Choline and fatty liver disease

Choline is essential for proper liver function, and research has linked choline deficiency to fatty liver disease. There is no evidence to suggest that choline can reverse fatty liver disease, but it may help prevent the disease.

This article explores choline and how it affects the liver. It explains the different types of fatty liver and how a person can manage them. Additionally, it outlines daily choline requirements and how a person can get choline from foods and supplements.

Choline is an essential nutrient that people need to maintain their overall health. Although the body produces choline, people must also consume it from food to get the amounts they need. Choline has several functions in human healthsuch as:

To research on humans and other mammals have suggested that choline is necessary to maintain normal liver function. Scientists in the 1930s demonstrated that a choline deficiency caused fatty liver disease in dogs and rats. Scientists introduced choline into the diet of animals and found that it solved the disease.

Choline plays a role in amino acid metabolism and methylation reactions in the body. Methylation reactions are essential for gene expression.

Choline also plays an essential role in fat metabolism in the liver and in the regulation of homocysteine. Additionally, choline supports the membranes of mitochondria, which are the energy components of cells.

The body can produce choline from phosphatidylcholine which is a type of specialized fat molecule, or phospholipid. However, people also need to get choline from food to get enough nutrients and keep the liver healthy.

According to National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), there are no drugs approved to treat NAFLD. Health professionals recommend treating NAFLD with weight loss.

However, scientists have studied the effects of choline on fatty liver disease.

For example, a older study in China indicated that the highest choline intake of 412 milligrams (mg) per day, was associated with a lower risk of fatty liver disease in women with a moderate body mass index (BMI) between 18.5 and 24.9. This lower risk was in comparison with the lowest intake of 179 mg per day.

However, the researchers found no association between choline intake and a lower risk of fatty liver disease in obese or overweight women.

Another one older study of 664 people with NAFLD or NASH found that postmenopausal women with insufficient choline intake had more severe fibrosis. However, researchers have not identified choline as a contributor to disease severity in other groups of people.

A recent case-control study from 2022 found that a combined high intake of choline and betaine was associated with a 81% reduction in obesity-related visceral fatty liver disease. However, the ideal dosage of choline remains uncertain.

Further conclusive research on the effects of choline on fatty liver disease is needed.

The National Institutes of Health (NIH) advises that the amount of choline someone has depends on several factors:

  • the amount of methionine, betaine and folate in the diet
  • genre
  • Pregnancy and breast feeding
  • stage of development (age)
  • individual ability to produce choline in the body
  • genetic mutations that affect individual choline needs

There is not enough information for experts to establish an accurate average choline requirement. However, the NIH advises that the following amounts of choline are adequate to prevent liver damage:

  • 425 mg per day for adult women
  • 550 mg per day for adult men
  • 450 mg per day during pregnancy
  • 550 mg per day while breastfeeding

Dietary sources of choline include:

Choline is available in food supplements either alone or combined with vitamins and minerals. The amounts of choline in nutritional supplements typically range from 10mg-250mg.

Choline supplements can come in the form of choline bitartrate, phosphatidylcholine, or lecithin.

Oregon State University indicates that phosphatidylcholine supplements can provide choline. However, choline only comprises approximately 13% of their weight. For example, a 4230 mg phosphatidylcholine supplement would contain 550 mg of choline.

Lecithin supplements from vegetable oils contain varying levels of phosphatidylcholine from 20% to 90%.

A person should speak with their doctor before taking any supplements, as some may interact with medications.

High intakes of choline can cause side effects. The NIH advises that the tolerable upper intake level for healthy adults from foods or supplements should be 3,500mg per day.

Side effects of too much choline can include:

Doctors can recommend that a person loses weight to treat NAFLD or NASH. Losing weight can reduce fat in the liver and prevent inflammation and scarring.

The NIDDK states that losing at least 3% to 5% of body weight can reduce fat in the liver. Additionally, a person may need to lose up to 7-10% of their body weight to reduce liver inflammation and fibrosis.

Physical activity can help a person lose weight, and it is always beneficial without weight loss. Additionally, people can lose weight gradually by eating a balanced diet and limiting their portion sizes. Rapid weight loss can make liver disease worse.

Usually, NAFLD is a silent disease, so people can I have few or no symptoms. However, symptoms may include fatigue and a feeling of discomfort in the upper right side of the abdomen.

A doctor can lead a physical exam and asking a person about their medical history to help diagnose NAFLD. They may also arrange blood tests, imaging tests, or a liver biopsy.

If someone with NAFLD wishes to try a choline supplement, they should consult their doctor first as it may not be suitable or may interact with their medications.

Scientists have not identified how much choline can reverse fatty liver disease. However, it is clear that choline is an essential nutrient for liver health, and a choline deficiency can contribute to fatty liver disease.

Choline also plays a vital role in brain health and fat metabolism. Therefore, it is essential for a person to consume choline for their overall health. People can consume choline from animal protein and plant sources. They may decide to take a choline supplement after consulting a doctor.

A person should talk to a healthcare professional if they think they have fatty liver disease.

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