Choline is a very popular pre-workout ingredient which is said to have a positive impact on mental focus, cognition, and liver health.

But does it work?

In this detailed article, I’ll break down all of the research on this cognitive enhancer and determine whether it’s should be considered a “top tier” pre-workout ingredient which can sit alongside the likes of caffeine and creatine, or whether it should be left on the sidelines. Let’s get stuck in!

Table of Contents

• Choline For Mental Focus
• Choline + Huperzine A
• Choline For Liver Health
• Which Foods Are High In Choline?
• There Are 4 Different Types Of Choline Supplements
• Choline: Russ’ Rating

Choline For Mental Focus

This is the main reason it is included in pre-workouts.

Choline assists in the formation of acetylcholine (the learning neurotransmitter), making it possible for you to hear colours and feel shapes.

Increased acetylcholine levels can improve the mind/muscle connection and also muscle contraction force, so it’s easy to see why this could be beneficial in the gym! It also appears that exercise depletes our body’s natural reserves of acetylcholine, so consuming a supplement which gives you a greater supply (i.e. choline) should lead to improved performance. (2, 3)

Unfortunately, it doesn’t.

Yep, this is one of those situations where a great theory doesn’t play out the way you expected it to.

Choline was first labelled a cognitive booster in 2013, when a group of Spanish researchers found that it improved attention span and the ability to learn new tasks. However, this study was performed on rats, and all human trials which have attempted to replicate the results have failed. (4, 5, 6, 7)

The only studies to date which show a positive effect in humans are those which involve children. A 2020 review published in the Journal of Neurodevelopment Disorders, which was following up with the participants of a study performed four years prior, noted that the children who supplemented with choline in the original study now displayed significantly higher non-verbal intelligence and memory than those who did not. (8)

Choline + Huperzine A

Good things come in pairs.

Edge and Christian… bangers and mash… and now we have a new one; choline and huperzine A.

Huperzine A is an ingredient which we very rarely see in pre-workout supplements, because it offers zero training benefits of its own, but research suggests it may be able to elevate choline to a whole new level.

As explained earlier, the idea behind pre-workouts including choline is to boost production of acetylcholine. It turns out one of the main functions of huperzine A is to decrease the breakdown of acetylcholine, so this is a potential dream team (more acetylcholine production, and less acetylcholine breakdown), but further studies are needed before it can be fully confirmed. (13, 14)

Choline For Liver Health

This is where the real benefits of choline begin to stack up.

Studies dating back to the 1930s show that choline supplementation resolved fatty liver disease (which is actually caused by choline deficiency) in dogs and rats. Human trials were conducted in the 1980s, and the results were positive! These findings have been re-confirmed in several studies in the years which have passed since then, so choline definitely has some benefits when it comes to optimizing liver health. (9, 10, 11, 12)

But here’s the problem…

A 2018 meta-analysis published in Nutrition Today Journal showed that the vast majority of Americans consume nowhere near enough choline to unlock any of these positive results. It was even elevated to “essential nutrient” status by the Food & Nutrition Board of the National Academies of Medicine back in 1998, with hopes of raising public awareness of the need to get this bad boy into our daily diet, but the public remain largely unaware. (1)

Which Foods Are High In Choline?

There Are 4 Different Types Of Choline Supplements

There are four different types of choline:

• Alpha GPC (alpha-glycerol phosphoryl choline)
• Choline chloride
• Choline dihydrogen citrate
• Choline bitartrate

I’ve listed these from highest-to-lowest in terms of quality, so Alpha GPC is the pick of the bunch. This will give you the biggest bang for your buck, because it unlocks the benefits of choline at a smaller dose than any of the others, while side-stepping the headaches which come from high doses.

Aim for a dose of 500mg-1500mg per day.

This is the product I recommend.

Choline: Russ’ Rating

Choline presents me with a conundrum.

We know how it should work, and we know why it should work… but there’s not enough research showing us that it actually does work!

Heck, a 2018 review paper on optimal nutrition supplements for the brain didn’t even consider it a viable option, because there is such a lack of evidence to back up the claims being made by supplement companies that it is a cognitive booster. (15)

Until that changes, I cannot recommend it as a must-have supplement.

For now, the main benefit of choline appears to be the positive impact it has on liver health, and considering most people have a gap here in their diet, I can recommend you use it for that alone.

References:

1. Wallace T. C., et al. Choline: The Underconsumed and Underappreciated Essential Nutrient. Nutrition Today (2018).
2. Sam C, et al. Physiology, Acetylcholine. StatPearls Publishing (2022).
3. Conlay L. A., et al. Exercise and neuromodulators: choline and acetylcholine in marathon runners. Int J Sports Med (1992).
4. Moreno H., et al. Chronic dietary choline supplementation modulates attentional change in adult rats. Behave Brain Res (2013).
5. Naber M., et al. Improved human visuomotor performance and pupil constriction after choline supplementation in a placebo-controlled double-blind study. Sci Rep (2015).
6. Warber J. P., et al. The effects of choline supplementation on physical performance. Int J Sport Nutr Exerc Metab (2000)
7. Deuster P. A., et al. Choline ingestion does not modify physical or cognitive performance. Mil Med (2002).
8. Wozniak J. R., et al. Four-year follow-up of a randomized controlled trial of choline for neurodevelopment in fetal alcohol spectrum disorder. J Neuro Dev Disorders (2020).
9. Caudill M. A., et al. Folate, choline, vitamin B12, and vitamin B6 (chapter 25). Biochemical, Physiological, and Molecular Aspects of Human Nutrition (2013).
10. Buchman A. L., et al. Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: proof of a human choline requirement: a placebo-controlled trial. JPEN J Parenter Enteral Nutr (2001).
11. Zeisel S. H., et al. Choline, an essential nutrient for humans. FASEB J (1991).
12. da Costa K., et al. Elevated serum creatine phosphokinase in choline-deficient humans: mechanistic studies in C2C12 mouse myoblasts. Am J Clin Nutr (2004).
13. Wessinger C. M., et al. Effect of Huperzine A on Cognitive Function and Perception of Effort during Exercise: A Randomized Double-Blind Crossover Trial. Int J Exerc Sci (2021).
14. Li Y, et al. Pharmacokinetics of huperzine A following oral administration to human volunteers. Eur J Metab Pharmacokinet (2007).
15. Meeusen R., et al. Nutritional Supplements and the Brain. Int J Sport Nutr Exerc Metab (2018).