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Fatty Liver Disease | Choline Vindicated

Choline is an essential nutrient found in cholesterol-rich foods like liver and egg yolks. Among many other roles, it supports neurological development and mental health and protects against fatty liver disease. So it will be no surprise to our readers that establishment nutritionists have choline in the crosshairs.

For example, a recent paper published in Nature suggests that dietary choline may contribute to heart disease (Nature 2011; 472(7341): 57-63). The authors argue that dietary choline, found mostly in a form called phosphatidylcholine, enters the intestine where our gut bacteria convert it to free choline and then to trimethylamine, a gas that smells like rotting fish.

Then our livers detoxify the trimethylamine to an odorless product called trimethylamine oxide (TMAO), and TMAO, the authors argue, fills our arteries with plaque.

They also showed that feeding mice phosphatidylcholine did in fact produce TMAO but only in the presence of gut bacteria. Further, feeding mice five-fold or ten-fold higher concentrations of choline chloride than they would ordinarily receive, or simply feeding them TMAO itself, increased atherosclerotic lesion size, and atherosclerotic lesion size correlated with blood levels of TMAO.

There’s just one major problem with this hypothesis. Studies in humans have shown that neither phosphatidylcholine nor choline-rich foods produce detectable increases in trimethylamine.

For example, in a 1999 study, researchers fed 46 different foods to humans and looked at the subsequent excretion of trimethylamine and TMAO. Choline-rich foods like liver and eggs did not produce any increase in urinary trimethylamine or TMAO over control levels.


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ohammed Jarrar, Zobair Younossi And Ancha Baranova
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