Health Hotline Magazine | July 2025

Choline + Muscle Health, Exercise Performance

women in their third trimester consumed either 480 mg or 930 mg of choline per day until delivery. All participants followed a standard diet providing 380 mg of choline daily, with additional choline supplementation (either 100 mg or 550 mg) to reach their target intake. Results showed that the infants whose mothers consumed the higher amount of choline had significantly faster reaction times and information-processing speeds when tested between four and 13 months of age. A follow-up 2021 study found that the higher choline intake (930 mg/day) during pregnancy also led to greater cognitive benefits in early childhood. At age seven, the children whose mothers consumed 930 mg/day demonstrated superior sustained attention compared to those in the 480 mg/day group, highlighting the long-term impact of prenatal choline supplementation on cognitive development in children. Choline also benefits the adolescent brain. When healthy adolescent males (aged 13–18) supplemented with either 250 mg or 500 mg citicoline (a form of choline specifically used for brain health) for four weeks, it improved their attention, psychomotor speed, and reduce impulsivity compared to a placebo. In adulthood, choline is deemed e ective at improving memory. In a randomized, double-blind, placebo-controlled study of male and female volunteers 50 to 85 years old, participants took either a placebo or 1,000 mg/day of citicoline for three months in the initial part of the study. In the crossover portion of the study, subjects took both placebo and citicoline (2,000 mg/day) for two months. Results showed that citicoline therapy improved verbal memory functioning in older individuals with relatively ine cient memories. The study concluded, “Citicoline may prove e ective in treating age-related cognitive decline that may be the precursor of dementia.” Alzheimer’s disease (AD), the most common cause of dementia, currently a ects six million U.S. adults and is projected to a ict 14 million Americans by 2050. The neuropathologies in AD include amyloid-beta plaques and neurofibrillary tangles forming in the brain, and neuronal loss, all of which are associated with cognitive impairment. Could a lack of choline in the diet be a contributing factor to this debilitating disease, and could supplementation be a preventive approach? Compelling research points to yes. Choline is a precursor to the neurotransmitter acetylcholine, and a loss of choline receptors and deficiency “of the cholinergic system” in the brain has been shown to contribute to AD. Additionally, when the brain’s resident immune cells (so-called “housekeeping cells”), called microglia, which rid the brain of deleterious debris,

As a precursor to acetylcholine, which signals muscle fibers to contract, choline plays an important role in muscle function. It also supports the structure and function of muscle cell membranes. As highlighted by a small study examining how a choline-deficient diet could impair muscle health, men experienced a significant rise in creatine kinase (CK) levels—an indicator of muscle breakdown and wasting—after just six to 42 days of the altered diet. Upon reintroducing choline into the diet, CK levels returned to normal. In another study, researchers conducted a randomized controlled trial investigating the impact of dietary choline intake on strength and lean mass in healthy older adults 60–69 years old. After 12 weeks of resistance exercise training (RET), results showed that the low-choline group experienced significantly smaller strength improvements compared to the medium- and high-choline intake groups. The study concluded, “… data suggest that this population of older adults does not consume adequate choline and lower choline intake is negatively and independently associated with muscle responses to RET.” Choline also has the potential to be a powerful ally for fitness enthusiasts and athletes looking to increase performance. In a placebo-controlled study conducted on college-aged males, those taking 600 mg per day of alpha-GPC, another form of choline, at the end of just six days, had significantly greater mid-thigh pull peak force compared with those taking a placebo. The study concluded, “sport-performance coaches can consider adding alpha-GPC to the diet of speed and power athletes to enhance muscle performance.”

Choline + Digestive Health

are over-activated, brain inflammation, neuronal death, and neurodegeneration occur. Studies show that “a lifelong regimen of choline supplementation protects the brain from AD both by blocking the production of amyloid-beta plaques and by reducing the activation of microglia.” When AD mice were given a lifelong regimen of

Choline, as phosphatidylcholine, is a key component of bile (an important digestive fluid), that breaks down fats and removes cholesterol from your liver, thereby supporting the digestive process and promoting gallbladder health. According to research, choline insu ciency has even been linked to increased intestinal permeability and inflammation, while animal studies have demonstrated that choline supplements increase intestinal-barrier function and lower inflammation. Choline intake can also influence the composition of the gut microbiota, with higher choline consumption being linked to an increase in beneficial bacteria.

choline (4.5 times the RDI), cognitive deficits improved and activated microglia were reduced.

For references, please visit naturalgrocers.com/issue-96

Natural Grocers ® | 31