Krill Oil, Choline, and NAFLD

Krill Oil, Choline, and NAFLD

In these modern times, our poor liver is always working overtime just trying to keep up with all the new toxins provided to us through the miracles of science. But, the liver already had full-time employment before having to cope with pesticides, preservatives, pollution, radiation, and xenoestrogens, etc.  Some of its most important basic functions include synthesizing proteins, producing hormones, aiding digestion, and cleaning the blood of natural compounds, found in our foods and environment, that should not be assimilated. In fact, it is assumed that the liver is involved in around 500 different biological functions in the body, so the last thing our poor liver needs is another modern assault, but here we are nonetheless.


By now many of you have heard of the newest liver ailment, called non-alcoholic fatty liver disease (NAFLD), a condition affecting over 25% of adults globally, and about one out of three people in Western populations.  NAFLD, now the most common liver disease in the world, is characterized by an abnormal buildup of fat in the liver, which unfortunately does not present early symptoms. Thus, it is often diagnosed after much liver damage has already occured, and if left untreated for too long can lead to liver failure.

Given the importance of the liver to our health, it is no surprise that NAFLD is “often seen in combination with obesity, diabetes, dyslipidemia (abnormal blood lipids), metabolic syndrome and cardiovascular disease”.

According to Western medicine, there is currently no treatment for this ailment other than a change of diet, in conjunction with physical activity.  “Given that currently no pharmaceutical intervention is approved for the treatment of NAFLD, focus shifts instead to mitigation of risk factors through avoidance of foods that are rich in red meat, trans fats, refined carbohydrates, and high-fructose corn syrup; are low fiber; and have high energy density. The landmark of treatment, however, continues to be weight loss and improvement of insulin resistance, often through a multimodality approach.”   (Source)

Natural Treatments

While the medical profession has no drugs that help this condition (which makes sense since all drugs add a further burden to the liver), there are a few things that are used in the natural healing field.  In this newsletter we are going to examine the value of phospholipids, omega-3s, and choline, all of which support liver health, and all of which are found in krill oil. But, before addressing that subject, I must mention the most obvious idea that springs to mind when noting the value of “improvement of insulin resistance”, which is of primary concern when addressing NAFLD.

That idea is to use berberine, one of my favorite supplements, and one that has proven to be comparable to the drug Metformin, in its ability to regulate insulin levels. And it didn’t take much research to find that studies have already confirmed the value of berberine in treating NAFLD. (Source)

(I would also be remiss, if I did not at this point mention, for those unaware, two  previous newsletters on the subject: Low Vitamin D May Increase Risk of NAFLD, and An Unusual Dietary Approach to NAFLD.)

Krill Oil

Now to krill oil, and why it is good for liver health. In short, it is because of the phospholipid bound omega-3 fatty acids and choline contained within krill oil, two essential nutrients that are a clinically proven way to support optimal liver health.  First, let’s appreciate that all of the trillions of cells in our body are covered in a cell membrane made up of phospholipids, which are the main building block for all our cells, and support the healthy functioning of these cells, including liver cells.

As I have pointed out repeatedly in previous writings, while NutriKrill may have low amounts of omega-3 fatty acids compared to conventional fish oils, it is so much more valuable because krill oil is in a phospholipid form. This form is easily welcomed into the cells (as are liposomal supplements, also a phospholipid form of nutrients), whereas most nutrients, supplemental or from food, do their work mostly outside of the cells. This same principle of low amounts of a nutrient with better absorption also holds true for the choline present in krill oil.


A vitamin-like nutrient (usually considered part of the B-complex), choline essential for normal cellular function, and required by many of our organs, including the brain, liver, kidney, pancreas, and also the muscles.  Choline is also required for the synthesis of certain phospholipids (phosphatidylcholine, and sphingomyelin required for maintaining our myelin sheath), which are essential components of cell membrane structure. Since phosphatidylcholine (PC) accounts for about 95% of total choline in tissues, if we are to supplement with choline, using PC (or lecithin granules, not capsules) is the preferred way to go.

The Recommended Daily Intake for choline is 425 mg for women and 550 mg for men. However, although choline is found in common foods such as eggs, salmon, soybean, beef and milk, most people do not consume an adequate amount through their diet (unless they skew paleo).

Since, aside from cell structure, choline is also needed for neurotransmitter synthesis, choline deficiency can lead to neurological disorders. In fact, choline has a role “as a neuroprotectant that may mitigate some of the adverse effects of neurodegenerative disorders and protect mental health across the lifespan”. (Source)

But for our purposes here, we are interested in the fact that the liver is central for choline metabolism and use, and it is essential for liver function. So, if we are choline deficient, liver fat builds up leading to damage and liver cell death.  Ingesting a therapeutic amount of choline helps create lipoproteins that carry fat away from the liver, directing to the cells that need it. This both prevents and can help to reverse the buildup of fat in the liver cells, which is associated with fatty liver (NAFLD).

Krill oil is a great source of choline as it contains a total of 40% phosphatidylcholine (and our liposomal products also contain an appreciable amount of PC: 400 mg per serving).

Omega-3 Fatty Acids

Several studies have shown beneficial effects of omega-3 supplementation for NAFLD. And a meta-analysis of 18 studies showed significant beneficial effects on metabolic risk factors, liver enzymes, liver fat content and liver damage, concluding that omega-3 fatty acids are an important treatment option for NAFLD. (Source)

Since omega-3s bound to phospholipids are more efficiently incorporated into our cells, and the combination provides both omega-3 and choline, krill oil is far superior to simply taking fish oil and choline supplements for influencing liver fat metabolism and liver fat content.

Scientific Support

Now let’s have a look at a couple of scientific studies that support this thesis.

  1. In this review, major data from the literature about the role of some dietary fats as a potential cause of hepatic fat accumulation or as a potential treatment for NAFLD are described. It is noteworthy that both quantitative and qualitative aspects of dietary fat influence triglyceride deposition in the liver. A high-fat diet or the dietary administration of conjugated linoleic acids induced hepatic steatosis (the initial phase of NAFLD). In contrast, supplementation of the diet with krill oil or pine nut oil helped in the prevention and/or in the treatment of steatotic liver.”   (Source)
  2. “The supplementation of a high-fat diet with 2.5% Krill Oil efficiently prevented triglyceride and cholesterol accumulation in the liver of treated rats. This effect was accompanied by a parallel reduction of the plasma levels of triglycerides and glucose and by the prevention of a plasma insulin increase.” In this study, krill oil also prevented oxidative damage of lipids and proteins, often found in animals fed a high fat diet.   (Source)
  3. As a bonus we have this study which suggests that krill oil promotes the burning of excess fat introduced by a high-fat diet. “This effect is obtained by stimulating mitochondrial metabolic pathways such as fatty acid oxidation, Krebs cycle, and respiratory chain complexes activity. Overall, krill oil counteracts the negative effects of a high-fat diet on mitochondrial energetic metabolism.”   (Source)


Our conclusion is pretty obvious: take krill oil to prevent and treat NAFLD, aside from the many other benefits it has proven to provide (Krill Oil and AthletesKrill Oil and Cognitive FunctionAre Krill Oil Benefits Even Better than Fish Oil Benefits?) In closing I will add one more natural treatment scientifically proven to help treat this common disease.

The purpose of this study is to determine the protective effect of Taraxacum official (dandelion) leaf extract (DLE) on high-fat-diet (HFD)-induced hepatic steatosis…These results indicate that the DLE may represent a promising approach for the prevention and treatment of obesity-related nonalcoholic fatty liver disease.”   (Source)

No surprise really, since not only is dandelion traditionally used to support liver health and treat liver problems, but it is also a source of…that’s right: choline.

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