Choline
About Choline
Choline is an essential nutrient, recognized as such by the Institute of Medicine in 1998, with intake recommendations that vary by sex and rise during pregnancy and lactation. It is a precursor of the neurotransmitter acetylcholine, of the membrane phospholipids phosphatidylcholine and sphingomyelin, and of betaine, which donates methyl groups in the methionine cycle. Choline is important for fetal brain development, and maternal choline status has been linked to offspring cognition. The liver makes some choline through the enzyme PEMT, but not enough to meet needs. Deficiency causes fatty liver and muscle damage. National surveys suggest most people in the United States consume less than the recommended amount. Eggs and liver are among the richest sources. Folate and vitamin B12 status influence choline needs because they share methylation pathways. Supplements have been studied for cognition with mixed evidence. Gut bacteria convert choline to trimethylamine, which the liver turns into TMAO, a marker associated with cardiovascular risk whose clinical significance is debated.
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