Choline and Gut Bacteria

Q I wanted to share this article that I stumbled across in Science Daily titled, “Specific Populations of Gut Bacteria Linked to Fatty Liver.” Your comments would be appreciated.


A Choline has been established to be an essential nutrient by the Institute of Medicine and that conclusion is supported by a great many studies. It is also quite clear that adequate intake of choline is necessary for proper memory function, and inadequate supplies result in the body cannibalizing the membranes of neurons for their phosphatidylcholine content, especially with increased age!

The Nature study (2011 April 7;472:57–63) contains a lot of anomalies. In it, the cardiovascular and atherosclerotic association was abolished when the mice were given broad-spectrum antibiotics. Yet, quoting from the study, “[P]rospective randomized trials with antibiotics in humans have thus far failed to demonstrate cardiovascular benefit and studies with germfree hyperlipidaemic mice confirm that infectious agents are not necessary for murine atherosclerotic plaque development” [Emphasis added]. Curiously, again quoting the study, “Deficiency in both choline and betaine has been suggested to produce epigenetic changes in genes linked to atherosclerosis.” [Emphasis added].

Furthermore, the humans who were analyzed and found to have a correspondence between choline levels and cardiovascular disease were not clearly defined, except that they were referred for cardiac evaluation at a tertiary care center. It may be (and seems plausible) that those predisposed to developing cardiovascular disease (a long-term event), have altered microflora. These alterations may be far more causal than higher levels of choline, per se, which could be a consequence, along with faulty metabolism. The study does not characterize the microflora. Research suggests that the relationship between gut flora and humans is not merely commensal (a non-harmful coexistence), but rather a symbiotic relationship. Does the progression of cardiovascular disease alter this symbiotic relationship? It may.

There are a lot of ways that microflora can be made more robust, including the reduction in gut inflammation, which can be done for example with polyphenols and other antioxidants.

The “Discussion” in the report leaves a lot to be desired, and suggests few alternative explanations, a definite weakness in composing an argument.

Two further considerations …

  1. The metabolomics approach (the systematic study of the unique chemical fingerprints that specific cellular processes leave behind) used in the study is a new and evolving technology and enormously complex.
  2. Daniel Rader, a heart disease specialist at the University of Pennsylvania School of Medicine (who was not involved in the study), says that gut bacteria may not be as big a factor in causing heart disease as diabetes or smoking, but could be important in tipping some people toward heart disease.

Don’t get tipped; take care of your gut, as well as your heart.

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