What is choline? The nutrient for your memory, muscles and more

What is choline?

Choline is an essential nutrient that your body needs to function properly and stay in good health. It is part of the vitamin B group of nutrients and can be found in vitamin B complex supplements. Your body makes a small amount in the liver, but most of the choline you need comes from your diet.   

However, research found that the diets of most people in the US and Europe don't provide them with the recommended amounts of choline - even if they also take choline supplements^1,2.   

Choline deficiency - where your choline levels drop dangerously low - is still quite rare. Yet, it's important you include food sources of choline in your meals, to keep your body working and healthy.

Choline benefits

"Choline has a number of roles to play in our health," says Reema Patel, gut health dietitian at Dietitian Fit. She gives these examples: 

• Cell function - "Choline is used by the fats in the cells that provide cell structure, so it is a key nutrient in the development of cells." 

• DNA synthesis - "Together with other nutrients, choline plays a key role in DNA production in the body." 

• Nervous system - "Choline is a key part of acetylcholine, a neurotransmitter involved in muscle movement, memory, and regulating heartbeat."

• Brain function - "Some research has shown a connection between higher blood levels of choline and improved cognitive function."

Can choline deficiency lead to liver disease?

Patel says: "Low levels of choline have been found to increase your chances of developing non-alcoholic fatty liver disease (NAFLD), which is where fat builds up around the liver, and leads to liver disease. In this way, getting enough choline supports a healthy liver."  

Can choline improve physical performance?

Although choline supplements are taken by some athletes, their effects on physical performance aren't proven nor fully understood³. We know that choline is involved in muscle movement, and that choline levels fall during long endurance exercises - like marathons - but it's unclear if supplements enhance performance.   

While some studies show no effect on performance, there is some evidence that not consuming enough choline can reduce muscle strength⁴. Overall, more research is needed.

Can choline protect against brain disorders?

It's possible that higher levels of choline can improve your memory, your ability to learn, and capacity for flexible thinking. Known as your cognitive functions, some studies have found that these are better in people who consume more choline⁵.

"However, more research is needed to see the influences of choline in adults with degenerative brain disorders, like Alzheimer's or Parkinson's disease," adds Patel.

Can choline reduce your chances of heart disease?

Choline is also thought to have heart healthy effects. "Consuming enough choline can support a healthy heart and blood vessels, mainly by reducing blood pressure," says Patel.  

As choline helps with heart health, experts have asked if having low levels puts you more at risk of cardiovascular disease (CVD). At this point in time, the evidence is conflicting and unclear - but this might change with more research.   

An analysis of the 2011-2016 National Health and Nutrition Examination Survey, that included 14,323 people, found that those who didn't have CVD consumed a lot more choline in their diets than those with CVD⁶. This was especially true for stroke. More studies are needed to confirm these findings as there is some evidence that too much choline can cause heart disease.

How much choline per day? 

How much choline you should consume through food depends on your age and gender. More research is also needed to determine exactly how much choline gives us the most health benefits⁶.   

Patel says: "As a general rule, children need between 200-500 mg choline per day and adults need between 425-550 mg choline per day." This will also depend on the children's age and whether the adults are pregnant or breastfeeding.

According to the dietitian, most people can get enough choline through their diet. Only certain groups who find it particularly hard to obtain enough choline in their diet alone may need choline supplements.  

People who have increased needs of choline may be at risk of deficiency. These populations include:  

• Pregnant and breastfeeding women. 

• People with restrictive diets. 

• People with certain genetic conditions. 

• People who are being fed through their veins (intravenously). 

Taking choline supplements during pregnancy

In recent years, the importance of choline during pregnancy has become increasingly apparent. It is thought that not getting enough choline may increase the likelihood of pregnancy complications. This could include neural tube defects, premature birth, low birth weight, and preeclampsia⁷. This is an area of ongoing research - but it's one that shows promise for improving the health of expectant mothers and unborn babies.  

Currently, there is no UK guidance on choline supplements in pregnancy.

Choline side effects 

Choline is a natural nutrient produced and needed by our bodies. Still, consuming an excessive amount of anything can potentially cause harm. Patel says: 

"Over consuming choline can cause several side effects such as vomiting, heavy sweating, salivation, a fishy body odour, and could also lead to low blood pressure⁸. The upper limit of choline for healthy adults is 3500 mg per day - which could lead to serious side effects." 

It's worth noting that it's very unlikely that you could consume this amount from food alone. The side effects above typically only apply to people taking choline supplements in large doses.   

Further reading  

1. National Institutes of Health: Choline.  

2. Zuk et al: Dietary choline intake in European and non-european populations: current status and future trends - a narrative review.

3. Moretti et al: Choline: an essential nutrient for skeletal muscle. 

4. Lee et al: The effect of choline and resistance training on strength and lean mass in older adults.  

5. Poly et al: The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort.  

6. Zhou et al: Association between dietary choline intake and cardiovascular diseases: National Health and Nutrition Examination Survey 2011–2016.  

7. Jaiswal et al: Choline supplementation in pregnancy: current evidence and implications.  

8. National Institutes of Health: Choline.