Choline Deficiency and Plant Oil Induced Diabetes

I’m going to deviate from my original plan for the “Dangers of a Zero-Carb Diet” series to discuss a topic that came up in the comments to the first post.

Leonie’s Diabetes and the Rose Corn Oil Trial

What prompted this diversion is Leonie’s interesting comment from Wednesday’s post:

I developed diabetes several years after being on a low carb diet. Continuing low carb to manage the diabetes did not halt its progress. It has taken about 18 months of adding more carbs (60 – 100 gr/day) to my diet to bring my fasting glucose down by a couple of mmol and eating more carbs has also lowered my Hba1c and post meal spikes significantly. I wonder if the liver is another organ that may be affected by carbohydrate deficiency.

I had not heard of such cases before, or so I thought, but Dr. Deans in the comments reminded us that Peter at Hyperlipid had noticed two similar cases in the Rose Corn Oil trial. [1] (The Rose Corn Oil trial, of course, figures prominently in our book’s discussion of PUFA toxicity.)

In the Rose Corn Oil trial, there were three arms – a normal diet arm, a high corn oil arm, and a high olive oil arm. The normal dieters were expected to eat “fried foods, fatty meat, sausages, … ice cream, cheese, … milk, eggs, and butter” while the oil arms were supposed to restrict these foods and replace them with corn or olive oil.

Here’s what happened:

Four patients were removed from the trial for other reasons. Two developed non-cardiac thromboembolism and were given anticoagulant therapy. The other two were removed because of diabetes mellitus. One of them already had mild diabetes, but glycosuria increased considerably soon after he started oil. Oil was stopped and glycosuria disappeared. Oil was restarted, but was stopped a month later because heavy glycosuria recurred. The other patient, not a previously recognized diabetic, developed glycosuria with a diabetic glucose-tolerance test a few weeks after starting oil. [1]

The patients who developed diabetes came one from the corn oil arm and one from the olive oil arm. Likewise, the patients who developed thromboembolisms came one from the corn oil arm and one from the olive oil arm. No such disasters occurred on the “fatty meat” arm.

Since all three diets were similarly fatty, it doesn’t appear to be the quantity of fat that was the issue. Rather it was the type of lipid, or some micronutrient that was present in the animal and dairy foods but lacking in the plant oils.

For insight into what the problem might be, let’s look at how scientists poison lab animals.

Insights from Diet Animal Poisoning Research

You have to pity diet researchers. It takes 60 years for bad diets to poison humans enough to significantly raise mortality rates. Yet a diet researcher is supposed to gain a Ph.D. in 4 years (or in 5 while simultaneously obtaining an MD!), do a postdoc in 2 years, win a grant in the first years of an entry-level position with PI status, and then demonstrate productive results within the term of a 2-to-5 year grant. Deadlines are pressing: A study needs to start rats or mice on two diets, and have one diet produce much better health than the other, in considerably less than a two-year time frame.

Just comparing McDonald’s fast food with a Mediterranean diet won’t do. Two years later both sets of mice will die happily of old age, with no significant differences between groups. Peer reviewers judge you to have discovered no new results. No new results means no paper, no grant, no job.

So “diet” researchers first have to become experts at quickly inducing disease in rats and mice. Find a diet that poisons animals in a few months, compare it to another diet that doesn’t, and you have a paper. Look for variations that slow or hasten the poisoning, and you have more papers. To be a highly productive scientist, one must be a skilled animal poisoner.

Various techniques have been developed for this purpose, including: knocking out some crucial gene; breeding a mutant strain that naturally develops disease; giving the animals poison with their food; or depriving them of crucial nutrients. Almost every study of diet in mice or rats uses one of these techniques.

If a missing nutrient can cause diabetes within a few years for Leonie and 12 to 18 months for the Rose Corn Oil trial volunteers, it’s likely to be pretty good at inducing disease in animals too. There’s a good chance diet animal poisoning researchers have already stumbled upon it in rats or mice.

Choline Deficiency Diseases

One of the most popular deficiency diets among researchers is the choline-deficient diet. A useful paper by Dutch scientists [2] gives a nice look at the impact of choline deficiency on rats.

Choline deficiency (CD) by itself induces metabolic syndrome (indicated by insulin resistance and elevated serum triglycerides and cholesterol) and obesity.

A combined methionine and choline deficiency (MCD) actually causes weight loss and reduces serum triglycerides and cholesterol, but induces more severe liver damage. The MCD diet prevents the body from manufacturing choline from methionine, vitamin B12, and folate, so MCD diets severely reduce choline levels; and without choline VLDL particles are not produced. Without VLDL particles, fats and cholesterol are trapped in the liver and never reach the blood and adipose cells.

Here is a measure of insulin resistance on the two diets:

The induction of insulin resistance by the CD diet is very rapid, requiring less than a week.

Induction of insulin resistance is thought to be mediated by elevated TNF-alpha production by adipose cells and by hypertriglyceridemia. Since the MCD diet neither raised serum triglycerides nor caused obesity which induces TNF-alpha production in adipose cells, it did not cause insulin resistance.

What Does This Have to Do With Diabetes?

Insulin resistance is a key step in the development of diabetes:

  • Insulin resistance in the liver causes the liver to release more glucose into the blood (since insulin inhibits glucose release by the liver). This is discussed in a nice paper [3] found by LynMarie Daye and cited in the comments by CarbSane.
  • Peripheral insulin resistance means that the rest of the body is less sensitive to insulin. The pancreas has to produce more insulin to dispose of the excess glucose that the liver is releasing.

This elevation of insulin and glucose levels is a crucial step toward diabetes; it is “pre-diabetes.”

Persistently elevated glucose levels can then poison the beta cells of the pancreas, diminishing insulin secretion capability and causing diabetes. [4]

The Rose Corn Oil trial was not a low-carb diet, so postprandial glucose levels could easily have risen to toxic levels.

If a CD diet can cause insulin resistance in a week, it’s plausible that it might cause diabetes in 12 to 18 months, which is when the Rose Corn Oil trial patients developed it.

What About the Thromboembolism Cases?

MCD diets induce fibrinogenesis. In the blood, excess fibrin formation leads to clotting, and clots can block vessels to cause thromboembolisms. It may be that the thromboembolism cases in the Rose Corn Oil trial had methionine, folate, or B12 deficiencies to go with their choline deficiency.

Why Do Plant Oils Induce Diabetes But Not Animal Fats?

So why did diabetes develop in the corn and olive oil arms of the Rose Corn Oil trial but not the “fatty meat and dairy” arm?

Well, look at the choline content of these foods:

Choline content of one cup (~200 g) oil or fat or 227 g (1/2 lb) meat

Beef liver 968.0 mg
Cube steak (beef) 290.0 mg
Beef tallow 164.0 mg
Butter 42.7 mg
Olive oil 0.6 mg
Corn oil 0.4 mg

Source: http://nutritiondata.com.

Take away meat and dairy and replace them with plant oils, and it’s very easy to have a choline deficiency.

What Does This Have to Do With Zero-Carb Diets?

Maybe nothing … without carb consumption, postprandial glucose levels are not as high, and beta cell poisoning is less likely … but it may be that a zero-carb diet aggravates a choline deficiency in some fashion. I will leave this as a topic for further research.

UPDATE: Leonie in a new comment gives us more information: she has PCOS, goiter with nodules, and auto-antibodies. This suggests autoimmunity as a more likely explanation for her zero-carb diabetes.

Conclusion

In the book, we recommend the use of animal fats such as beef tallow for cooking, and recommend that pregnant women and vegetarians supplement with choline. We thought seriously about recommending that everyone supplement choline, but were reluctant to recommend too many supplements.

In retrospect, we should have recommended choline supplements for everyone who is overweight, has elevated blood glucose or lipids, or has elevated liver enzymes.

We have been using beef tallow as our cooking oil for several months now. It might be good practice for everyone to favor animal fats like beef tallow over plant oils for cooking.

References

[1] Rose GA et al. Corn oil in the treatment of ischaemic heart disease.  Br Med J. 1965 Jun 12;1(5449):1531-3. http://pmid.us/14288105.

[2] Veteläinen R et al. Essential pathogenic and metabolic differences in steatosis induced by choline or methione-choline deficient diets in a rat model. J Gastroenterol Hepatol. 2007 Sep;22(9):1526-33. http://pmid.us/17716355.

[3] Sonksen P, Sonksen J. Insulin: understanding its action in health and disease. Br J Anaesth. 2000 Jul;85(1):69-79. http://pmid.us/10927996.

[4] Leibowitz G et al. Glucose regulation of ?-cell stress in type 2 diabetes. Diabetes Obes Metab. 2010 Oct;12 Suppl 2:66-75. http://pmid.us/21029302.

Leave a comment ?

70 Comments.

  1. I’m not sure I’m following here.

    Choline is abundant in meat as well as soft fat, like you pointed out.

    Are you suggesting that excess methionine may cause choline deficiency?

    If you need a real life example of zero-carb diets being a viable long-term option, check out Delfuego’s children.

    http://www.youtube.com/watch?v=kInj86ZPWbQ

    They have eaten nothing but, get ready… pemmican for their whole lives.

  2. I think the point is that a “low carb” diet is not [necessarily] a cure-all against diabetes. For example, you could follow a “low carb” diet that consisted of nothing but lean meats and dark green veggies, both cooked in olive or vegetable oil.

    Just to speculate from my armchair, it’s also possible that there is something about the components of choline synthesis/uptake that require a certain amount of dietary carbohydrate.

    To the author: is lard as good as beef tallow? Thoughts?

  3. Hi Danny,

    Actually, many people are deficient in choline. The US recommends 500 mg or more per day, and many fall short. You can see why: 200 g / 1800 calories beef tallow has only 164 mg.

    No, excess methionine doesn’t cause choline deficiency. A methionine deficiency can prevent the liver from synthesizing choline from methionine. This prevents the liver from making VLDL particles to export fats.

    I’m sorry, but that video doesn’t prove to me that a pemmican-only diet is healthy!

    Best, Paul

  4. Hi Becky,

    Yes, exactly. It’s very rare to develop diabetes on a low-carb diet — Leonie could be the only case, since the Rose Corn Oil trial wasn’t low carb — but if it is possible, it would be good to figure out how.

    Based on a new comment from Leonie on the last thread, it looks like autoimmunity is a more likely explanation for Leonie’s diabetes.

    The way zero-carb or low-carb could interact with choline is the missing piece of this story. If Leonie’s case isn’t due to zero-carb dieting, that missing piece may stay missing.

    Lard is good, but beef tallow is better because it is lower in omega-6 fats. Lard has about 100 mg choline per cup.

    Best, Paul

  5. What evidence is the 500 mg recommendation for daily intake of choline based on? If we cannot get it at all from large quantities of the most choline rich food, it strikes me as too high.

  6. Very interesting post. A caveat worth mentioning is that coconut oil is a highly saturated plant oil that is relatively stable (non-oxidizeable) at cooking temperatures and so makes for an excellent cooking oil. In my home I cook most dishes in coconut oil and occasionally use bacon drippings or ghee. So long as one has plenty of animal foods in their diet (and avoids grains and legumes and oils made from them) I think one could easily avoid choline deficiency while cooking with nothing but coconut oil.

  7. Hi Jeremy –

    If the fats come from cell membranes, rather than stored triglycerides, then they have a lot more choline. A 0.4 pound portion of cube steak has only 412 calories but 236 mg choline. See http://nutritiondata.self.com/facts/beef-products/3533/2. A 0.15 pound portion of beef liver has only 130 calories but 290 mg choline. http://nutritiondata.self.com/facts/beef-products/3469/2. So eat liver!

    I’ve just updated the post to include beef liver and cube steak in the table.

    It would be the exclusion of meat that primarily induces choline deficiency. This is why vegetarians are so much at risk.

  8. Hi Aaron,

    Yes, we are fans of coconut oil too. It’s a great oil. But it is lacking in phospholipids compared to animal fats. So you do have to eat a touch more meat if you cook with coconut oil.

  9. I have been reading your book. Excellent btw. I have also been zero carb or near zero carb for the last 3 years. My blood sugar runs between 70 and 95. Rarely over 100. For two years the only carbohydrate I got was from heavy whipping cream. I eat fatty meat, beef, pork, chicken w/skin and eggs from pastured hens. Sometimes I have venison or pheasant. For the last 3 months I added 10 blue berries per day and .5 ounce of almond meal. I use bacon grease or coconut oil for cooking. I feel great eating this way. My triglycerides won’t go below 100 and my total cholesterol is over 400 and I can’t lose weight. I am 5′ tall, female and 59 years old. I got to 118 pounds then suddenly gained 12. Most of the excess weight is abdominal. Now it won’t budge. I have tried calorie restriction. Currently I only eat enough to satisfy hunger. The sweetest thing I eat is the blue berries. No other sweetener.

  10. I did a phospholipid post a while back called “Zombieland” – brains, eggs, and certain seafoods and organ meats such as chicken hearts are good sources. I also found in my reading that our phospholipid intake is about 1/3 what it was 100 years ago. Strikes me that this could be a part of our rapid increase in diabetes in the last 50 years. Eat the egg yolks. I honestly don’t understand the greater and greater official push to more vegan-like diets without replacing these nutrients. I mean, epidemiology had a heyday in the 80s and 90s, but you would think the hormone replacement therapy debacle would have taught us a valuable lesson.

  11. Hi Deb,

    It’s rather puzzling, but I would suspect nutrient deficiencies as a likely issue.

    Did this develop after you became zero carb? What was cholesterol and weight like before you started zero carb? What is your thyroid status?

    Best, Paul

  12. Hi Emily,

    We surely need phospholipids. I’m not too surprised intake has collapsed compared to the pre-vegetable oil pre-lipid hypothesis pre-USDA food pyramid era.

    The thing that does surprise me is that vegans don’t get sick even faster. It’s so easy for them to be malnourished.

  13. Paul, thanks for tackling a pretty complex issue.

    When you talk of choline supplementation, what form do you suggest? Can you also use things like phosphatidylserine with complementary effects (do you even need choline then?)

    I’ve heard reports of choline increasing the likelyhood of stomach cancer — have you ever read that?

    Lastly, maybe you only need more choline if you have a really high fat diet? The Kitavans seem to have 0 problems with choline deficiency yet they dont really consume that much of it (at least from how I’ve read their reported diet). This also seems to be the case with many healthy cultures that eat higher carbs at the expense of fat. The issues with choline are far from clear cut, but you may have hit the head on the nail for why you can’t just increase any type of fat on a low carb diet.

  14. Hi Aaron,

    Well, as Emily says, egg yolks are a great supplement! That and liver are in effect what we use – we don’t take choline in pills.

    But there are choline supplements for those who prefer pills. Vegans I suppose would have to take the pills.

    I haven’t heard that choline increases the likelihood of stomach cancer. A quick search of Pubmed turns up the opposite — for at least one genotype, high choline consumption reduced stomach cancer risk by 45%: http://www.ncbi.nlm.nih.gov/pubmed/19288150. It’s possible that choline like B6, B12, and folate could accelerate the proliferation of advanced cancers.

    Your last suggestion I think is quite likely: high-fat diets make choline deficiency more severe, maybe they also increase choline needs. However, I haven’t been able to find papers showing this directly. I just infer it from the animal studies, where “high fat diets” make the consequences of choline deficiency more severe.

    The Kitavan example is a good counterpoint. They do eat a lot of seafood, however, so I’m not sure they’re actually deficient. One would have to quantify their choline intake.

  15. I think another good question to ask is where other primates get their choline from — Even if we as humans have specialized needs for animal foods, I would argue that most primates needs would not be the different from that of humans (so i gander that it is their low fat intake that allows them to get away with low choline intake). I think your greatest contribution to the subject so far is to eat your animal fats if you do eat fat.

    I always have to nod my head a bit when people suggest egg yolks when I have an allergy to them <— sucks.

    I am also usually wary of b-vitamin supplements — they are the ones that need to be in balance with each other, and taking too much of any 1 could possibly throw off the others. Especially when different people have different needs.

  16. Hi Aaron,

    Foods highest in choline per gram:
    1. Egg yolks
    2. Kidneys
    3. Brain
    4. Fish eggs / caviar
    5. Chitterlings (small intestine)
    6. Liver
    7. Heart
    8. Sweet or acid whey
    9. Shiitake mushrooms
    10. Tripe (stomach)
    11. Meat generally

    Hopefully there’s something there you’re not allergic too!

  17. Thank for your reply Paul,

    To preface this, I do not follow a carnivorous, although I was on one for two years.

    I agree, Delfuego’s children are by no means “proof positive” that carnivorous are “healthy,” but to say they’re dangerous might inaccurate.

    Great site you guys have. I’m looking forward to the rest of the series.

  18. It honestly never occurred to me that one would criticize a zero carb diet by using a diet low in meat as example. While technically one could eat a diet essentially devoid of carbohydrates using plant protein isolates and plant oils, it would hardly seem to be the prototypical zero carb diet. The typical zero carb diet, as I understand and practice it, consists of eating meat pretty much to exclusion, fat included, maybe with some eggs and green leafy herbs.

  19. Hi Amber,

    This particular post isn’t a criticism of zero-carb diets, it’s an exploration of phenomena. In that sense it is a diversion from the zero-carb dangers series.

    It does however illustrate that micronutrient deficiencies are a possible causal factor in health problems that afflict some people, but by no means all, on a zero-carb diet. A zero-carb high-fat diet has to be nutrient complete, and the micronutrient needs might be different (and larger) than on the standard American diet.

  20. One question and a comment for Aaron.

    Do you consider the omega-6 content of egg yolks when recommending them for choline, and roughly how many per week is reasonable? I went for years avoiding the horrible killer eggs, then educated myself a bit and went the other way, eating probably too many now. Is there a limit?

    Aaron, just one thought on the egg allergy is that most people are allergic to the white due to the protein. Depending on how severe your reaction is, you might be able to try separating them and eating yolks only.

    Great site Paul, my book arrived today so I will start on it soon!

    Rodney

  21. Hi Rodney,

    There was the famous case of the man who ate 25 eggs a day for 15 years and had no ill effects: http://www.nejm.org/doi/full/10.1056/NEJM199103283241306.

    I think it’s not perfect to eat an egg diet because it will be high in omega-6 and vitamin A, so imbalanced, also high in protein if you don’t throw out the whites on some of them.

    I eat 3 egg yolks probably 4 days a week.

  22. A bit more info. I lost 40 pounds on low carb. 20 grams of carbs or less per day. That took about 4 years. Then lost another 12 on zero carb in about 1 year. I had awful acid indigestion and acid reflux before I went zero carb. After about 6 months of zero carb the acid indigestion and reflux was mostly gone unless I ate something a bit too carby. Blemishes on my face cleared up. Joints were no longer painful.

    I discovered about 6 years ago I have an allergic reaction to wheat, rye and oats. It manifests itself as painful, burning welts on the roof of my mouth. The pain subside pretty quickly but the welts are there for a day or so.

    Total cholesterol has been going higher every time it is tested from just under 200 in 1999 to last year over 400. Last year I had a VAP test and LDL was predominately large buoyant. Triglycerides 126 and HDL 72.

    Never had thorough testing of thyroid. The only symptoms of thyroid malfunction is the high TC and Triglycerides, abdominal adipose tissue (waist circumference is 32″), body temp. always normal. I only feel cold if the ambient temperature is cold.

  23. This topic reminded me of a thought I had once when reading the carbohydrate is not a dietary necessity:

    I’ve heard of the liver’s “mixed function oxidase” system that lets the body rid itself of water insoluble chemicals by joining the chemical to a molecule of glucose.

    Not being a highly technical person I don’t know how to research this – just throwing it out as a possibility/question, would extremely low carbohydrate reduce this subsystem’s function?

  24. Paul,

    Would you have any reason to advise against supplementing choline through a B complex vitamin supplement? Any reason to not take a B complex vitamin?

    • Hi TL,

      The concern with a B complex supplement is too much niacin and folic acid. This is discussed in the book. We prefer supplementing B vitamins individually for that reason.

      Hi Sam,

      Thanks! I’ll have to look into the mixed function oxidase system. Nigel has thrown a wrench into all glucose-deficiency explanations, so there are some hurdles to making that explanation work.

  25. Hi Paul, I don’t think diabete developed during zero-low carb diets is due to choline deficiency.

    It is an adaptative mechanism to save glucose:

    http://high-fat-nutrition.blogspot.com/2007/10/physiological-insulin-resistance.html

    • Hi Kratos,

      I don’t think it can have been physiological insulin resistance, because they weren’t on low-carb diets. Also one of the patients was diabetic before the trial started, and his diabetes got worse. There’s no reason to think they got the diagnosis wrong.

      So choline deficiency seems the likely explanation.

      Best, Paul

  26. Is there any evidence that increasing choline intake can help reverse fatty liver and restore sensitivity to insulin?

  27. Choline deficiency interests me particularly because it was only by supplementing choline+inositol (1 gram of each per night) that I was able to make a dent in my intractable insomnia. I still need 5-6 mgs of doxylamine to sleep through, but with that plus the choline I am now getting 6-7 hours of very deep, restful sleep every night. (FWIW, yes, I tried melatonin in a wide range of dosages, Vit D., 5-htp, sleep hygiene, meditation, dark room, etc. These experiments went on for years without result.)
    However, my diet is and always has been high in eggs and muscle meat. From whence the deficiency?

  28. Hi Kathy,

    Interesting!

    It’s odd that eggs and meat aren’t enough. Maybe choline needs are increased in some people.

    I would have to think about the mechanism for the insomnia. Choline is also a precursor for the neurotransmitter acetylcholine, and a methyl donor which supports B6/B12/folate, and has many functions and pathways, so this may be complicated. But very interesting.

    If you want to help out, you could test whether supplementing choline only, without the inositol, works.

    Best, Paul

  29. One additional note, after only a few days of choline/inositol supplementation, my persistent carpel tunnel symptoms disappeared. Does it make sense that choline would help heal nerve damage?
    Maybe if I knew more about acetylcholine, it would all come clear.

  30. Kathy – Another thing to research! Interesting!

  31. […] Perfect Health Diet » Choline Deficiency and Plant Oil Induced Diabetes […]

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  34. Would there be any problem with using a supplement called phosphatidylserine?
    I have used it over the years with cycling off
    periodically. I have found that my brain function is improved and also surprisingly I become naturally more outgoing-talking to strangers at the grocery store. Not my norm. I might say my mood improves.
    But I don’t want to mess anything up while beginning PHD.

    I have never commented on a thread before and may need some correction as to where to submit a question. let me know.
    thanks-Lgordon

  35. Hi LGordon,

    In general I think if you eat a diet rich in animal fats and eggs then you should get enough PS, and so for most people I would recommend food only. However, if you find that supplementing helps you, then there’s no reason not to supplement. PS is pretty safe and the literature finds largely beneficial effects from supplementation.

    Just be aware that though it helps you now, that might not always be the case. So try stopping it once in a while to see if you get better or worse.

    Best, Paul

  36. Richard Gibson

    Could it be that the whole of the so-called metabolic syndrome is caused by a deficiency of choline. Could it be that the rising levels of diabetes & hypertension are because most peoples’ diets are deficient because people are avoiding eggs, liver, other offal etc.
    I have suffered from hypertension since I was in my 40s and developed diabetes in my late 50s. All this time I have done lots of exercise, not been overweight etc etc. Could it be this was caused by a choline deficiency?
    I am now stuffing myself with foods that contain lots of choline. Let’s see!

    • Mitch Bradley

      How did it go? Did the choline help the hypertension?

      I am hypertensive, despite eating three eggs a day and beef liver once a week and following PHD fairly closely.

  37. My daughter is allergy to eggs and soy and I can’t get her to eat any organ meats…can anyone recommend a good supplement without egg and soy?

    I have diabetes and would like to start taking Choline supplments as well — would taking a higher dose — say 1,000 be helpful in treating diabetes? I do eat eggs regularly.

  38. Paul,
    Thanks so much for the quick response!!!
    I’m nervous about taking inositol as I read that it’s a sugar alcohol and may raise blood sugar and can actually cause insomnia and mania in some people?
    What would be the added benefit of it and do you recommend alternating every other day or weekly?

  39. Hi Paul,

    What are your thoughts on Citicoline (CDP-Choline) compared to other choline-only and choline/inositol supplements besides additional cost?

    Here’s an example:
    http://www.amazon.com/Jarrow-Formulas-Choline-250mg-Capsules/dp/B0013OUJPS/ref=cm_cr_pr_product_top

    Citicoline [stabilized CDP Choline (cytidine 5’diphosphocholine)] is a naturally occurring intermediate involved in the synthesis of phosphatidylcholine; a major constituent of the grey matter of brain tissue (30%). Citicoline consumption promotes brain metabolism by enhancing the synthesis of acetyl-choline; restoring phospholipid content in the brain and affecting neuronal membrane excitability and osmolarity

    Thanks,
    Mark

  40. Ettienne du Preez

    Hi I have just been diagnosed with type 2 diabet. Which obviously came as a shock. It got me thinking about my fatty liver which is possibly the major cause of my condition.

    I am a poultry farmer doing about 1 million birds per week, about two years ago ago i doubled the recommended choline dose in the broiler ration, and the results are simply astonishing. Mortality decreased by fifty percent, growth increased substantuialy but most important the birds converted better and the livers are really in great condition.

    Since the change in the ration we have send about 100 000 000 birds to plant with perfect livers. I am sure that Choline and the subsequent effect of Betaine have an effect on our humans systems. Further i am a hunter and mainly venison which has less Choline than other meats, i think I might have a huge Choline shortage.

    Will be discussing this with the physician in the morning as I am still in hospatal trying to stabilise suger levels. My email for more info edupreez @ sovfoods.co.za

    • Hi Ettienne,

      Choline is certainly very important so you should absolutely improve your status by eating liver and eggs!

      That is great about your chickens, thank you for sharing.

  41. Dear Etienne, Looking at your email address, I think you must be living in Africa. My impression from staying in hotels there is that everyone has 2 eggs every day for breakfast as a matter of routine. Are you the exception as this would otherwise be helping to provide you with at least some choline?

  42. Hi Paul and others,
    I wanted to ask your opinion… I know you can’t directly give advice, but just wanted to know what you would do if you were in this situation.
    My brother’s 4-year-old son was just diagnosed with Type 1 diabetes two weeks ago. (not sure if you remember, but I am also Type 1 as well as a different brother). Right now, he is going through the “Honeymoon Period” where the pancreas is still producing enough insulin such that he barely needs any right now. Anyway, my brother just called to ask me what I would do if I were in my honeymoon period again, knowing things I know now, after reading health info, nutrition, etc… what would I try? I first thought of the Rose Corn Oil Trial and something about choline or methionine deficiency (I know type 1 is categorized as “autoimmune” but I hate that, it makes it seem like we’ve resolved it because it is classed as something. I don’t think autoimmune is in itself a cause, but there was something that caused the autoimmune condition.) Anyway, and then I thought of eliminating wheat/ gluten. I thought of choline supplements. He’s willing to try something and he knows it’s just a shot in the dark, but he knows it would be ridiculous not to try something.
    So, I know you can’t give medical advice, and I’m not taking this as advice, but rather as your opinion of what YOU might do if it were you or your child…? I hope that’s ok to ask…
    Thank you so much, as always!
    KH

    • Giving up wheat, choline supplementation, liver / vitamin A, and vitamin D optimization would be my top tips. Also sufficient salt and iodine. Circadian rhythm tactics. The key I think is immune enhancement. Diabetes is often caused by small intestinal /pancreatic infections or wheat/gluten sensitivity.

      • Thanks Paul!
        I agree with your ideas– my biggest suspicions are on either the wheat or a virus.

        • A book by Prof. Keith Woodford (Devil in the Milk) points the finger at alpha1 beta-casein as a possible trigger for type 1 Diabetes.

  43. Ettienne du Preez

    Hi I cant comment on the type 1, however I posted something about Choline on this forum and got a reminder now when email came up. Been using Choline daily since 26 Feb 2013, in the meantime the Doc advise me to stop Cholesterol,hypertension and diabetic medication. 500 mg Choline and 500mg TMG a day seems to keep the suger away. My liver count dropped from 365 to 65 in 4 weeks after taking Choline. My health has not been this great in years. Fatty liver seem to be a great cause of type 2. I am no doctor but at least 5 friends are on the same treatment with the same result. Choline is a fatty liver killer!

    • Wow, that’s great! Thanks for sharing your experience. My brother said that their kids get a children’s vitamin every day, but I bet they don’t have choline in them…? Not sure though. But it seems so easy to be choline deficient if you don’t eat egg yolks everyday and/or liver every week. Surely adding choline to his diet wouldn’t harm anything if it’s a child- appropriate amount.

  44. Just discovered this great post!
    Some thoughts – therapeutic ketogenic diets are often protein restricted (low methionine).
    Larger intake of dietary fat may increase demand for choline to package said fats.
    No problem to evolution, when fats always came with protein and choline. But now we have refined fats/oils, choline-free, and refined proteins.

    See also: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0074806;jsessionid=9508C78FFCC5B5D5763C693BAB1B7217

    Role of Choline Deficiency in the Fatty Liver Phenotype of Mice Fed a Low Protein, Very Low Carbohydrate Ketogenic Diet

  45. Also- carbohydrate/insulin modulates flux in sulfur pathways.
    High glucose/insulin = methylation pathway favoured (homocysteine >SAMe >choline)
    Carbohydrate restriction = transsulfuration pathway favoured
    (homocysteine >cysteine >glutathione & taurine)
    http://jn.nutrition.org/content/137/2/311.full

  46. Hi there, If you are worried about diabetes the best progress that I have ever seen was with Blood sugar sniper (just google it) Without a doubt the most helpful program that I have used to help start reversing it.

  47. Hello all,
    I think the problem is , as is often is the case , that vegatable oil contains only fat and choline is water soluble , so for instance an olive contains the choline to asist proper digestion of the fats contained in the olive , consuming only the oil , uses choline from the body to make the food ¨¨ whole ¨”again , this being a factor in refined sugar also , as in all processed foods .

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