What is Choline? 4 Different Forms Discussed – Lecithin, Choline Bitartrate, CDP-Choline, Alpha GPC

What is choline? This article explores various types of choline available today. Choline supplements are recommended for improving memory and cognition. Supplementing with choline may also have the potential to improve a variety of other health factors.

Choline supplements are especially relevant to vegetarians and vegans, who are at risk of not consuming sufficient dietary choline. Choline supplements have also been recommended by various researchers and medical professionals and are effective for most people.

We explore the potential risks linked to diets that are overly rich in choline. These risks are also associated with a high consumption of animal products.

What is choline? Studies suggest that choline supplements may enhance memory

What is Choline?

Choline is an essential nutrient, as recognized by the Institute of Medicine (IOM) in 1998. Our bodies cannot manufacture choline and we require additional choline from our diets. Choline deficiency is linked to serious diseases including liver damage, muscle dysfunction, compromised immunity, and diseases of the kidney, pancreas, brain, and nervous system. [1]

Choline has a variety of roles throughout the human body. These include:

• Maintaining cell structure and cell membrane function
• Cellular signaling
• Central nervous system (CNS) impulse transmission
• Transport and metabolism of fats
• Methyl-donor, important for enzyme function
• Regulation of osmotic stress [2]

The required doses of choline vary from person to person based on age, gender, genetics, and factors like pregnancy or breastfeeding. The Adequate Intake (AI) for adults is 550mg/day for men and 425mg/day for women. According to the National Academies of Sciences, the upper tolerance of choline is 3.5grams/day. [3]

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Why should you take Choline?

• Pregnant and breastfeeding women: The demand for choline is exceptionally high during these life periods. [4] The recommended Adequate Intake (AI) for pregnant women is 450 mg/day; 550 mg/day for breastfeeding women. This is often higher than what could be naturally consumed, even from a healthy and varied diet. [5]

• Improving memory development: Especially at a young age, choline is important for the development of memory and brain function. Again, studies have shown that adequate choline intake is especially important during pregnancy and breastfeeding. [6]

• Promoting cardiovascular health: Choline is a vital nutrient for the methylation of homocysteine –a toxic compound that results from a number of biochemical reactions. Increased homocysteine levels are associated with an increased risk of heart disease, cancer, cognitive decline, and bone fractures. [7]

• Improving inflammatory markers: A large study on over 3000 men and women was published in the American Journal of Clinical Nutrition in 2008. The study looked at the average choline intake in people’s diets and compared it to the prevalence of inflammation. There was a statistically significant correlation between choline and a reduced level of inflammation.[8]

• Improving cellular functions: Researchers have found that human blood cells from people with an experimental choline-deficient diet had increased DNA damage and cell death. [9] Furthermore, a hallmark study published in the FASEB Journal in 2008 indicated that women with diets that were higher in choline had a reduced risk of developing breast cancer of 24%. [10]

Alternative forms of choline may have different and more pronounced benefits, which we discuss below.

Sufficient choline is required for a healthy body

What are the different forms of Choline?

Today, there are four major forms of choline that people take as dietary supplements. There are a few other minor forms too, but we will focus only on the four most relevant forms available today. These include lecithin, CDP-Choline, Alpha GPC, and Choline Bitartrate.

1.    Lecithin

Lecithin is a common dietary source of choline and is defined as a yellow-brown fatty substance found in plant and animal products. Lecithin is not actually a form of choline – rather, it is a source of choline. Lecithin contains phosphatidylcholines, saturated and unsaturated fatty acids, glycerol, and triglycerides. [11]

Lecithin was first isolated from egg yolk in the 19^th century by a French chemist called Theodore Gobley. Today, lecithin extracts are used as food additives because of their emulsification abilities. Soy-derived lecithin (also known as soy lecithin) is used in a number of food products and is a source of controversy among some people. [12]

Soy lecithin contains a number of compounds including:

Soy is a great nutritional source of lecithin

• Phosphatidylcholine
• Phosphatidylethanolamine
• Inositol phosphatides
• Other phosphatides
• Soybean oil
• Sterols
• Carbohydrates [13]

 

While lecithin is an important source of dietary choline, it is definitely not the best source of choline for beneficial health effects. Soy lecithin, the most common source of lecithin, is a highly processed food substance.

It must go through a number of industrial processes before it can be added to food products. There are numerous health issues with processed foods, and we recommend avoiding eating them as much as possible. [14]

Processed foods include:

Although marketed as being healthy, breakfast cereals are actually highly processed

• Breakfast cereals
• Dairy products
• Canned foods
• Packaged breads
• Savoury ‘snacks’, like packaged crisps or crackers
• All meat products
• “Convenience foods” – (microwave meals or ready meals)
• Sodas and soft drinks
• Fast foods [15]

Many of these foods contain soy lecithin as an additive. Mind you, the lecithin is not added for its health benefits – in processed foods, it is used purely as an emulsifier. [16] The negative effects of processed foods outweigh any positive effects from the choline found in lecithin. [17]

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2.    CDP-Choline

CDP-Choline, also known as Citicoline (INN), is a form of choline that is sold as a dietary supplement and has scientifically-verified benefits. CDP-Choline is an intermediate chemical in the conversion of choline to phosphatidylcholine – a biochemical mechanism that occurs in plants and animals. [18]

When CDP-Choline is taken as a supplement, your body converts it into both choline and cytidine. The cytidine is then further converted into uridine. CDP-Choline is a form of fatty acid, known as a choline-containing phospholipid. CDP-Choline supplements are used as Nootropic substances to improve cognitive performance and to enhance memory. [19]

There have been numerous studies indicating the efficacy of CDP-Choline as a Nootropic supplement. The benefits of CDP-Choline include:

• Increased attention: A 2012 study published in the Journal of Scientific Research found that CDP-Choline improved attention and cognitive performance over 4 weeks, especially at a dosage of 500mg/day. [20]

• Improved memory: A 1997 study found that CDP-Choline had such a positive effect on memory in elderly people that the authors recommended it to be used as a treatment for memory deficits. Effective dosage range was between 300-1000mg/day. [21]

• Decreased blood pressure: The same study as above also found a minor decrease in systolic blood pressure and improved immune function in the CDP-Choline group. ¹¹

• Appetite Suppression: A 2010 article published in the Journal of Eating Disorders showed data indicating that high doses of CDP-Choline (2000 mg/day) resulted in a decreased appetite and increased brain responses to food stimuli. [22]

CDP-Choline has the potential to work as a potent Nootropic and improve focus and attention

3.    Alpha GPC

Alpha-GPC is another choline-containing phospholipid and is very similar to CDP-Choline. Alpha-GPC is a bioactive compound that is formed during lecithin metabolism. Alpha-GPC increases your choline levels and acts as a precursor molecule to phosphatidylcholine and acetylcholine.

Alpha-GPC is found in naturally in low concentrations in meat products. However, the most common form of Alpha-GPC is made synthetically from soy lecithin. [23]

There is a lack of data to support the purported cognitive enhancing benefits of Alpha-GPC in healthy people. However, scientists have outlined some benefits of Alpha-GPC that they’ve found so far:

• May help to reduce cognitive decline in elderly people: A 2003 study published in the Journal of Clinical Therapy found that daily doses of Alpha-GPC over 180 days significantly improved scores in various cognitive assessments for elderly people suffering from dementia. [24]

• May increase athletic power: A study on Alpha-GPC was published in the Journal of the International Society of Sports Nutrition in 2008. Researchers found that a 600 mg dose of Alpha-GPC increased post-exercise growth hormone and athletic force during resistance training. It had no effect on peak power, heart rate, or any other exercise-related factors. [25]

• May improve fat oxidation: A study on eight healthy young adults indicated that Alpha-GPC may have a significant effect on fat oxidation (fat burning). Furthermore, the study found that growth hormone levels had also increased around 120 minutes after the dose was taken. [26]

Although these potential benefits are interesting and thought-provoking, the body of evidence for Alpha-GPC’s efficacy in healthy people is still lacking. More studies need to be conducted on this compound to further elucidate its potential health benefits – especially in improving cognition, memory, and athletic power.

Studies have shown that Alpha GPC may have the potential to improve athletic power

4.    Choline Bitartrate

Choline Bitartrate is a salt form of choline. It is the simplest version of choline available as a dietary supplement and provides and effective source of choline supplementation.

The benefit of taking choline bitartrate

Liftmode Choline, 99%+ purity

instead of ‘pure choline’ is that the bitartrate allows greater stability during storage as well as improved digestion and absorption. Choline bitartrate is hygroscopic and also has the potential for degradation if not stored correctly. We recommend checking out some capsules as an option for improving stability during storage. [27]

There have been many studies on the effects of choline supplementation. Some view Choline Bitartrate as an effective Nootropic substance. Others recommend that Choline Bitartrate is seen as a dietary supplement to improve choline levels and improve health as a result.

Importantly, a meta-review was published in the Journal of Nutrition Reviews in 2009. The review focused on the existing data about choline intake available at that time. The authors concluded that there was legitimate evidence to suggest that as much as 50% of the American population has a genetic mutation which reduces the ability of the body to absorb choline. [28]

Furthermore, dietary sources of choline are usually extremely high in cholesterol. Eggs, for example, contain around 212mg of cholesterol and 125mg of choline, per egg. [29] This is why it is recommended to take a Choline Bitartrate supplement instead.

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Potential Risks of Choline Consumption

There is a potential increased risk of prostate cancer for men who consume diets that are high in choline content. An epidemiological study on over 47,000 men for a period of 22 years found that diets that were rich in choline contributed to an increased risk of prostate cancer. [30]

Importantly, the study looked at the dietary content of choline. Researchers asked participants to give information about their dietary consumption of foods that are high in choline 6 times over a 22-year period.  Food sources that are rich in choline include:

Eggs are traditionally marketed as being high in choline

• Eggs
• Fish
• Dairy
• Poultry
• Red meat

All of these food products have been linked to health problems and specifically to cancer in various studies – these links are not commonly associated with the choline content, but rather with other factors like animal proteins, saturated fats, cholesterol, contamination, and carcinogenic compounds:

• Eggs: Consumption linked to increased ovarian cancer risk [31]
• Dairy: Increased risk of prostate cancer [32]
• Poultry: Increased risk of all cancers due to high prevalence of heterocyclic amines [33]
• Fish: Increased risk of disease due to high levels of contamination [34]
• Red meat: Class II carcinogen, with processed meat being a Class I carcinogen as defined by the WHO [35]

Diets that are high in animal products and processed foods can lead to obesity, diabetes, and other diseases.

Basically, the link that the study makes between high dietary choline levels and increased risk of prostate cancer is confounded by other dietary factors. Seeing as most people do not consume adequate choline in their diets, it is not likely that choline supplementation within the recommended daily dosages would be a risk factor. [36]

However, we’d encourage you to not exceed the recommended dosage for Choline Bitartrate, and we also recommend speaking to your physician if you are currently consuming a diet that is high in animal products and processed foods.

Conclusion: What is choline and why take it?

So then, what is choline? In conclusion, there are four main types of choline that people take: lecithin (either as a supplement or in food), CDP-Choline, Alpha GPC, and Choline Bitartrate. Each has it’s pros and cons.

Lecithin is primarily used as a food additive but is also a good source of dietary choline. CDP-Choline and Alpha GPC have strong evidence suggesting Nootropics uses – improved memory and cognition. Choline Bitartrate is a good supplement to improve choline levels and promote good health.

Choline is an essential nutrient with vital functions in your body. Studies suggest that the majority of people do not consume adequate choline in their diets. Choline is especially important during pregnancy, breastfeeding, and infancy, and may also have an important role in reducing cognitive decline in aging.

There may be health risks associated with diets that are overly high in choline – ie, diets that are rich in animal products like meat, eggs, fish, and dairy. No studies have been done to assess the long-term effects of high-dosages of choline supplements. Do not exceed the recommend dosage for any choline supplement.

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Choline is an essential nutrient that is important for maintaining a healthy body

References:

[1] LM. Sanders, SH. Zeisel, “Choline: Dietary Requirements and Role in Brain Development”, Nutr Today. 2007; 42(4): 181–186.

[2] “Choline”, Oregon State University, Micronutrient Information Center, available online, accessed April 27, 2017

[3] “Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline”, Institute of Medicine (US) Standing Committee on the Scientific Evaluation of Dietary Reference Intakes and its Panel on Folate, Other B Vitamins, and Choline, Washington (DC): National Academies Press (US); 1998.

[4] IY Ozarda, G Uncu, IH Ulus, “Free and phospholipid-bound choline concentrations in serum during pregnancy, after delivery and in newborns”, Arch Physiol Biochem. 2002 Dec;110(5):393-9.

[5] SH Zeisel, MD Niculescu, “Perinatal choline influences brain structure and function”, Nutr Rev. 2006 Apr;64(4):197-203.

[6] AM Molloy et al., “Choline and homocysteine interrelations in umbilical cord and maternal plasma at delivery”, Am J Clin Nutr. 2005 Oct;82(4):836-42.

[7] P Ganguly, SF Alam “Role of homocysteine in the development of cardiovascular disease”, Nutr J. 2015; 14: 6, Published online 2015 Jan 10.

[8] P Detopoulou et al., “Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: the ATTICA study”, Am J Clin Nutr. 2008 Feb;87(2):424-30.

[9] KA da Costa et al., “Choline deficiency increases lymphocyte apoptosis and DNA damage in humans”, Am J Clin Nutr. 2006 Jul;84(1):88-94.

[10] X Xu et al., “Choline metabolism and risk of breast cancer in a population-based study”, FASEB J. 2008 Jun; 22(6): 2045–2052.

[11] “Soy Lecithin Fact Sheet”, soyconnection.com, fact sheet provided by the United Soybean Board, accessed April 27, 2017

[12] “Is Soy Lecithin Good or Bad for Me?”, by A Schaefer, Healthline.com, accessed on April 27, 2017

[13] CR SCHOLFIELD, “Composition of Soybean Lecithin”, Journal of the American Oil Chemists’ Society, vol. 58, no. 10 (October 1981), p. 889-892.

[14] SS Anand et al., “Food Consumption and its impact on Cardiovascular Disease: Importance of Solutions focused on the globalized food system”, J Am Coll Cardiol. 2015 Oct 6; 66(14): 1590–1614.

[15] “Eating processed foods”, nhs.co.uk, available online, accessed April 27, 2017

[16] JD Weete et al., “Improvement of lecithin as an emulsifier for water-in-oil emulsions by thermalization”, Journal of the American Oil Chemists’ Society, July 1994, Volume 71, Issue 7, pp 731–737

[17] LD Kushi et al., “American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer With Healthy Food Choices and Physical Activity”, CA Cancer J Clin 2006;56;254-281

[18] “Phosphatidylcholine”, by William Christie, AOCS Lipid Library, lipidlibrary.aocs.org, accessed April 27, 2017

[19] “CDP-Choline”, Examine.com, accessed April 27, 2017

[20] E McGlade et al., “Improved Attentional Performance Following Citicoline Administration in Healthy Adult Women”, FNS, Vol.3 No.6, June 2012

[21] XA Alvarez et al., “Citicoline improves memory performance in elderly subjects”, Methods Find Exp Clin Pharmacol. 1997 Apr;19(3):201-10.

[22] WD Killgore et al., “Citicoline affects appetite and cortico-limbic responses to images of high-calorie foods”, Int J Eat Disord. 2010 Jan;43(1):6-13.

[23] AM Brownawell, “Safety assessment of AGPC as a food ingredient”, Food Chem Toxicol. 2011 Jun;49(6):1303-15

[24] M De Jesus Moreno Moreno, “Cognitive improvement in mild to moderate Alzheimer’s dementia after treatment with the acetylcholine precursor choline alfoscerate: a multicenter, double-blind, randomized, placebo-controlled trial”, Clin Ther. 2003 Jan;25(1):178-93.

[25] T Ziegenfuss et al., “Acute supplementation with alpha-glycerylphosphorylcholine augments growth hormone response to, and peak force production during, resistance exercise”, Journal of the International Society of Sports Nutrition20085(Suppl 1):P15

[26] T Kawamura et al., “Glycerophosphocholine enhances growth hormone secretion and fat oxidation in young adults”, Nutrition. 2012 Nov-Dec;28(11-12):1122-6

[27] AB Gangurde, “Modified extrusion-spheronization as a technique of microencapsulation for stabilization of choline bitartrate using hydrogenated soya bean oil”, Int J Pharm Investig. 2015 Oct-Dec; 5(4): 275–283

[28] SH Zeisel, KA da Costa, “Choline: An Essential Nutrient for Public Health”, Nutr Rev. 2009 Nov; 67(11): 615–623

[29] “Egg Cholesterol in the Diet”, Michael Greger M.D. FACLM  August 31st, 2011  Volume 5, available online, accessed April 27, 2017

[30] EL Richman et al., “Choline intake and risk of lethal prostate cancer: incidence and survival”, Am J Clin Nutr. 2012 Oct; 96(4): 855–863.

[31] ST Zeng et al., “Egg consumption is associated with increased risk of ovarian cancer: Evidence from a meta-analysis of observational studies”, Clin Nutr. 2015 Aug;34(4):635-41.

[32] “A Milk Protein, Casein, as a Proliferation Promoting Factor in Prostate Cancer Cells”, SW Park et al., World J Mens Health. 2014 Aug; 32(2): 76–82.

[33] KI Skog et al., “Carcinogenic Heterocyclic Amines in Model Systems and Cooked Foods: A Review on Formation, Occurrence and Intake”, Food and Chemical Toxicology 36 (1998) 879±896

[34] “Fish”, Physicians Committee for Responsible Medicine, pcrm.org, available online, retrieved on April 27, 2017

[35] “Q&A on the carcinogenicity of the consumption of red meat and processed meat”, World Health Organization (WHO), October 2015, available online, accessed April 27, 2017

[36] “Choline: Fact Sheet for Health Professionals”, National Institutes of Health, US Department of Health and Human Services, available online, accessed April 27, 2017

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