Strategy For Preventing Cognitive Decline With Choline

Performance on verbal and visual memory was better in the individuals who consumed higher levels of choline.
One of the greatest fears that each of us harbor is the loss or decline of our cognitive abilities. New Research from the American Journal of Clinical Nutrition reminds us that choline is related to higher cognitive  performance  and even reduced white matter hyperintensity. White matter hyperintensity can be seen on MRIs and is associated with impaired cognitive  function, an increased risk of stroke, dementia, Alzheimer’s disease and death.

Choline is the precursor to the neurotransmitter acetylcholine. The 2011 Article Volume 94 looked at a population of non-demented individuals that were part of the Framingham Heart Study-Offspring. Results showed that higher levels of choline were related to better cognitive performances. More importantly participants with high choline levels showed reduced or no white matter hyperintensity.

1391 subjects, 744 women and 647 men, completed food frequency questionnaires from 1991 to 1995 and then again from 1998 to 2001. Participants took neuropsychological evaluations and MRIs at the end of the study.  Performance on verbal memory and visual memory was better in the individuals who consumed higher levels of choline.

Animal studies have shown choline to be neuroprotective and prenatal supplementation affected memory function in rats well into adulthood. Choline metabolites are important for the structural integrity of cell membranes and for cholinergic transmission and signaling during the development of neuron cells. Dietary levels of choline from lecithin have been shown to elevate blood choline, brain choline and brain acetylcholine concentrations significantly. In scientific literature the term lecithin generally refers to phosphatidylcholine.

Autopsies of Alzheimer’s patients show depleted levels of acetylcholine and choline in brain tissues. Adequate concentrations of acetylcholine in the brain are believed to be protective against certain types of dementia including Alzheimer’s disease.

Choline is needed for myelination of nerves and supplies methyl groups for folate metabolism. Whenever you hear the words folate and methylation “think DNA repair.” You can see why chronic low INTAKES of choline decrease memory in mammalian animal studies.

Let’s look at an association that will give you one of those ah-ha moments. High homocysteine levels have been associated with reduced cognitive abilities and an increased risk for Alzheimer’s disease. Most of us think a deficiency of B6, B12 or folate as a cause of high homocysteine concentrations. However, oxidized choline forms the methyl donor betaine which is also needed for the conversion of homocysteine to methionine which reduces homocysteine concentrations. This means that elevated levels of homocysteine can also be a result of a choline deficiency.

In the same token, if adequate choline levels are not available from the diet, the amino acid L-methionine is used to produce choline. Methionine can supply the necessary methyl groups needed for the methylation reactions that the body needs for life.  L-methionine is also needed as a precursor to L-cysteine.

L-cysteine is needed to produce glutathione and as a source of sulfur for phase II liver detoxification. So low levels of choline can cause depleted levels of methionine and eventually the methionine that is present can be become depleted as the body breaks down methionine for its methyl groups.

So how much choline is enough and how does that relate to average dietary intake? This is where the story gets good because the suggested amount is a mere 550 mg a day for adults.  Yet according to a study per- formed by Iowa State University reported in the 2007 issue of The FASEB Journal, on 10% of people in the US consume adequate intakes of choline.

Dietary sources of choline are eggs, beef, veal, turkey,  chicken  and salmon. The organs, especially the liver, having the highest concentrations. Due to the current “fat phobia” and the negative trend toward organ meats, most people are not going to ingest organ meats.

Phosphatidylcholine is an excellent source of choline as well as a structural component of the phospholipid membrane of all cells.  Each capsule yields 425 mg of phosphatidylcholine and 54 mg of elemental choline.

Veteran viewers know we have discussed this supplement as we use it for adrenal and liver support. See below for a more detailed discussion.

6 to 9 capsules a day can be used therapeutically; but based on this article and common sense, 3 capsules of phosphatidylcholine per day as low dose supplementation and to increase dietary choline in our non-demented days can be a highly effective strategy to prevent loss of cognitive function later in life.

Thanks for reading this week’s edition. I’ll see you next Tuesday. Dr. Jason Godo

Increasing Vitamin K for Healthy Bones & Heart

Is vitamin K on your nutritional radar screen? Mom always said “eat your green leafies;” but as kids, we never quite understood why. If we knew back then what we know now about the benefits of vitamin K, it might have made it a little easier.


We are all familiar with the profound effects vitamin D has on our metabolism. Some clinicians are calling vitamin K the next vitamin D due to its systemic effects. Vitamin K has powerful effects upon bone building, cardiovascular health especially plague build up, certain forms of cancer, and even dementia in addition to its commonly associated coagulation effects.


Three basic forms of vitamin K exist. K1 which is from green leafy plants is called phylloquinone or phytoquinone. “Phyto” helps me think plants. Sources of K1 are green leafy vegetables like collard greens, spinach, kale, brussels sprouts, broccoli and other foods like cauliflower or olive oil.


K2 is called menaquinone and comes primarily from fermentation. For example, K2 is found in fermented soy or natto, some cheeses, sauerkraut, butter from grass fed cows, Kim chi and certain meats. We make K2 naturally through the fermentation of anaerobic bacteria in our colon. The third form of vitamin K, K3, represents several synthetic forms that we will not discuss.


Both K1 and K2 in the form of vitamin K are needed and here’s why. Osteocalcin is a type of protein which is made by the osteoblasts during bone formation. Osteocalcin must be modified in a process called carboxylation which allows it to bind to calcium. Vitamin K is essential for this carboxylation process. Researchers have found that low levels of carboxylated osteocalcin are accompanied with low levels of vitamin K. The inverse is also true; high levels of carboxylated osteocalcin are accompanied with elevated levels of vitamin K. If we want to build healthy bones we need adequate amounts of carboxylated osteocalcin. Can you see why Vitamin K is so important to bone health?


Several studies have shown “vitamin K is a key factor with vitamin D, calcium and trace minerals to reduce osteoporosis.” It appears that when using the plant form, phylloquinone or K1, significantly higher doses are needed to attain adequate levels of carboxylated osteocalcin.


K2 or menaquinone has been shown to have some exciting cardiovascular protective attributes. There are proteins that are vitamin K dependent and these proteins have been shown to inhibit vascular calcification. The 2004 Rotterdam Study showed those consuming the upper levels of menaquinone or K2 had the lowest levels of aortic calcification, cardiovascular mortality as well as all cause mortality. People who consumed 45 mcg lived seven years longer than participants ingesting 12 mcg per day.


A follow up study called the Prospect Study tracked 16,000 people for 10 years. Each additional level of dietary K2 of 10 mcg resulted in nine percent fewer cardiac events.


The American Journal of Clinical Nutrition in 2008 reported on an 8 year prospective study following over 11,000 men comparing vitamin K and prostate cancer. Their conclusions: “our results suggest an inverse association between the intake of menaquinones, K2, but not that of phylloquinone, K1, and prostate cancer.”


Dr. Vermeer, one of the principal European researchers, suggests 45 to 185 mcg of vitamin K. It appears most of his interests are in coronary heart disease and vascular integrity.


In Japan, scientists are using 45-90 mg of vitamin K to treat osteoporosis with good success and without side effects. More doesn’t mean better, but taking more is not causing side effects.


If you are in any stage of osteoporosis or heart disease, consider increasing your levels of vitamin K1 and K2 by eating more green leafy vegetables as well as the fermented foods mentioned earlier.


In addition, ask Dr. Godo how to supplement with a form of vitamin K that is biologically active and pharmaceutically pure. You won’t find this type of vitamin K in your traditional over the counter multi-vitamin. The different forms of vitamin K are worth paying attention to. Put vitamin K on your nutrient radar screen for healthy bones and a healthy heart.