Introduction:
Choline is an essential nutrient that the body makes in small amounts, but choline must be obtained from the diet for the body to receive an adequate amount. Foods which contain the largest amounts of choline include dairy, meats, and eggs. Choline helps cell membranes function properly, it plays a role in nerve communication, reduces homocysteine levels (elevated levels are linked to heart disease), and reduces chronic inflammation.
Choline and allergic rhinitis:
An 8-week study of allergic rhinitis (allergies, hay fever), compared the effectiveness of oral tricholine citrate (TRI, an essential nutrient called choline) versus intranasal budesonide (BUD, an anti-inflammatory) in 60 patients. Participants were randomized to receive BUD 200 mcg twice daily or TRI 500 mg 3 times daily. Results demonstrated that compared to TRI, BUD was associated with a significant reduction in symptoms of allergies. Overall, 76% of patients taking BUD reported the drug to be effective verses 43% with choline. The nasal steroid achieved better treatment results. (1)
Choline and asthma:
High dose vs low dose choline: Choline, an essential nutrient, was found to benefit individuals with bronchial asthma after 4 months of taking either low dose choline (500 mg TDS) or high dose choline (1 g TDS). Reduction in asthma symptoms and an increase in the number of days without symptoms were reported by those receiving choline or placebo. These improvements however were only significant in the 2 groups taking choline. Airway improvement and reduction in need to use asthma medication were significant only in the high dose choline group. (2)
A 3-month study that examined the effectiveness of disodium cromoglycate (DSCG, an anti-inflammatory drug) versus choline (an essential nutrient with anti-inflammatory properties) versus placebo (bronchodilators only) for asthma found clinically significant decreases in the severity of symptoms, number of symptomatic days, and the need to use bronchodilators in patients with asthma in study participants taking choline. However, all participants showed some improvement. (3)
Common Highest Choline Containing Foods:
| Milk, canned, condensed, sweetened 306 1 cup | 272.6 mg |
| Chicken, broilers or fryers, giblets, cooked, simmered 145 1 cup | 258.2 mg |
| Turkey, whole, giblets, cooked, simmered 145 1 cup | 225.6 mg |
| Fast Foods, biscuit, with egg and sausage 180 1 biscuit | 176.2 mg |
| Fish, salmon, sockeye, cooked, dry heat 155 1/2 fillet | 174.7 mg |
| Egg, whole, cooked, hard-boiled 50 1 large | 146.9 mg |
| Egg, whole, cooked, fried, 1 large | 145.9 mg |
| Fast foods, english muffin, with egg, cheese, Canadian bacon, 1 muffin | 127.8 mg |
| Cake, chocolate, prepared from recipe without frosting, 1 piece | 122.0 mg |
| Tomato products, canned, paste, without salt added, 1 cup | 100.9 mg |
| Beef, chuck, blade roast, lean only, 0″ fat, cooked, braised, 3 oz | 100.6 mg |
| Beans, baked, canned, with pork and tomato sauce, 1 cup | 99.2 mg |
| Spinach soufflé, 1 cup | 83.0 mg |
| Fish, swordfish, cooked, dry heat, 1 piece | 82.2 mg |
| Lamb, leg, whole (shank and sirloin), trimmed 1/4″ fat, roasted, 3 oz | 81.9 mg |
| Soybeans, mature cooked, boiled, without salt, 1 cup | 81.7 mg |
| Beans, navy, mature seeds, cooked, boiled, without salt, 1 cup | 81.4 mg |
| Milk, canned, evaporated, added vitamin D, no added vitamin A, 1 cup | 80.1 mg |
| Beans, baked, canned, plain or vegetarian 254 1 cup, 3 oz | 79.7 mg |
| Eclairs, custard-filled with chocolate glaze, 1 eclair | 79.6 mg |
| Chickpeas (garbanzo beans), canned, solids and liquids, 1 cup | 78.2 mg |
| Beans, kidney, red, mature seeds, canned, solids and liquids, 1 cup | 78.1 mg |
| Fish, pollock, Alaska, cooked, dry heat, 3 oz | 77.9 mg |
| Cowpeas (blackeyes), immature, frozen, boiled, drained, no salt, 1 cup | 77.5 mg |
| Crustaceans, shrimp, mixed species, cooked, breaded and fried, 3 oz | 77.5 mg |
| Turkey, enhanced, dark meat, roasted, 1 serving (3 oz) | 76.8 mg |
| Collards, frozen, chopped, cooked, boiled, drained, without salt, 1 cup | 76.7 mg |
| Beef, cured, corned beef, canned, 3 oz | 75.9 mg |
| Fish, salmon, chinook, smoked, 3 oz | 75.7 mg |
| Barley, pearled, raw, 1 cup | 75.6 mg |
| Fish, salmon, pink, canned, total can contents, 3 oz | 74.6 mg |
| Buckwheat flour, whole-groat, 1 cup | 65.0 mg |
| Lentils, mature seeds, cooked, boiled, without salt, 1 cup | 64.7 mg |
Adapted from: Nutritive Value of Foods, United States Department of Agriculture, Agricultural Research Service, Home and Garden Bulletin Number 72. May be accessed at: https://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR25/nutrlist/sr25w421.pdf
Assessment and Plan: Choline
- An 8-week study of allergic rhinitis compared oral tricholine citrate (TRI-an oral form of choline) vs intranasal budesonide (BUD, an anti-inflammatory) at a dose of BUD 200 mcg twice daily or TRI 500 mg 3 times daily showed BUD to be effective in 76% of patients vs. 43% with choline (BUD was more effective) (1).
- After 4 months of low dose (500 mg choline) or high dose (1 g choline), subjects showed some improvement on low dose choline, but the high dose showed the most significant reduction in asthma symptoms, reduced requirement for asthma medication, and an increase in the number of days without symptoms (2).
- A 3 month study testing asthma response to disodium cromoglycate, vs. choline vs. placebo (bronchodilators only) for asthma did show some response for all 3 treatments, but only found clinically significant decreases in the severity of symptoms, number of symptomatic days, and the need to use bronchodilators in study participants taking choline (3).
- Optimal dosage of choline for control of bronchial asthma has not yet been determined and more research is needed for this purpose.
References:
1.Das S, Gupta K, Gupta A, Gaur SN. Comparison of the efficacy of inhaled budesonide and oral choline in patients with allergic rhinitis. Saudi Med J. 2005 Mar;26(3):421-4. http://www.ncbi.nlm.nih.gov/pubmed/15806211
2.Gupta SK, Gaur SN. A placebo controlled trial of two dosages of LPC antagonist-choline in the management of bronchial asthma. Indian J Chest Dis Allied Sci 1997 Jul-Sep;39(3):149-56. http://www.ncbi.nlm.nih.gov/pubmed/9357148
3.Gaur SN, Agarwal G, Gupta SK. Use of LPC antagonist, choline, in the management of bronchial asthma. Indian J Chest Dis Allied Sci 1997 Apr-Jun;39(2):107-13.
http://www.ncbi.nlm.nih.gov/pubmed/9339609
4.Nutritive Value of Foods, United States Department of Agriculture, Agricultural Research Service, Home and Garden Bulletin Number 72. May be accessed at:https://www.ars.usda.gov/SP2UserFiles/Place/12354500/Data/SR25/nutrlist/sr25w421.pdf and http://www.nal.usda.gov/fnic/foodcomp/Data/HG72/hg72_2002.pdf