This is because choline helps with neurotransmitter maintenance and, as someone ages, nerve signaling can decrease and signs of dementia can be experienced. [, Bidulescu A, Chambless LE, Siega-Riz AM, Zeisel SH, Heiss G. Usual choline and betaine dietary intake and incident coronary heart disease: the Atherosclerosis Risk in Communities (ARIC) study. [, Resseguie ME, da Costa KA, Galanko JA, Patel M, Davis IJ, Zeisel SH. Br J Nutr 2014;112:1858-72. A polymorphism, R653Q, in the trifunctional enzyme methylenetetrahydrofolate dehydrogenase/methenyltetrahydrofolate cyclohydrolase/formyltetrahydrofolate synthetase is a maternal genetic risk factor for neural tube defects: report of the Birth Defects Research Group. J Nutr Biochem 2008;19:158-65. Zeisel SH. Typical amounts of choline in dietary supplements range from 10 mg to 250 mg. A.S.P.E.N. Research has continued, and a 2017 study has found that levels of phosphatidylcholine are directly related to Alzheimers disease. The ULs apply to healthy children and adults, but not to those taking high doses of choline under medical supervision. Clin Nutr 1993;12:33-7. Choline is converted into a neurotransmitter called acetylcholine, which helps muscles to contract, activates pain responses, and plays a role in brain functions of memory and thinking. Prenatal dietary supplements typically contain little if any choline [17]. Institute of Medicine. Corbin KD, Zeisel SH. WebThe increased unsaturation in the liver lipide of choline-deficient rats appeared to be due to a higher content of dienoic fatty acids, which made up approximately 60% of the dietary lipide. Tolerable Upper Intake Level (UL): Maximum daily intake unlikely to cause adverse health effects. 2016, Beef top round, separable lean only, braised, 3 ounces, Beef, ground, 93% lean meat, broiled, 3 ounces, Fish, cod, Atlantic, cooked, dry heat, 3 ounces, Potatoes, red, baked, flesh and skin, 1 large potato, Broccoli, chopped, boiled, drained, cup, Mushrooms, shiitake, cooked, cup pieces, Fish, tuna, white, canned in water, drained in solids, 3 ounces, Cauliflower, 1" pieces, boiled, drained, cup, Bread, pita, whole wheat, 1 large (6 inch diameter), Tangerine (mandarin orange), sections, cup, Apples, raw, with skin, quartered or chopped, cup. Yes, You Can: Repair and Reverse Your Fatty Liver Disease 1 Take It Easy On The Sugar. According to Dr. 2 Eat More Liver and Eggs. Liver and eggs are the highest known food source 3 Supplement With Choline and B-Vitamins. If youre not able to get enough choline through dietary Choline is a source of methyl groups needed for many steps in metabolism. (13) Homocysteine is an amino acid that enters the body from protein sources, normally meat, and high levels of homocysteine have been correlated with development of heart and blood vessel diseases. Web17 iun 2022. It is also a rich source of choline and allows you to add a significant helping of liver, without changing the taste. Avoid more harmful fat sources such as saturated or trans fats. This article is based on scientific evidence, written by experts and fact checked by our trained editorial staff. Not only is it the perfect dish for nourishing your body and warming up on chilly fall and winter days. The FNB has established ULs for choline from food and supplements based on the amounts of choline that are associated with hypotension and fishy body odor (see Table 3) [2]. Updated on June 24, 2022. Some individuals with NAFLD can develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease, which is marked by liver inflammation and may Am J Clin Nutr 2013;98:1209-17. are clickable links to these studies. Another one of the benefits of choline is its ability to keep your mind mentally sharp as you age. And its not because genetic mutations are passed down (although that can happen). [, Buchman AL, Sohel M, Brown M, Jenden DJ, Ahn C, Roch M, et al. Common genetic polymorphisms affect the human requirement for the nutrient choline. Choline deficiency can cause muscle damage, liver damage, and nonalcoholic fatty liver disease (NAFLD or hepatosteatosis) [1,2,4,15]. The richest plant sources are collards, Brussels sprouts, broccoli, crimini mushrooms, asparagus and cauliflower (although these foods provide only about 17-60 mg per cup). Choline acts like a precursor to certain important neurotransmitters, including acetylcholine, which is used in healthy nerve and muscle function. The forms of choline in dietary supplements include choline bitartrate, phosphatidylcholine, and lecithin. Pregnant women Our bodies are able to make a small amount of choline on their own, but the rest we must obtain from food sources. In the United States, it is the most common form of chronic liver disease, affecting about one-quarter of the population. [, Buchman AL. Benefits, Signs of Deficiency and Food Sources. Prog Mol Biol Transl Sci 2012;108:159-77. da Costa KA, Kozyreva OG, Song J, Galanko JA, Fischer LM, Zeisel SH. Its not recommended to take more than 3,500 mg of choline per day during pregnancy. There is not enough data to establish a Recommended Dietary Allowance for choline. Intakes from supplements contribute a very small amount to total choline intakes. Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: proof of a human choline requirement: a placebo-controlled trial. Plasma choline levels do not decline below 50% of normal, even in individuals who have not eaten for more than a week [3]. Millard HR, Musani SK, Dibaba DT, Talegawkar SA, Taylor HA, Tucker KL, Bidulescu A. Dietary choline and betaine; associations with subclinical markers of cardiovascular disease risk and incidence of CVD, coronary heart disease and stroke: the Jackson Heart Study. Her passion is educating on how foods promote health and protect against disease and creating simple and delicious recipes for vibrant health and enjoyment. They are one of the top choline-rich foods available, with one serving providing 147 milligrams. read my affiliate policy. DRIs is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. [, Poly C, Massaro JM, Seshadri S, Wolf PA, Cho E, Krall E, et al. Faseb j 2014;28:2970-8. Choline is not actually considered a mineral or a vitamin, but is known to be an essential micronutrient needed for many functions of the body, especially for brain function. A key component to reverse fatty liver with choline is by eating a diet high in choline, which is required by the PEMT gene to make Phosphatidylcholine. AI: The Adequate Intake for men and women ages 19+ years is 550 mg and 425 mg daily , respectively. (3). Low plasma free choline is prevalent in patients receiving long term parenteral nutrition and is associated with hepatic aminotransferase abnormalities. It [, Mills JL, Fan R, Brody LC, Liu A, Ueland PM, Wang Y, et al. The Tolerable Upper Intake Level (UL) for choline for adults 19 years and older is 3,500 mg daily and is based on the amount that has been shown to produce these side effects. 10th ed. The contents of this website are for educational purposes and are not intended to offer personal medical advice. Choline is essential for healthy liver function, and research has linked People with certain genetic alterations These values, which vary by age and sex, include: Insufficient data were available to establish an EAR for choline, so the FNB established AIs for all ages that are based on the prevention of liver damage as measured by serum alanine aminostransferase levels [2]. Eat More Liver and Eggs Liver and eggs are the highest known food source of a nutrient called choline. And they have been shown to reduce inflammation and boost detoxification. Foods highest Neurological disorders The richest sources of this vital nutrient include liver, beef, eggs, poultry and seafood. You can take glutathione, you can take N-acetylcysteine, lipoic acid, milk thistle, curcumin. Choline, its potential role in nonalcoholic fatty liver disease, and the case for human and bacterial genes. Best Choline For Fatty Liver Resources However, these intake levels are only minimums. Cruciferous vegetables (broccoli, cauliflower. Eggs. FDA does not require food labels to list choline content unless choline has been added to the food. In addition, choline is needed to produce acetylcholine, an important neurotransmitter for memory, mood, muscle control, and other brain and nervous system functions [1-3]. WebSo what drugs do you take with grade 1 fatty liver? Benefits, How to Follow, Risks & More, What is Betaine? There appears to be an association with diets high in choline-rich foods and cardiovascular disease, but the reasons for this link need further study. Lose Weight. Read Next:What is Betaine? (A single drink [e.g., 12 oz beer, 5 oz wine, or 1.5 oz hard liquor] contains about 1214 g alcohol.) Choline is associated with brain health because it is converted into acetylcholine, which plays a role in memory and thinking. And well also show you a super-tasty way to add liver to your familys diet and have every person at the table coming back for seconds! It can also help you absorb more nutrients. This is a fact sheet intended for health professionals. Includes a variety of protein foods such as lean meats; poultry; eggs; seafood; beans, peas, and lentils; nuts and seeds; and soy products. Most choline is metabolized in the liver where it is converted into phosphatidylcholine, which assists in building fat-carrying proteins and breaking down cholesterol. Some reports even show that choline can help prevent learning disabilities, including ADHD, and can improve concentration in children and teens. AI: The Adequate Intake for men and women ages 19+ years is If you vastly exceed the recommended amount of choline, you can possibly experience symptoms, including diarrhea, nausea, fatigue, higher blood pressure, excessive perspiration and a fishy odor of the skin. Washington, DC: National Academy Press; 1998. JPEN J Parenter Enteral Nutr 2001;25:30-5. Vanek VW, Borum P, Buchman A, Fessler TA, Howard L, Jeejeebhoy K, Kochevar M, Shenkin A, Valentine CJ, Novel Nutrient Task Force, Parenteral MultiVitamin and MultiTrace Element Working Group, American Society for Parenteral and Enteral Nutrition (ASPEN) Board of Directors. What is cholines role in gene expression and DNA? Choline also plays important roles in modulating gene expression, cell membrane signaling, lipid transport and metabolism, and early brain development [1,2]. Choline is essential for the process of removing the cholesterol from the liver, and there is an established correlation between choline deficiency and non-alcoholic fatty liver. However, choline intake was associated with NAFLD in normal-weight women only and not in those with overweight or obesity. So, how much do you need and how do you get more of it in your diet? Choline was shown to completely reverse fatty liver in a small Explore the downloadable guide with tips and strategies for healthy eating and healthy living. Its also important to point out that folate plays a part in the bodys ability to create and use choline as the two nutrients have a strong relationship and rely on one another to do their jobs. U.S. Department of Agriculture, Agricultural Research Service. The following 12 foods provide high levels of choline naturally, in addition to many other nutrients. Tang WW, Wang Z, Levison BS, Koeth RA, Britt EB, Fu X, Wu Y, Hazen SL. [, Dalmeijer GW, Olthof MR, Verhoef P, Bots ML, van der Schouw YT. The U.S. Food and Drug Administration (FDA) developed DVs to help consumers compare the nutrient contents of foods and dietary supplements within the context of a total diet. All rights reserved. Required fields are marked *. (14). WebConsuming too much alcohol can cause inflammation and swelling in the organs, which can lead to pain. Men and women aged 19 years and up are recommended to get 550 mg and 425 mg respectively, daily. (1) Choline is still being studied in order to learn more about its potential benefits and uses, but at this time, most experts agree that the amounts listed below are sufficient for producing optimal benefits without causing any harm: Some experts recommend getting even higher levels of choline in order to boost brain function and to retain memory. Benefits, How to Follow, Risks & More. BMC Cardiovasc Disord 2007;7:20. Ask ODS It has the potential to affect future generations as well. One of the main benefits of choline is that it is used by the body in a variety of ways that are crucial for nerve functioning, including aiding in nerve signaling and maintaining the membranes of brain cells. Here are some choline-rich foods to add to your diet to support your brain health. Nutr Rev 2015;73:500-22. In todays article, we discuss the critical importance of choline. Washington, DC: Wiley-Blackwell; 2012:405-18. This section focuses on three conditions in which choline might play a role: cardiovascular and peripheral artery disease, neurological disorders, and NAFLD. In addition, because phosphatidylcholine can serve as a phospholipid precursor, it might help support the structural integrity of neurons and thus might promote cognitive function in elderly adults [8]. Although a choline deficiency can lead to liver dysfunction, it is not yet clear if dietary choline or choline supplementation can treat NAFLD. Choline plays a part in several important processes within the body that are carried out hundreds of times, every single day. Another unique aspect of choline is that it contains chemical structures called methyl groups. ), Walnuts: Choose This Brainy Nut For Health. This difference by weight status was not observed in men. The body needs choline to synthesize phosphatidylcholine and sphingomyelin, two major phospholipids vital for cell membranes. London and New York: Informa Healthcare; 2010:136-43. Choline plays a part in transporting both cholesterol and triglycerides, two forms of important fats, from the liver to other parts of the body where they are needed. The richest sources are meat, fish, poultry, dairy, and eggs. Diabetes Diet Its no wonder that adequate methylation within your body reduces the risk of almost every chronic illness including cancer, heart disease, depression, Alzheimers and more. [, Nurk E, Refsum H, Bjelland I, Drevon CA, Tell GS, Ueland PM, et al. So while at this time there isnt an official Daily Value Recommendation for Choline established by the USDA, its important toavoid a choline deficiency to helpsupport various systems throughout the body, including the nervous, endocrine, digestiveand reproductive systems. A pilot study in 15 adults on TPN found that NAFLD resolved completely in all patients who received their usual TPN regimen with an additional 2 g choline and in none of the patients who received their usual TPN regimen only [49]. [6] There was a 26% increased risk of CVD deaths when combining data from both cohorts comparing the highest intakes of phosphatidylcholine with the lowest. Giving choline intravenously (by IV) helps treat this condition. Maternal choline concentrations during pregnancy and choline-related genetic variants as risk factors for neural tube defects. The Top 20 Antioxidant Superfoods (and How to Maximize Their Power! Today, I want to share with you my secrets to reduce sugar Accordingto the United States Department of Agriculture, Americans consume around 0.7 pounds Giloy: The Ayurvedic Herb that Aids Digestion, Detoxification & More, What Is the Boiled Egg Diet? Choline belongs in a pregnancy diet. Enjoy the Most Delicious Dinners You've Ever Set on the Table, 2614 Tamiami Trail North, Ste #219, Naples, FL 34103. Choline was first discovered in the 1930s. [, Higgins JP, Flicker L. Lecithin for dementia and cognitive impairment. In a cross-sectional study of 664 adults and children from the Nonalcoholic Steatohepatitis Clinical Research Network, postmenopausal women who had nonalcoholic steatohepatitis (an extreme form of NAFLD involving liver inflammation and fibrosis) and a choline intake less than 50% of the AI had more severe fibrosis, but the results showed no relationship between choline intake and degree of liver steatosis [48]. Potatoes and French fries dont count. The amount of choline that individuals need is influenced by the amount of methionine, betaine, and folate in the diet; gender; pregnancy; lactation; stage of development; ability to produce choline endogenously; and genetic mutations that affect choline needs [1,2,4,5]. Updated: J Nutr 2014;144:2034-40. Most people in the United States consume less than the AI for choline. Choline can be found naturally in foods including eggs, liver, beef, salmon, cauliflower, Brussel sprouts and breast milk. BY MOUTH: General: Adequate intake (AI) of choline for adults is 550 mg per day for males, 425 mg per day for females, 450 mg per day for pregnant females, and 550 mg per day for lactating women. Epigenetics You can make a small amount of choline in your liver, but most of the choline in your body comes from [12]. Vanek VW, Borum P, Buchman A, Fessler TA, Howard L, Jeejeebhoy K, et al. This ultimately interferes with normal liver function. Plasma free choline, betaine and cognitive performance: the Hordaland Health Study. Choline and folate assist in the conversion of homocysteine, which prevents the body from accumulating too much fat and may be beneficial in cutting down on the risk of having a heart attack or stroke. For a reader-friendly overview of Choline, see our consumer fact sheet on Choline. Note that the numbers in parentheses (1, 2, etc.) WebThe liver is probably the major site of choline metabolism, where it is found primarily as phosphatidylcholine ().Phosphatidylcholine and other choline-containing phospholipids, lysophosphatidycholine, sphingomyelin, and choline plasmalogen, are components of plasma and organelle membranes (1, 2).The choline moiety provides these phospholipids with a Join the ODS Email List. Higher dietary choline intake is associated with lower risk of nonalcoholic fatty liver in normal-weight Chinese women. Very high intakes of choline can lead to low blood pressure (hypotension) and liver toxicity. Limits foods and beverages higher in added sugars, saturated fat, and sodium. The information in our articles is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. The great news is that you can influence how those genes are expressed. Eat a variety of whole grains (like whole-wheat bread, whole-grain pasta, and brown rice). Abstaining from alcohol is the most beneficial thing that you can do to protect your liver from future damage. Choline metabolism provides novel insights into nonalcoholic fatty liver disease and its progression. Choline is a source of methyl groups needed for many steps in metabolism. Soy lecithin is a controversial substance that is used in food products as an emulsifier and sold as supplements. Webjustin powell nba draft. Therefore, all plant and animal cells need choline to preserve their structural integrity [1,2]. Choline also helps form tissue within the nervous system that plays a part in brain development and growth. WebYou also need choline to form the membranes that surround your bodys cells. (18). Our team aims to be not only thorough with its research, but also objective and unbiased. Turkey, chicken, beef, and broccoli also provide a boost. This is the reason its added to most infant formulas. Washington, DC: National Academy Press; 1998. [. High homocysteine levels are a risk factor for CVD. Free choline, phosphocholine, and glycerophosphocholine are absorbed in the small intestine, enter the portal circulation, and are stored in the liver, where they are subsequently phosphorylated and distributed throughout the body to make cell membranes [1-3]. Soy lecithin contains choline and other molecules, including fatty acids, glycerol and phosolipids. Although most women of childbearing age are resistant to NAFLD because of their high estrogen levels, at least 40% have a polymorphism that makes them insensitive to activation of the gene by estrogen; adequate consumption of dietary choline is particularly important for this population [46]. New research, published in The FASEB Journal, found that choline can lower levels of stress. Fatty liver can be reversed with a liver friendly diet and supplements that support liver function and repair liver cells. are clickable links to medically peer-reviewed studies. 1. It was originally extracted from egg yolks, but today is derived from cottonseeds, marine sources, milk, sunflowers or most commonly, soy beans. Intake recommendations for choline and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) of the Institute of Medicine (IOM) [2]. The most important thing is to change the diet, quit alcohol, smoke, should not eat greasy food. The most important thing is to change the diet, quit alcohol, smoke, should not eat greasy food. [, Guerrerio AL, Colvin RM, Schwartz AK, Molleston JP, Murray KF, Diehl A, et al. If you choose to take choline supplements, its best to purchase one that is made from whole food sources and is of very high quality. Use healthy oils (like olive and canola oil) for cooking, on salad, and at the table. PLoS One 2012;7:e43448. [, Sentongo TA, Kumar P, Karza K, Keys L, Iyer K, Buchman AL. M. Glen A. I. M. Zeisel S. Shering A. For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. The information presented on this website is not intended as specific medical advice and is not a substitute for Furthermore, having diabetes heightened that risk. Is Lamb Healthy? Fatty liver disease and choline deficiency: A study of 57 normal adults investigated the effects of limiting either choline from the diet or folate from the diet for a period of 6 weeks. Some studies have shown that choline and lecithin can help to reduce blood cholesterol and risk for heart disease, but different studies have yielded inconsistent results, so more research is still needed before doctors will begin to prescribe choline for its ability to lower LDL (bad) cholesterol and trigylcerides. [, Bertoia ML, Pai JK, Cooke JP, Joosten MM, Mittleman MA, Rimm EB, et al. It prevents fat from accumulating in your liver. Similarly, a prospective study in 14,430 middle-aged adults in the Atherosclerosis Risk in Communities Study found that over 14 years, risk of coronary heart disease was not significantly different in the highest choline intake quartile compared to the lowest quartile [36]. Choline intake in a large cohort of patients with nonalcoholic fatty liver disease. Cardiovascular and peripheral artery disease And the best way to get optimal levels of this nutrient in your diet is to consume liver, If you (or someone in your family) are among those who simply cant stand liver, there is a good chance you will still LOVE our Superfood Paleo Bolognese recipe. Choline has been suggested to both protect and increase the risk of cardiovascular disease (CVD). The addition of choline to parenteral nutrition. What is the most bioavailable form of choline? WebSubscribe to @HarrySerpanos to catch him live, and view his other content! Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk. WebWhen taken by mouth: Choline is likely safe for most people when taken in doses below 3.5 grams daily. Choline status is not routinely measured in healthy people. Choline is not typically included in TPN formulas unless specified. Not surprisingly, it is also critical during pregnancy and fetal development. Pregnant and lactating This post may contain affiliate links. Choline, Its Potential Role in Nonalcoholic Fatty Liver Disease, and the Case for Human and Bacterial Genes. Table 1 lists the current AIs for choline [2]. Therefore, an average amount is hard to establish. Eating a varied diet is the best way to ensure you acquire enough choline. For example, premenopausal women may have lower requirements for dietary choline because higher estrogen levels stimulate the creation of choline in the body. NAFLD involves the accumulation of lipids in the livers of people who consume less than 20 g/day ethanol and who have no other known causes of steatosis [42,43]. WebCan choline reverse fatty liver? Corbin KD, Zeisel SH. Choline is available in dietary supplements containing choline only, in combination with B-complex vitamins, and in some multivitamin/multimineral products [13]. And if you happen to be a vegetarian, youre almost certainly deficient in this vital compound. Choline is present in the form of phosphatidycholine, a compound that makes up the structural component of fat, and thus can be found in different types of foods that naturally contain certain fats. The risk of NAFLD was 32% lower in women in the highest quintile of choline intake (412 mg/day) compared to the lowest (179 mg/day) and 25% lower in men in the highest (452 mg/day) quintile compared to those in the lowest quintile (199 mg/day). WebNAFLD is increasingly common around the world, especially in Western nations. 5 Reasons to Add Lamb Meat to Your Diet. [, Wu BT, Dyer RA, King DJ, Richardson KJ, Innis SM. Other Supplements like probiotics, resveratrol, curcumin, vitamin E, vitamin C and vitamin D may help to naturally improve a fatty liver and overall health. Neuron synapses are being formed in the brain of fetuses and infants at a very rapid rate, so choline plays a major part in helping to build the foundation of the brains structure. The following groups are among those most likely to have inadequate choline status. Copyright 2019 Health-e Enterprises, LLC. In healthy adults, the concentration of choline in plasma ranges from 7 to 20 mcmol/L [2]. In adults, the average daily choline intake from foods and beverages is 402 mg in men and 278 mg in women. An analysis of data from the 20132014 National Health and Nutrition Examination Survey (NHANES) found that the average daily choline intake from foods and beverages among children and teens is 256 mg for ages 219 [14]. Recommended Dietary Allowance (RDA): Average daily level of intake sufficient to meet the nutrient requirements of nearly all (97%98%) healthy individuals; often used to plan nutritionally adequate diets for individuals. [, Shaw GM, Finnell RH, Blom HJ, Carmichael SL, Vollset SE, Yang W, et al. women who ate 930 mg of choline per day had 33% lower levels of cortisol compared to women who ate only 430 mg daily. [10] A true choline deficiency can lead to muscle or liver damage, and nonalcoholic fatty liver disease. Higher blood levels of TMAO have been associated with a higher risk of CVD in animal studies. Approximately 90%95% of pregnant women consume less choline than the AI [16]. In a University of North Carolina study, 80 percent of women with fatty liver who upped their choline intake had a 100 percent reversal of the condition, often within 30 days. 2nd ed. Effects of choline on health across the life course: a systematic review. (7). UL: A Tolerable Upper Intake Level (UL) is the maximum daily dose unlikely to cause adverse side effects in the general population. In fact, choline is needed for forming new brain connections between neurons called synapses, which is the chemical reaction needed for memories to actually form in the brain. This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. The more veggies and the greater the variety the better. Its not recommended to take more than 3,500 mg of choline per day during pregnancy. Choline is also important during pregnancy because of its relationship with folate. With strict editorial sourcing guidelines, we only link to academic research institutions, reputable media sites and, when research is available, medically peer-reviewed studies. A monthly update filled with nutrition news and tips from Harvard expertsall designed to help you eat healthier. Post Author: Post published: 12, 2022 Post Category: does a frog have a backbone does a frog have a backbone When it comes to getting choline from soy products, Id advise you to only consume organic fermented soy products (tempeh, natto, miso) in moderation and to avoid unfermented soy, especially the kinds that are not organic and are processed. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Recommended Amounts [2] The Food and Nutrition Board established an Adequate Intake (AI) for choline based on the prevention of liver damage.