By Cameron Vazquez, MPH
So many of us try to fight the natural aging process. Products everywhere claim to have anti-aging properties that defy the natural course of life and keep you younger. Here at the Center for Better Bones, we don’t fight aging — we embrace it! However, it is imperative to distinguish between healthy aging and unhealthy aging.
While many of us are living longer than previous generations, we don’t necessarily enjoy a higher level of health in our senior years. Even though the average person in the U.S. has a life expectancy of almost 80 years, the age for developing a serious illness is 63. (1)
These last 17 years or so of life are spent in poor health, plagued by one or more degenerative diseases. This is “unhealthy aging.” On the other hand, there are those in this culture and around the world who enjoy a high level of health, free from degenerative diseases and disability almost to their final days. This is “healthy aging” and suggests an extension not just of ones “lifespan” but of ones “health span,” that is, the length of time spent as a healthy, happy, and fully functioning member of society.
What can we do for unhealthy aging?
A highly underrated nutrient that can help fight unhealthy aging is choline. Never heard of choline? You’re not alone. Considering that 90% of Americans are deficient in choline, many are unaware of this vital nutrient and its dramatic influence on our aging process even from before the very day we were born! (2)
Keep reading to find out why we need to start talking about choline to combat the unhealthy aging of our bones and brains.
What is choline?
Choline is classified as an essential nutrient that is crucial for numerous physiological processes in the body, including neurotransmitter synthesis, cell-membrane structure and signaling, lipid transport, and methylation. (3)
The main functions of choline
Choline’s key roles in so many significant bodily functions make it just that important. It can impact our brains, heart, liver, muscles, and bones in a major way. Some of its most important functions include:
- Preventing non-alcoholic fatty liver disease and liver damage (4)
- Helping muscle function (5)
- Improving athletic performance (6)
- Reducing negative birth outcomes (5)
- Aiding proper signaling, transport, and repair of cells (4)
- Enhancing magnesium uptake to the cells
Choline and your bones
Choline is a key player in keeping bones healthy and strong. For instance, it regulates homocysteine levels in the body. High homocysteine levels are associated with decreased bone mineral density and increased bone fragility. (7) Choline deficiency is also associated with other inflammatory markers that can damage bone. (8)
Choline is associated with an increased risk of osteoporosis. One study found that those with choline intakes of less than or equal to 300 mg per day had 2.5 times the prevalence of osteoporosis compared to those with choline intakes of 600 mg per day or more. Overall, this study found an association between an increased risk of osteoporosis and low dietary choline intake. (9)
Another study had similar results. Amongst subjects with the lowest choline intakes, there was a significantly higher risk of having low femoral neck bone mineral density compared to those with the highest choline intakes. Ultimately, a positive association between choline from diet and BMD in middle-aged and elderly participants was found. (10)
This research confirms our previous findings on the importance of choline on bone. In the past, we have found that choline-stabilized orthosilicic acid impacts bone. Now we know that both choline-stabilized orthosilicic acid and choline itself influence bone health!
Choline and your brain
Choline is a nutrient that impacts the brain throughout our lifespan. Research emphasizes choline’s importance within the first 1,000 days of life due to its impact on fetal brain development, birth outcomes, behavioral patterns, (11) and its protective abilities against fetal alcohol exposure. (12)
However, choline also drastically affects our brains in the later stages of life.
Aging leads to decreased cognitive function and an increased risk of developing Alzheimer’s disease. Currently, more than 6 million Americans have Alzheimer’s disease. This number is expected to increase to 13 million by the year 2050. Sadly, Alzheimer’s and other dementias kill more seniors than breast cancer and prostate cancer combined. (13)
Alzheimer’s disease is linked to the neurotransmitter, acetylcholine, that tells our brain to store memories. Specifically, low concentrations of acetylcholine have been found in those afflicted with Alzheimer’s disease. (14)
What does acetylcholine have to do with choline? Without choline, our bodies cannot form acetylcholine. Therefore, it’s important to make sure you’re supplying your brain with enough choline to produce this crucial neurotransmitter.
As we mentioned before, choline plays a role in regulating the levels of homocysteine in our body. And Alzheimer’s disease and dementia are associated with high levels of homocysteine. Adequate choline intake may be able to lower these high levels of homocysteine. (15)
Despite these scary statistics, there is hope in the form of choline!
The clinician who has developed the most effective clinical program for preventing and reversing cognitive decline, Dr. Dale Bredesen, MD, has detailed the importance of choline and cognitive functioning in his book, The End of Alzheimer’s Program.
Other researchers have shown that choline by itself can improve cognitive function in those with mild and moderate Alzheimer’s disease. (16)
Protect your bones and your brain
At the Center for Better Bones, we always recommend pure choline citrate instead of choline bitartrate because choline bitartrate can contain irritating antigens, such as corn starch. The optimum level of choline citrate is between 650–1,300 mg/day, which is about 1 to 2 teaspoons of liquid choline citrate.
If you are using choline citrate to combat a loose stool from magnesium, take 1 teaspoon of liquid choline citrate each time you take magnesium. You can listen to a brief video of Dr. Brown explaining how to take choline citrate here.
If you’d like to know more about magnesium uptake, read our blog, Enhance Your Magnesium Uptake and More with Choline Citrate.
Protect your future self with choline!
Click to view References
- Peterson, T. 2017. Healthspan is more important than lifespan, so why don’t more people know about it? Harvey A. Friedman Center for Aging Blog Page, Washington University in St. Louis Institute for Public Health.
- Wallace, T. C. and V. L. Fulgoni, III. 2016. Assessment of total choline intakes in the United States. Journal of the American College of Nutrition 35(2):108-112.
- Zeisel, S. H. and K. A. da Costa. 2009. Choline: An essential nutrient for public health. Nutrition Reviews 67(11):615-623.
- NIH (National Institutes of Health). 2021. Choline: Fact sheet for health professionals. NIH Office of Dietary Supplements website. Accessed May 2022.
- Korsmo, H. W., et al. 2019. Choline: Exploring the growing science on its benefits for moms and babies. Nutrients 11(8):1823.
- Conlay, L. A., et al. 1992. Exercise and neuromodulators: Choline and acetylcholine in marathon runners. International Journal of Sports Medicine 13(Suppl 1):S141-S142.
- Fratoni, V. and M. L. Brandi. 2015. B vitamins, homocysteine and bone health. Nutrients 7(4):2176-2192.
- Detopoulou, P., et al. 2008. Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: The ATTICA study. The American Journal of Clinical Nutrition 87(2):424-430.
- Zhang, Y. W., et al. 2021. Low dietary choline intake is associated with the risk of osteoporosis in elderly individuals: A population-based study. Food & Function 12:6442-6451.
- Øyen, J., et al. 2017. Dietary choline intake is directly associated with bone mineral density in the Hordaland Health Study. The Journal of Nutrition 147(4):572-578.
- Derbyshire, E. and R. Obeid. 2020. Choline, neurological development and brain function: A systematic review focusing on the first 1000 days. Nutrients 12(6):1731.
- NIH (National Institutes of Health). 2020. Choline supplements in young children with fetal alcohol spectrum disorder have lasting cognitive benefits. NIH National Institute on Alcohol Abuse and Alcoholism Research Update website. Accessed May 2022.
- Alzheimer’s Association. 2022. Alzheimer’s disease facts and figures. Alzheimer’s Association website. Accessed May 2022.
- Jia, J. P., et al. 2004. Differential acetylcholine and choline concentrations in the cerebrospinal fluid of patients with Alzheimer’s disease and vascular dementia. Chinese Medical Journal 117(8):1161-1164.
- Smith, A. D., et al. 2018. Homocysteine and dementia: An international consensus statement. Journal of Alzheimer’s Disease 62(2):561-570.
- Moreno Moreno, M. D. J. 2003. 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. Clinical Therapeutics 25(1):178-193.