Choline and fatty liver disease. Cholesterol 7.

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A simple clip listing the benefits of choline and its main dietary sources.  It is a principal component of acetylcholine, the chemical messenger in the brain and body used for memory formation and storage, for attention and for muscle contractions.  It is generally listed under the B group of vitamins.  The nutrient choline is also used in other ways in the body and good levels are important for liver health.  This is because the type of cholesterol VLDL – very low density lipoprotein – is made in the liver using choline.  VLDLs transport fat from the diet out of the liver and into the body for use as an energy source or for storage and so a diet lacking in choline will directly lead to a build up of fat in the liver, which is known as fatty liver disease.  What is of interest is the best dietary sources of choline.  The following information can be found on the US Dept of Agriculture Nutrient Data base.  All the foods are 100gms and raw.

  • Soybean oil, salad: 0.2
  • Brussels sprouts: 19.1
  • Broccoli: 18.7
  • Butter: 18.8
  • Pine nuts: 55.8
  • Cod: 65.5
  • Farmed Salmon 78.5
  • Beef chuck steak: 102
  • Wild Coho Salmon: 109.4
  • Chicken livers: 194.4
  • Whole eggs: 293.8
  • Soybean oil as lecithin: 350
  • Egg yolk: 820.2

The list is in ascending order and it can quite clearly be seen that the best dietary sources of choline are non-vegetarian, with egg yolks reigning supreme.   The chicken livers do well.  From this list it can be seen the problems that current food guidelines give us.  Don’t eat eggs because they raise cholesterol.  Ditto red meat.  Don’t eat too much oily fish.  So we are warned off the very foods that help us avoid fatty liver disease and help us make the lipoproteins vital for our health and well being(to call LDL a cholesterol is deeply misleading.  It is  low density lipoprotein used for transporting fats and cholesterol about the body.  The previously linked blog goes into this).  Soybean lecithin is a supplement and I will talk about this shortly.

It is very clear that eggs are the best source of choline – however eating too many eggs will most likely lead to intolerance of eggs, the commonest symptoms being bloating, gas, sleepiness, and acne.  However, provided the diet is rich in red meat, organ meats and oily fish salmon sized or smaller, then there will be a good regular supply of choline.  At certain times of life, like pregnancy, menopause and old age we do have greater need of choline so supplementation should be considered.  We should certainly supplement if we are vegan.

Choline helps lower a substance produced by the body called homocysteine.1  Homocysteine is produced from protein in the diet and should be converted into either a brain product called SAMe2 or an immune product called glutathione.  Not everybody does this conversion well, so good choline levels will help.  High homocysteine levels are linked to many diseases including heart disease and dementia.  Choline also forms part of the makeup of the cell walls.  For health and weight loss, it is important that the cell walls are in the best form to enable nutrients in and out of the cells – it is a fat lot of good having a good supply of body fat if it can’t get out of the cells to be used for energy.

Choline can be taken in supplement form, the commonest and most easily available being lecithin.  Lecithin can be made from various things, including egg yolks, with the commonest form from soybean and, increasingly other vegetable oils such as sunflower.  The lecithin is extracted from the source either mechanically or chemically, using hexanes.  With mechanical extraction, care must be taken to ensure cold pressing or the heat turns the oil rancid.  Hexanes are made from gasoline and are linked with problems with the peripheral nervous system leading to muscle weakness, lack of co-ordination and problems with vision.  So great care has to be taken if planning to take lecithin as a supplement.  However, the tale does not end there since many manufactured foods use lecithin for thickening or emulsification – from breads to cocoa powder.  If the lecithin is produced well, there will not be a problem.  However, food companies tend to look after their profits more than the quality of such ingredients as lecithin.  So start to watch out for just how often lecithin is added food.

There are other forms of choline available for supplementation, but the best is as phosphatidyl choline, which is the form found in food.  This form is recognised by the body and will lead to good uptake. Before taking this supplement, it is wise to take  a course of probiotics since phosphatidyl choline needs healthy guts to metabolise it properly3 or it can promote heart disease.  But assuming healthy guts, this is a good supplement provided we are confident with the manufacturer of the supplement.

So if we have been diagnosed with fatty liver disease, the first thing to do is take a course of first class probiotics, improve digestive function then eat more choline rich foods.  If we do not eat choline rich foods or are at a stage of life with greater need of choline, then high quality supplementation is a good thing to do.  Both body and brain will function better with good choline levels, and, if pregnant, a healthier, brainier child will be born.  But as with all supplements, care must be taken to ensure good quality.

  1. Shin W.  choline intake exceeding current dietary recommendations preserves markers of cellular methylation in a genetic subgroup of folate-compromised men. J Nutr. May 2010 Vol 140 No.5 975-980 []
  2. SAMe si S-adenosyl methionine a natural anti-depressant, anti-arthritic and liver proctecting agent.  Glutathione is an anti-aging anti-oxidant and detoxifying agent []
  3. Hazen SL.  Gut flora metabolism of phosphatidyl choline promotes cardiovascular disease. Nature 472 56-63 (07 April 2011. Abstract []

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