorphism, R653Q, in the trifunctional enzyme methylenetetrahydrofolate dehydrogenase/methenyltetrahydrofolate cyclohydrolase/formyltetrahydrofolate synthetase is a maternal genetic risk factor for neural tube defects: report of the Birth Defects Research Group. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. These values, which vary by age and sex, include: Insufficient data were available to establish an EAR for choline, so the FNB established AIs for all ages that are based on the prevention of liver damage as measured by serum alanine aminostransferase levels [2]. The choline-fatty liver connection is likely influenced by numerous confounding factors. Nonalcoholic fatty liver disease (NAFLD) is a health condition where you have too much fat in your liver. However, other studies on healthy people and those with dementia found no effects on memory (39, 40, 41). In adults, the average daily choline intake from foods and beverages is 402 mg in men and 278 mg in women. For more in-depth resources about vitamins, minerals, and supplements, visit our dedicated hub. Dr. Karen Corbin, RD, Research Scientist with the Translational Research Institute for Metabolism and Diabetes, discusses the overall health benefits of chol. This website is using a security service to protect itself from online attacks. More research is needed to clarify the role of choline in fatty liver disease. Healthcare professionals recommend treating NAFLD with weight loss. Both inositol and choline can be derived from lecithin, which can be found in many food products. Most choline is metabolized in the liver where it is converted into phosphatidylcholine, which assists in building fat-carrying proteins and breaking down cholesterol. According to an analysis of 20072008 NHANES data, black males of all ages had lower mean choline intakes than their white and Hispanic counterparts, but choline intakes did not differ substantially among females of different races/ethnicities [10]. Hepatology 1995;22:1399-403. Choline also plays an integral part in fat metabolism in the liver and regulating homocysteine. Early second trimester maternal plasma choline and betaine are related to measures of early cognitive development in term infants. June 2, 2022 Although choline deficiency is rare, certain people are at an increased risk (14): People who are at an increased risk of choline deficiency include athletes, those who drink a lot of alcohol, postmenopausal women and pregnant women. health professional fact sheet on Choline. What is Jaundice and its Different Levels? Choline, Its Potential Role in Nonalcoholic Fatty Liver Disease, and the Case for Human and Bacterial Genes. Although choline may lower homocysteine levels, the association of choline intake with heart disease risk is not clear (27, 28, 29, 30, 31, 32). The body needs choline to synthesize phosphatidylcholine and sphingomyelin, two major phospholipids vital for cell membranes. |July 3, 2007 1 min Choline is a micronutrient needed for nerve signaling, cholesterol transport, energy metabolism and maintenance of cell membranes. With NAFLD, this happens in people who aren't heavy drinkers. [, Wu BT, Innis SM, Mulder KA, Dyer RA, King DJ. It impacts liver function, healthy brain development, muscle movement, your nervous system and metabolism. Oregon State University advises that phosphatidylcholine supplements can provide choline. However, little research conducted to date supports this hypothesis, as described below. Choline plays a role in the metabolism of amino acids and methylation reactions in the body. However, other studies have shown that choline supplements do not improve cognition in healthy adults or in patients with Alzheimers disease, Parkinson's dementia, or other memory problems. Prospective study on dietary intakes of folate, betaine, and choline and cardiovascular disease risk in women. The NIDDK advises that losing at least 3%-5% of body weight can reduce fat in the liver. One small study in 57 adults 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 (11). Supplementing with 1,000 mg per day led to improved short- and long-term verbal memory in adults aged 5085 who had poor memory (37). (2022). In healthy adults, the concentration of choline in plasma ranges from 7 to 20 mcmol/L [2]. These levels are also used as an indicator for certain mood disorders, and choline supplements are sometimes used to treat bipolar disorder (48). But more research is needed to better understand how choline might help prevent or treat NAFLD. Choline is an essential nutrient that is required for optimal health. The FNB has established ULs for choline from food and supplements based on the amounts of choline that are associated with hypotension and fishy body odor (see Table 3) [2]. Plasma homocysteine, dietary B vitamins, betaine, and choline and risk of peripheral artery disease. In one study in 26 men, six developed symptoms of choline deficiency even when consuming the AI (9). AI: The Adequate Intake for men and women ages 19+ years is 550 mg and 425 mg daily, respectively. Additionally, it outlines daily requirements for choline and how a person may consume choline in foods and supplements. Cruciferous vegetables and certain beans are also rich in choline, and other dietary sources of choline include nuts, seeds, and whole grains. What you need to know is that the more fat you have in your blood on a daily basis, whether it comes from animal foods or plant foods, the more likely you are to develop a fatty liver. In addition, choline is needed to produce acetylcholine, an important neurotransmitter for memory, mood, muscle control, and other brain and nervous system functions [1-3]. Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. And Whats The Best Treatment? 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