Choline is an essential micronutrient, which, like B vitamins, is needed for the synthesis of substances that play a crucial role in our metabolism. The phospholipids built from it are components of cell membranes, so choline has a structural function as well. The production of an important neurotransmitter, acetylcholine, also relies on choline. Acetylcholine regulates a wide range of biological functions, including the cardiovascular, and nervous systems, and even digestive functions. (1) Adequate choline intake is of paramount importance during pregnancy; in a randomized controlled trial, higher choline intake was associated with a positive effect on children's ability to cope with stress, but it is also important in preventing neural tube closure and other complications. (2,3) Unfortunately, there are relatively few good sources of choline, with only 10% of adults and older children achieving the required intake, according to one study. (4) Choline deficiency can lead to liver damage, non-alcohol-related fatty liver, and a range of other problems such as neuromuscular damage. (5,6,7)  

Types of choline 

There are several types of choline, found in foods in the form of phosphatidylcholine, glycerophosphocholine, sphingomyelin, and free choline. An active form, betaine, also plays an important role in our metabolism and, just like the other forms, is also found in certain foods (8).   

Different forms of choline are required for different biological functions, for example, phosphorylcholine and free choline are mainly required for the structure of cell membranes and the function of the liver and bile. Adequate choline intake is important for, among other things, biliary function and the digestion of fats, the prevention of fatty liver disease of non-alcoholic origin, and the maintenance of cognitive functions such as memory. 

Betaine, a key player in a process called methylation, produces many important substances such as creatine. Proper methylation affects many aspects of health, without it, we cannot perform well physically or mentally. If for some reason methylation is inadequate, homocysteine levels in the body can increase, which can increase cardiovascular risk and, in women, induce pregnancy complications. (9, 10) However, supplementation with choline and betaine has been shown to effectively reduce homocysteine levels in several studies. (11,12) In addition to choline and the betaine it is transformed into, consuming vitamins B2, B9, and B12, adequate protein intake, and minerals are important. If, as is the case in many, an MTFHR gene mutation prevails, a higher intake of these is worthwhile as well. 

How much choline do we need? 

The recommended daily intake is 450 mg for women and 550 mg for men, and less on a body weight basis for children. During pregnancy, a supplement of 550 mg is also officially recommended for women, but in the above-mentioned study, a daily intake of 930 mg of choline was much more beneficial than the lower intake. Since some choline would be converted to betaine to support methylation, half of our choline needs may come from the latter. 

Most do not reach the above amounts, so choline deficiency can be considered a common condition. If you want to calculate your choline requirements accurately, visit choline.gal.uk and fill in the questionnaire!   

Dietary sources of choline 

Few foods are considered good sources of choline, the most important being egg yolks and liver. If you eat eggs regularly, 3-4 egg yolks a day alone can provide the necessary choline intake. For those who do not eat such foods, a supplement of lecithin, 15-20 grams of which provide the body with 300 mg of choline, may be a solution. In addition, although they also contain choline, quinoa, amaranth, beetroot, and spinach are worth eating, mainly because of their high betaine content (12). 

Lean meats, fish, grains, pulses, and nuts contain between 50-100 mg of choline per 10 dkg, which, although not considered to be an outstanding source of choline, can be taken into account when consuming large amounts. (13) 

The following foods contain as much choline as 1 egg yolk, which is a quarter of your daily intake: 

• 500 g liver 

• 150-200 g salmon/other fish/seafood 

• 150-200 g meat 

• 500 g soybean meal, 10 dkg soybeans 

• 200 g quinoa, amaranth, or peanuts 

The following foods contain the equivalent of 1 betaine in the yolk of 1 egg (which covers only half of the choline intake): 

• 20 g quinoa, amaranth, wheat germ 

• 50 g spinach, pickled beetroot, shrimp 

• 15 dkg spelt, barley, or rye flour 

• 25 dkg wheat flour 

Any combination of the following foods is suitable, for example, 2 eggs a day with 50 g quinoa, or 10 dkg liver, 15 dkg salmon with 50 g spinach.

[The cover image of the note shows eggs. 100 grams contain 250 mg of choline, 3-4 whole eggs provide the daily choline requirement.]