Choline – Why It’s Critical for Long-Term Health
Written by Tanya Goldfrad, R.P.H., M.P.H.
When we think about supplements critical for our health, depending on our stage in life, there are many things that may come to mind. For example, most women of child-bearing age know that Folic Acid is important for healthy pregnancies. Science has shown that there are many key vitamins and minerals that when gone without, can have short- or more serious long-term effects: For example, it was long known that sailors without access to fresh fruit developed scurvy, and in the mid-1700s it was finally linked to a lack of vitamin C. Low intake of calcium has been associated with low bone density, and so on. Although some vitamins and minerals get more attention than others, God has formulated our physical shells to need them all, even if in micro amounts.
Since this month’s theme is focusing on the vegetarian/vegan lifestyle, I wanted to focus on one of the deficiencies that occur commonly in vegetarians and vegans. Let me clarify: This is not an attempt to persuade you to eat animals, rather giving direction for how to avoid long-term issues that can arise from this deficiency that you may never even be aware of.
Along with the more widely known B12 deficiency (easy fix folks, take a supplement) that clinicians see in vegetarians, is choline deficiency. Choline is an essential nutrient that has several jobs in the body. It is responsible for membrane formation. Membranes exist around cells to act as part of the cellular defense. They act as a wall to prevent any Tom, Dick, or Harry particle from penetrating our precious cells. Like armor around knights of old, membranes protect our cells from many of the attackers they would face. Using the same analogy, the better the armor, the better protected the knight. Here, the better quality the membrane, the better protected our cells are. To weave optimal cell membranes we need readily available phospholipids, cholesterol, and proteins. Choline is part of the magic in making phospholipids. Choline metabolites (the pieces left over after the body metabolizes choline) are critical pieces in the formation of cell signaling molecules, for example, the platelet-activating factor.
Choline is also the precursor (a step before) of acetylcholine. Acetylcholine is a neurotransmitter. It is active in muscle control (the involuntary heartbeat), the circadian rhythm (our ability to sleep), memory, and even mood.
Acetylcholine is the parent compound to a series of chemicals that are called catecholamines, some of which you may know under the more familiar names of dopamine and epinephrine.
Part of God’s blueprint is our genetic portions (DNA & RNA). But we were not left at the mercy of genetics alone. We have free choice, even in our health! By making better epigenetic choices (think lifestyle: sleep, food, exercise) we can positively impact our health. One of the technical ways this happens is through methylation. For most cells, not all, when a cell is methylated it is turned off or has its expression suppressed. If someone has a genetic disposition for a disease such as cancer, God forbid, it doesn’t have to be expressed. If they take the precautions and their body is properly methylated, those codons holding the cancer data can remain in the off position and never show up in their health. Choline is a critical part of making that happen. A lack of choline (or its byproducts) has also been associated with heart disease. One of its byproducts, betaine, is the backup method for recycling homocysteine. Lower levels of homocysteine have been associated with a reduced risk of heart attacks. Although heart attacks are rarer in premenopausal women because of the protective factor from estrogen, once women become post-menopausal they are at the same risk as men.
In several studies, choline was shown to reduce the risk factor of preeclampsia during the 3rd trimester of pregnancy. Preeclampsia can impact the embryo’s size and can be life-threatening for both mother and child. As
pregnancies progress, embryos experience rapid cell growth. Choline supports rapid cell division, helps with methylation and fetal development. Like with iron, as the pregnancy progresses the need for choline increases. Along with folate, choline has been indicated in reducing neural tube defects. In fact, women with the lowest amounts of dietary choline had four times the risk of delivering a child with neural tube defects. In animal studies, low choline levels in rodents were associated with poorer memories in their young.
Remember how I mentioned membrane fragility? New studies have associated choline deficiency with membrane fragility and increased DNA damage. This study found an association of breast cancer risk reduced by 24% in women with higher choline intake!
So what does all this have to do with a vegetarian/vegan diet? Choline is found in its highest concentration in eggs, fish, meat, organ meat, and dairy. Vegetarians can still make sure they are getting enough of this critical nutrient through their consumption of eggs and dairy, but vegans need to make a concerted effort to do so. If you are ideologically opposed to animal products, you need to find other ways of getting this critical nutrient. The risks are simply too high. Other foods with a higher amount of choline include shiitake mushrooms, wheat germ, soybeans, cruciferous vegetables, quinoa, lima and kidney beans, as well as almonds. None of these are as high in choline as animal products, but still, if you incorporate them into your diet you can protect yourself now and for the long term!
Along with the more widely known B12 deficiency (easy fix folks, take a supplement) that clinicians see in vegetarians, is choline deficiency.
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