Choline
Choline featured article
Choline is an essential nutrient critical for various bodily functions, including brain development, liver health, and muscle function. It acts as a precursor to acetylcholine, a neurotransmitter involved in memory, attention, and muscle control. Choline also contributes to the synthesis of phospholipid membranes and serves as a source of methyl groups necessary for metabolic processes. While the body can produce small amounts of choline, most of it must come from the diet to meet physiological needs.
The benefits of choline are wide-ranging. During pregnancy, adequate choline intake supports fetal brain development and may enhance memory, attention, and visual-spatial learning in children. It also plays a role in cardiovascular health by reducing the risk of heart disease and stroke. Additionally, sufficient choline levels have been linked to improved cognitive function and may lower the risk of cognitive decline and dementia. For athletes, choline is vital for muscle...
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Dr. Rhonda Patrick discusses organic produce, fasting-mimicking diets, sleep, sauna, sunscreens, red light therapy, reverse osmosis water, and fiber.
Dr. Rhonda Patrick discusses protein needs, choline in pregnancy, urolithin A, melatonin's benefits and risks, and creatine's effects on liver health.
In this clip, Dr. Rhonda Patrick reveals four common micronutrient deficiencies—vitamins C, E, K, and choline—that accelerate aging and increase...
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Rhonda Agriculture Aging Magnesium Fasting Fiber Sulforaphane Fatty Liver Skin Environment Time-Restricted Eating Sauna Supplements Cardiovascular Red Light Therapy CholineDr. Rhonda Patrick discusses organic produce, fasting-mimicking diets, sleep, sauna, sunscreens, red light therapy, reverse osmosis water, and fiber.
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Dr. Rhonda Patrick discusses protein needs, choline in pregnancy, urolithin A, melatonin's benefits and risks, and creatine's effects on liver health.
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In this clip, Dr. Rhonda Patrick reveals four common micronutrient deficiencies—vitamins C, E, K, and choline—that accelerate aging and increase...
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Choline is an essential nutrient that plays important roles in human health. It provides methyl groups for many aspects of metabolism, is a component of cell...
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News & Publications
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Supplementation with essential phospholipids lowered liver-fat markers in fatty liver disease. doi.org
Fatty liver disease linked to metabolic health is increasingly common worldwide, but evidence for approaches that can be added to lifestyle changes to reduce liver fat remains limited. A new study tested whether supplementation with essential phospholipids, molecules that help form the membranes around cells, could lower liver fat markers in people with this condition.
The trial included 193 adults with metabolic dysfunction-associated steatotic liver disease (MASLD), a condition in which fat builds up in the liver alongside metabolic risk factors such as obesity, high blood sugar, or abnormal cholesterol levels. Participants were randomly assigned to receive 1800 mg per day of soy-derived essential phospholipids or placebo for 6 months. Both groups also received lifestyle guidance focused on diet, avoidance of fructose-rich drinks and foods, alcohol restriction, and exercise, and researchers followed participants for 3 months after treatment ended. The main outcome was an ultrasound-based estimate of fat buildup in the liver at the end of the supplementation period.
- Over six months, the liver fat estimate fell about twice as much with essential phospholipids as with placebo. The difference was already present at three months and remained three months after treatment ended.
- More participants receiving the supplement moved from the highest liver-fat category to lower categories, and a score that is used to flag patients at higher risk of disease progression improved modestly.
- HbA1c, a marker of average blood sugar levels over the previous 2–3 months, started at about 5.8% with essential phospholipids and 5.7% with placebo. Over six months, it fell by about 0.25 percentage points with essential phospholipids and rose by about 0.30 percentage points with placebo.
- Several other measures, including a liver scarring marker, liver enzymes, blood lipids, body weight, and a quality-of-life score did not clearly differ between groups.
- Adverse events occurred at similar rates in both groups. The most common were headache, diarrhea, and cold-like symptoms.
How might essential phospholipids produce these effects? One explanation involves phosphatidylcholine, one of the main components of essential phospholipids. Liver cells use phosphatidylcholine to build and maintain healthy cell membranes and to package fat for transport out of the liver. In MASLD, fat accumulates inside liver cells, and changes in cell membrane composition may impair how those cells function and handle fats. By supplying additional phosphatidylcholine, essential phospholipids may help support the liver's normal fat-handling processes. Although the study did not test this mechanism directly, it provides a biologically plausible explanation for why liver fat markers improved without a clear difference in body weight or changes in body weight between the groups.
The study had industry funding, and some authors had financial ties to or were employees of the funder, so independent confirmation would strengthen confidence. The trial was also too short to assess the effects on long-term complications associated with MASLD. Still, the findings make essential phospholipids an interesting treatment candidate for MASLD patients while keeping lifestyle care and metabolic risk management central. In Q&A #82, I discussed whether increasing choline intake and other lifestyle strategies can help reverse fatty liver disease.
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Inflammation during pregnancy can increase the risk of complications for both mother and baby. Researchers in Canada explored whether an often underconsumed nutrient, choline, might be linked to lower levels of inflammation late in pregnancy.
The study drew on data from 1,300 participants in the Alberta Pregnancy Outcomes and Nutrition cohort. At about 32.5 weeks of pregnancy, each participant completed a detailed 24-hour dietary recall and provided a nonfasting blood sample. Researchers measured high-sensitivity C-reactive protein (hs-CRP, a sensitive blood marker of inflammation), choline intake (including five different forms of choline found in foods), and related nutrients involved in a process called one-carbon metabolism, in which the body transfers small chemical units (e.g., methyl groups) that are used to build DNA, regulate gene activity, and support other chemical reactions that keep cells functioning properly.
- Average choline intake was about 366 milligrams per day (mg/d), below the recommended 450 mg/d during pregnancy. About 19% of participants had hs-CRP levels above 5 milligrams per liter (mg/L), a common clinical cut-off for elevated inflammation.
- Higher choline intake was linked to lower hs-CRP levels. Predicted hs-CRP values dropped from about 2.2 mg/L at 200 mg/d to about 1.7 mg/L at 900 mg/d.
- Compared with women consuming less than 300 mg/d, those consuming more than 700 mg/d were about 93% less likely to have hs-CRP above 5 mg/L.
- The association appeared strongest when focusing on lower hs-CRP values, particularly below 1 mg/L and below 5 mg/L, which are more consistent with chronic low-grade inflammation rather than acute illness.
- Total choline intake was linked to hs-CRP, whereas no individual choline form showed a clear association, and the pattern did not clearly change with betaine, vitamin B12, or folate intake.
Choline can be converted into betaine, which helps recycle homocysteine, an amino acid associated with inflammation, back into the amino acid methionine. This process occurs in the methionine cycle, part of one-carbon metabolism. Lowering homocysteine may help reduce inflammatory signaling. Choline-derived methyl groups may also influence DNA methylation, a chemical tagging process that can turn genes on or off, including genes involved in regulating inflammation.
This study was cross-sectional, meaning it captured diet and inflammation at a single point in time, so it cannot prove that choline directly reduces inflammation. Even so, the findings suggest that higher choline intake during pregnancy is associated with lower inflammation levels. In this Aliquot, I explore choline's roles in metabolic and brain health, including potential supplementation risks.
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Anxiety disorders are common and often difficult to treat, yet we still lack a clear understanding of the brain's chemical and metabolic changes that could guide new therapies. In a new meta-analysis, researchers examined which brain metabolites differ between patients with social anxiety disorder, generalized anxiety disorder, or panic disorder and healthy volunteers.
The study included 25 human datasets covering 370 patients and 342 healthy controls, all scanned with proton magnetic resonance spectroscopy, an imaging technique that can measure brain metabolites. The investigators focused on eight commonly reported metabolite measures: total choline-containing compounds, N-acetylaspartate (NAA), total creatine, myo-inositol, glutamate, glutamate plus glutamine, gamma-aminobutyric acid (GABA), and lactate.
The analysis revealed a characteristic pattern of brain chemistry in anxiety disorders compared with controls:
- Choline levels were consistently lower in the brain's outer regions (the cortex) in people with anxiety disorders. Across studies, this reduction averaged about 8%, making it the strongest and most reliable finding.
- NAA levels were also lower, but this pattern was weaker and less consistent than the choline result.
- In unmedicated patients, creatine also appeared lower, but this result is uncertain due to suboptimal measurement methods.
- Deeper brain regions (subcortical areas) such as the basal ganglia and hippocampus did not show clear differences in choline or NAA.
- The other measured brain chemicals did not show reliable differences between people with anxiety and healthy volunteers.
- The size of the choline reduction was similar in generalized anxiety disorder, panic disorder, and social anxiety disorder, pointing to a shared pattern across these diagnoses.
The brain depends heavily on choline, and its supply can drop when demand outpaces uptake from the bloodstream. Anxiety disorders are marked by persistent overactivation of arousal-related systems, including the noradrenergic stress network. This kind of long-term arousal may increase the brain's need for choline, for example to support myelination, the process of building and maintaining the myelin sheath that insulates nerve fibers and helps them transmit signals efficiently.
The pattern for NAA fits into this broader picture. In other psychiatric conditions, larger drops in NAA tend to appear together with actual thinning of cortical tissue. This combination has not been observed in anxiety disorders, but the small and inconsistent NAA reduction seen in this analysis may point to a subtle metabolic strain on neurons.
The study is limited by the modest number of datasets, incomplete reporting on measurement quality, and its correlational design, which cannot establish causality. Even so, it highlights reduced cortical choline as a consistent pattern across anxiety disorders and an interesting target for future mechanistic and supplementation trials. In Aliquot #67, I talk about the role of choline in metabolic and brain health.
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Prenatal choline supplementation may reduce mental illness risk in children born to Black mothers. www.eurekalert.org
Choline, a phospholipid compound present in a wide range of foods, is an essential nutrient that plays critical roles in building cell membranes and producing the neurotransmitter acetylcholine. Previous research indicates that supplemental prenatal choline improves cognitive ability, attention, and social behavior in children up to seven years of age. A pair of papers published this year explores the effects of prenatal choline supplementation on pregnancy outcomes and neuropsychiatric disease risk in Black Americans.
Neuropsychiatric diseases – commonly referred to as mental illnesses – impair the ability of affected persons to learn and work, imposing an immense burden on society. Physiological alterations that drive neuropsychiatric diseases impair normal brain function, emotion, and mood, and can arise from both genetic factors and environmental factors present before and after birth. One of the physiological alterations commonly observed with neuropsychiatric diseases is impaired suppression of irrelevant environmental mental stimuli, contributing to low mood, poor cognitive functioning, and sensory sensitivities.
Maternal stressors during pregnancy, including nutritional deficiencies, are associated with an increased risk of neuropsychiatric diseases such as schizophrenia, attention deficit disorder, and autism. Epidemiological research has revealed systemic health disparities that contribute to poorer health outcomes for Black Americans, including higher rates of neuropsychiatric diseases. Nutritional interventions may be effective in preventing and treating neuropsychiatric diseases by promoting healthy brain physiology.
The investigators collected data from two observational studies and a randomized clinical trial. In the first observational study, the investigators collected data from 183 pregnant females of varying ethnic identities from the United States at 14 to 16 weeks' gestation. In a second observational study, the investigators collected data from 166 pregnant females from rural Uganda at 18 to 25 weeks' gestation. Finally, in a randomized trial of choline supplementation, 100 pregnant females consumed 3,600 milligrams of choline each morning and 2,700 milligrams each night from week 16 of gestation until delivery. For each study, the investigators measured plasma concentrations of choline and the stress hormone cortisol; maternal mood and stressors; newborn P50 recording; and infant and childhood behavior measures.
Black American females had lower plasma choline concentrations at 16 weeks’ gestation compared to white American females and rural Ugandan females. These lower choline levels were associated with higher maternal concentrations of cortisol and with shorter gestation and decreased P50 inhibition, which both indicate immature neural development at birth. At three months of age, infants born to Black American mothers who had lower gestational choline presented with decreased attention and relation to caregivers, a risk factor for mental illness.
These findings suggest that the cognitive and behavioral deficits associated with lower prenatal choline may predispose children born to Black American mothers to later neuropsychiatric diseases. Prenatal choline or phosphatidylcholine supplementation may reduce disease risk.