Choline - Beneficial and Dangerous?


I want to discuss an ingredient that after exhaustive study, I believe we should be cautious with, choline. Choline is primarily found in meat, eggs and supplements. The supplements that it is found in are multivitamins, B-complex vitamins, brain enhancement formulas and lecithin. It is a vitamin like substance that we need for a variety of reasons including cellular health and neurotransmission. It is so important that the USDA requires choline to be supplemented in non-cow’s milk infant formula. So we all need it and should make sure we have an adequate amount.

The problem is what happens when we get too much of it over time. Choline is associated with TMAO, which makes the blood more prone to clotting. A 2013 article in the New England Journal of Medicine discussed the mechanism by which phosphatidylcholine (lecithin) creates TMAO and raises risk of heart disease and stroke. The Cleveland Clinic published a study earlier this year that showed that people with the highest levels of TMAO had a 400% increase in all-cause mortality than those with the lowest TMAO. There are plenty of articles that refute the connection, but they are not convincing to me.

I believe that choline is another essential nutrient like zinc and Vitamin D that needs to be kept in the “goldilocks zone”, not too much and not too little. Some articles indicate that 90% of people are choline deficient and some articles say that there is very little choline deficiency in the general population. As usual, one has to wonder what to do with strikingly different sets of evidence. Meat, eggs, seafood and lecithin are all major sources of choline. Vegetarians may need lecithin (preferably not soy), wheat germ or a mix of choline containing vegetables such as collard greens because of the lack of meat and eggs in the their diet. But meat and especially egg consumers need to be careful. One egg contains about as much choline as you need for the day. I know that I will continue to eat an egg a week, but that is it. I have already virtually eliminated any choline source from my supplements based on earlier evidence. A balanced diet that leans heavily in the Mediterranean direction enhanced with a moderate amount of vitamins, minerals, phytonutrients and healthy fats seems to be the safest route. Elimination diets just rob us of protein and many nutrients we cannot get anywhere else. The things we need to eliminate are things we are allergic to or that exacerbate certain conditions that we have like auto-immune conditions. I will be presenting auto-immune diet suggestions at our next Logic Based Health Meetup November 14 at Tech Alpharetta.

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