For decades, scientists have known that choline deficiency makes the liver fatty – and that choline supplementation does the reverse, de-fattening the liver. Okay, sure, most doctors don't know this. But it doesn't matter. The important thing is you won't end up with a fatty liver.
There are two main reasons why choline keeps your liver fat-free and healthy:
- Point 1: Without enough choline in your diet, you can't make enough phospholipids.
Choline is an essential component of these membrane lipids. The consequence: fats can't leave the liver and accumulate there instead. For fats to be transported in the blood at all, they need to be made water-soluble with the help of a phospholipid coating. And that requires choline.
- Point 2: Mitochondria become dysfunctional when they don't get enough choline.
This is actually a straightforward point. When our mitochondria – the cellular "powerhouses" where fats are burned – don't get enough choline, they simply don't function properly. And without healthy mitochondria, fat metabolism in the liver can't work at all.
This is also an important reason why malnutrition and prolonged fasting cause fatty liver. The liver simply can't get rid of the fats because choline – a nutrient that must come from food – eventually runs out.
Something similar applies to muscle. While muscle can't export fats the way the liver does, it can only store or burn them. But choline also de-fats muscle – or rather, helps it de-fat itself. One reason is, as described above, that the abundant mitochondria in muscle need choline to function properly at all.
Additionally, choline deficiency causes fatty acids to accumulate as fats or fat metabolites in muscle cells rather than being incorporated into cell membranes. Choline also regulates genes that boost fat burning in muscles while simultaneously suppressing genes that promote fat production in muscles. All of this improves the metabolic profile of muscle and... de-fats it.
Fat in muscle tissue is problematic. Remember: too much (unburned) fat in muscle causes insulin resistance. And that ultimately drives the development of metabolic syndrome. Anyone who wants to stay metabolically healthy needs enough choline in their diet. This was recently confirmed in the impressive Newfoundland CODING study (Complex Diseases in the Newfoundland population: Environment and Genetics) with 2,400 adults: people with the highest choline intake also had the best insulin sensitivity – and vice versa.
The authors of this study explain this observation partly by the fact that choline is converted in the body into a substance called betaine – and by the way, this conversion requires the cofactor PQQ (contained in our Multi supplement). Betaine doesn't get much attention, but it's also a nutrient rockstar. In studies, betaine improves insulin sensitivity in the liver and adipose tissue, and generally reduces inflammation – which in turn positively impacts metabolic health.
Isn't that fascinating? Back in the "Golden Age of Bodybuilding," Vince Gironda – the trainer of many bodybuilding stars (including Larry Scott, Frank Zane, Don Howorth, Lou Ferrigno, and Arnold Schwarzenegger) – recommended choline to his trainees because he believed that, as a so-called lipotropic nutrient, it mobilizes body fat. According to recent research, choline has such a positive effect on fat metabolism that it apparently can reverse fat metabolism disorders associated with Alzheimer's disease.
Here's an expert tip: choline also inhibits ketosis. Because ketosis requires fat in the liver. So if you're taking a lot of choline and having trouble getting into ketosis... now you know that this is actually normal with high choline intake.
Finally, a word about your choline status: choline was long considered "nice to have" – a non-essential substance your body could supposedly produce on its own. Wrong. Today, choline is classified as an essential micronutrient that we should consume around 500 mg per day. Only a few of us manage that. Most of us get somewhere between 200 and 350 mg daily on average.
Eggs are by far the best choline source we have (about 150 mg per egg). All animal products are also good (50–100 mg per 100g), especially liver (300–500 mg per 100g). Plants generally contain very little choline (<30 mg per 100g); soy and sunflower lecithin as supplements and wheat germ (150 mg per 100g) are the exceptions.
You can read more about choline in this blog post from us.