Choline

Like all essential nutrients, choline is required for most of the body’s basic functions, but many athletes don’t get enough. Choline is critical for proper fat metabolism, is associated with the adrenal glands’ regulation of stress, and has anti-inflammatory effects. It also prevents the deposit of fat in the liver, helps transport other nutrients throughout the body, and is important for the brain’s production of acetylcholine (a neurotransmitter used throughout the brain, especially for memory). Egg yolks may be the best source of choline in the diet, along with fish.

Asthma is a common condition associated with low levels of choline. Wheezing, coughing from bronchial spasm, and excessive mucous production during exercise has been termed “exercise-induced asthma,” although it also occurs in those who don’t exercise. During training, the body normally dilates the airways to allow for better air passage into and out of the lungs. In those with asthma, the dilation of the airway is followed by excessive narrowing, causing breathing difficulties. Choline can help the nervous system control proper bronchial action. In this situation, a moderate dose of choline may be needed initially : for example, 500 mg several times daily until breathing improves and dietary choline is increased. (In addition, the excess intake of refined carbohydrate can maintain inflammation, which could also contribute to chronic asthma.)

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To illustrate the importance of choline, I am reminded of one patient named Roy. He was a slim, forty-four-year-old construction worker who wanted to “run with the guys” after work; but after fifteen minutes he had trouble breathing due to severe asthma that had plagued him since childhood. Roy’s asthmatic reaction was due in part to several factors : the stress of running at too high a heart rate without proper training; a diet high in refined carbohydrates; and, in particular, a significant need for choline. After two weeks of taking a choline supplement (600 mg, five times throughout the day), his breathing symptoms during running were mostly gone. Roy was so elated that he wanted to learn all he could about proper diet and exercise. I spent a significant amount of time helping him in his endeavors.

Roy focused on improving his aerobic system and eating well, including several eggs daily to keep his choline intake adequate. After about three months, he was able to eliminate the choline supplement without any recurring breathing problems. While he ultimately enjoyed road racing in 5K and 10K events, his passion was most evident on the track. As a masters’ sprinter, Roy started performing extremely well in 100- and 200-meter races, and anchoring an impressive team relay, all in the New York area. He also expanded his events to include triple jump and long jump. About eighteen months after first visiting my clinic, Roy qualified for and competed in the world masters’ track and field meet in Australia, where he won a number of medals in sprint and field events.