If you don’t eat liver or runny egg yolks, you need to read this. All of this!!
Twenty years ago the Institute of Medicine (IOM) officially recognized choline as an essential nutrient. Choline is not commonly discussed in the medical community, yet evidence exists that it supports all stages of life and crucial to overall health. Choline impacts metabolism, maternal health and fetal development. So why is it that 90% of Americans are not meeting the daily requirement (1)?
Why Choline?
Choline is a major dietary source of methyl groups, made from biological reactions. Methylation reactions and methyl-group metabolism play large roles in our body’s ability to make and transport lipids. It’s also involved in several metabolic pathways and body detoxification (2). Choline is also required to make phospholipids in the body, which are essential for cell-membrane formation and signaling. It is also needed for acetylcholine formation. This chief neurotransmitter in the body affects memory, muscle control, and other functions (2, 3).
Some studies have also been able to associate choline-rich diets with lower levels of several inflammatory markers in the body (2). Other studies are being done to evaluate the risk between a deficiency and breast cancer. One study found that breast cancer risk was reduced 24% among women with high dietary intakes of choline (2).
Because of its wide range of roles in everything from cell structure to neurotransmitter synthesis, choline deficiency can impact a variety of diseases. A deficiency can impact diseases such as: nonalcoholic fatty liver disease, atherosclerosis, and possibly neurological disorders (2).
How much do I Need?
Choline is acquired from foods or made in the body via methylation. The choline our body makes is normally not enough to meet our requirements, making choline-rich diets essential. The chart below provides choline rich food sources, but please compare them to the Daily Adequate Intake recommendations provided! You may be surprised and recognize a gap in your own intake. Common genetic variants can increase daily choline needs. (2).
| Life Stage | Daily Adequate Intake (AI) |
| Children | |
| Birth to 6 months | 125 mg/day |
| 7-12 months | 150 mg/day |
| 1-3 years | 200 mg/day |
| 4-8 years | 250 mg/day |
| 9-13 years | 375 mg/day |
| Males | |
| 14+ years | 550 mg/day |
| Females | |
| 14-18 years | 400 mg/day |
| 19+ years | 425 mg/day |
| Pregnancy | 450 mg/day |
| Lactation | 550 mg/day |
Some men have higher choline requirements than women. However, women often use it more efficiently than men. Currently, the elderly need not adjust their intake. Though, choline transport across the blood-brain barrier is lower in older adults compared to younger adults (3).
Special Populations
Pregnancy: during pregnancy the body synthesizes choline more efficiently to help meet demands. But during pregnancy, a large amount of a mother’s choline is delivered to the growing fetus across the placenta. While beneficial for baby-to-be, this leaves mother’s stores depleted and unable to meet the body’s growing demands if not consuming a choline rich diet (2). Adequate intake helps lower risk for neural tube defects, spina bifida, and anencephaly (2). Interestingly, choline is also important for bile release from the gallbladder. Many women end up getting their gallbladder removed during pregnancy or shortly after. This appears to be too ironic to dismiss.
Lactation: human breast milk is rich in choline, making it a great source for baby. The increased maternal demand results in depletion of her tissue stores, making it essential to increase intake of choline rich foods (2).
Heart disease: if the body has low levels of choline stores, it is less efficient in its methylation reactions. In relation to heart disease, this can lead to higher levels of homocysteine, which is associated with greater risk for cardiovascular disease (and a variety of chronic diseases). In a study with older men, supplementation was shown to decrease their elevated homocysteine levels, suggesting adequate intake can reduce risk for cardiovascular disease (2).
Exercise: in studies done on trained athletes, strenuous physical activity reduced plasma choline levels significantly. In triathletes and marathon runners, supplementation prior to exercise helped preserve store levels (3).
Choline is not known to have any clinically relevant interactions with medications. Excessive intake is associated with:
- lowered blood pressure
- fishy body odor
- vomiting
- excessive sweating and salivation
- liver toxicity (4).
Food Sources
The Food and Drug Administration (FDA) is asking for food manufacturers to voluntarily add choline to the nutrition facts label in the upcoming nutrition facts label changes. This will help consumers identify these foods easier.
Choline-Rich Foods |
|
| Food Source | Choline Content (mg) |
| 3 oz. beef, turkey or chicken liver | ~360 |
| 1 egg (soft or runny yolk is ideal) | ~125 |
| ½ cup roasted edamame/soybeans | ~100 |
| 3 oz. grass-fed beef | ~85 |
| 3 oz. chicken or turkey | ~70 |
| 3 oz. Atlantic cod or salmon | ~70 |
| ½ cup cooked shiitake mushrooms | ~60 |
| 1 large red baked potato | ~60 |
| 2 Tbsp wheat germ | ~50 |
| ½ cup cooked kidney beans | ~50 |
| ½ cup roasted pistachios | ~40 |
| 1 cup cooked quinoa | ~40 |
| 1 cup cow or goat milk | ~40 |
Recommended Supplements:
This is NOT a product to skimp on when it comes to quality. If you decide to supplement, stick to a professional brand not using GMO soy. Examples: Xymogen, Body Bio and Seeking Health.
Resources:
- https://www.ncbi.nlm.nih.gov/pubmed/26886842
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782876/
- https://www.ncbi.nlm.nih.gov/books/NBK114308/
- https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
Written by 131 Method Dietitian, Ana Cristina Jurczyk, MS, RDN
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