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Humans express three malic enzymes, one cytoplasmic that requires NADP + and two mitochondrial enzymes, one that requires NADP + and one that requires NAD +

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[ 10] This step can be enhanced by Docosahexaenoic Acid (DHA), a main structural component of neuronal cell membranes, which improves the capacity of the high-affinity choline uptake system to transport choline into neurons, thereby increasing its availability for acetylcholine synthesis.* [27 ] This might be part of the reason that dietary DHA increases acetylcholine levels