In 1973, Dolly Parton released the single “Jolene,” which went on to become one of the most covered country songs of all time. Which brings me to a nutrient that rhymes with Jolene and most people have never heard of: choline. Choline has been making headlines recently (and by that I mean media attention, not scalp wrinkles), partly because of a 2019 article by a nutritionist, Emma Derbyshire, published in the prestigious BMJ Nutrition, Prevention & Health. Provocatively titled, “Could we be overlooking a potential choline crisis in the United Kingdom?”, it argued that “accelerated food trends towards plant-based diets/veganism” could worsen an already-widespread choline shortfall, and called for choline to be added to UK food databases and dietary guidelines.
Here’s where things get interesting. After publication, the BMJ added a corrected competing-interests statement disclosing that the author had consulted for and advised the Meat Advisory Panel, Marlow Foods (Quorn), the Health Supplement Information Service, and the British Egg Information Service. These are all organizations with a financial stake in eggs, meat, supplements, and (interestingly) a meat alternative.
Now, just because someone may have financial incentives to arrive at a particular conclusion doesn’t mean they’re wrong. Choline is a legitimate nutrient of concern (even if nobody has yet written the country song it deserves). The underlying physiology and population-level intake data are solid, and we’ll cover them in full below.
And as we’ll see, Derbyshire was at least half right. But her paper offered no new data on how much choline people in Britain actually eat. The warning about plant-based eating was a projection based on falling meat consumption, not something observed in British diets.
The European data shows this isn’t only a plant-based problem. When EFSA researchers pooled national dietary surveys, including Britain’s own National Diet and Nutrition Survey, average choline intake among adults ranged from 291 to 468 milligrams a day, below the recommended level for a largely omnivorous population.
The U.S. picture is similar. National survey data show the average American woman takes in 284 milligrams of choline a day and the average man 390, with only 6% of women and 11% of men getting more than the recommended amount. Since just 4% of Americans identify as vegetarian and 1% as vegan, the overwhelming majority of people falling short eat meat, eggs, or dairy.
So yes, plant-based eaters should pay attention to choline. The limited data we have suggests they tend to take in somewhat less than omnivores. And most people, whatever they eat, are coming up short.
In this article, we’ll look at what choline is, what it does, and the evidence for how it helps us survive and thrive. We’ll explore how you can get choline from food, with special attention to plant-based options, as well as issues that might affect your ability to absorb it. We’ll also explore whether a supplement might be a good idea for you.
What Is Choline?
Choline is a water-soluble essential nutrient. It often gets grouped with the B vitamins because it works so closely with them. It isn’t officially a vitamin, partly because your body can make some of its own. It was first discovered in the mid-1800s and named choline because it was first found in pig bile. (The Greek word for bile is chole, which also explains why people thought to have an excess of the bodily fluid were deemed to have choleric personalities.)
Your body can synthesize some choline, but not enough to meet all its needs. The U.S. Institute of Medicine recognized this in 1998, when it formally designated choline an essential nutrient. In nutrition-science terms, that’s practically yesterday. This makes choline the newest member of the essential-nutrient club, and something of a celebrity among science geeks. If nutrients had fan clubs, I’m pretty sure choline’s would meet in a lab and argue about methylation.
What Does Choline Do in the Body?
Choline performs many important jobs in your body and is crucial throughout your life cycle.
In a sense, choline makes you who you are: It provides every cell in your body with structural integrity and facilitates the transfer of lipids across cell membranes. Your cells also need it to communicate and coordinate with each other, a process known as cell signaling.
Your body needs choline to make acetylcholine, which is a neurotransmitter essential for cognition, memory, and muscle control.
A Partner in Methylation
Choline also plays a key role in a process called methylation. Think of it as your body’s labeling system. It attaches tiny chemical tags, called methyl groups, to genes, brain chemicals, and other molecules, which can switch them on or off or change what they do.
The main molecule that hands out those tags is SAM. (No, not the Dr. Seuss character.) SAM is short for S-adenosylmethionine, and your body makes it from an amino acid called methionine. That’s where choline comes in. By way of a compound called betaine (which we’ll meet again later), choline helps your body recycle homocysteine back into methionine, keeping the SAM supply going. That recycling matters for another reason, too: High homocysteine levels are linked to heart disease.
Methylation helps your body make and regulate brain chemicals like serotonin and dopamine, control which genes are active, process hormones and medications, and keep your liver working normally.
Choline has backup in this work. Folate and vitamin B12 run a second recycling pathway, and the two routes can partly cover for each other. Choline’s route does more of the work in the liver and kidneys, while the folate and B12 route is more active elsewhere in the body. When one runs low, the other has to carry more of the load. That’s why choline, folate, and B12 work best as a team, and why it helps to get enough of all three.
Fat Transport and Liver Function
Choline is needed to package fat into lipoproteins for export from the liver. Not enough choline can cause fatty liver (fortunately, often reversible when choline levels are restored) and muscle damage.
What Are the Health Benefits of Choline?
Given that insufficient choline can be harmful, it makes sense that getting enough is going to be good for you. Growing evidence shows choline is crucial for the brain and liver and may be linked to lower cancer risk.
Brain Development and Cognitive Function
A 2011 study of roughly 1,400 adults without dementia found that those who self-reported consuming more choline-rich foods performed better on verbal and visual memory tests. MRI brain scans also showed that choline maximizers had less white matter damage.
The next natural question is, can choline help prevent dementia? In a 2024 study, researchers tested this question using genetically engineered mice that are highly prone to developing the same kind of amyloid plaque in their brains that’s a hallmark of Alzheimer’s disease. They found that giving supplemental choline to the mice shortly after their birth improved their performance on memory tests well into adulthood, and may also reduce amyloid-beta buildup in the hippocampus region of their brains.
(Our view on the use of animals in medical research is here.)
Fetal Brain Development and Neural Tube Defect Prevention
Choline needs rise in pregnancy (see below for details). Not getting enough choline and betaine in utero has been linked to an elevated risk of neural tube defects like spina bifida.
A 2018 study found that mothers who got 930 milligrams of choline a day during their third trimester (a controlled diet plus a 550 milligrams supplement) gave birth to infants with faster information-processing speed than mothers who got 480 milligrams a day (the same diet plus a 100 milligrams supplement).
A 7-year follow-up of the same children published in 2021 found that those born to higher-choline mothers showed superior attention, working memory, and problem-solving proficiency at age 7. I want to pause to applaud; this is one of the very few nutrition randomized controlled trials with long-term cognitive follow-through.
At the same time, the study was quite small, with just 26 mothers and 20 of their children tested at age 7. So while the data are promising, they don’t yet represent settled fact. As researchers love to write at the end of their publications, “more research is needed.” And researchers aren’t all reading the evidence in the same way. A 2022 review concluded that higher choline during pregnancy probably benefits children’s thinking skills, while a 2025 review of the available trials found most outcomes showed no clear effect. What nobody disputes: Most pregnant people fall well short of the Adequate Intake, so reaching it is a reasonable goal while the question of going beyond it gets sorted out.
Liver Health
Choline is essential for packaging fat and exporting it from the liver, and controlled feeding studies show that diets very low in choline can cause fat to build up in the liver. Whether everyday differences in choline intake matter is less clear. A large 2014 cohort study of Chinese women found that those who ate more choline were less likely to have fatty liver, but the link appeared only among women of normal weight. In women with overweight or obesity, other factors may be more prominent than the level of choline in the diet.
Possible Role in Cancer Risk
A 2024 analysis of national survey data from U.S. adults found that people who reported eating more choline were less likely to have had colon cancer. Because it captured a single point in time, it can’t tell us whether choline helped prevent cancer or whether people who’d had cancer simply ate differently afterward. Say it with me: “More research is needed.”
An Unanswered Health Question
Does choline fight heart disease? The first study I came across seemed to say yes. It’s a 2023 analysis that found the participants with cardiovascular disease (CVD) got significantly less choline in their diets than those without heart disease. That’s cool, but the way the study was designed means that we can’t say which came first: CVD or lower dietary choline.
In other words, rather than saying that low choline intake causes heart disease, we could just as reasonably conclude that people diagnosed with CVD would be told by their doctors to eat less meat, eggs, and dairy — some of which, as we will see, are high in choline.
One year later, a meta-analysis of six cohort studies including almost half a million participants pointed in the opposite direction. Each additional 100 milligrams of daily choline was associated with an 11% higher risk of dying from cardiovascular disease.
Again, it’s an association, and doesn’t prove causation. But it gives me enough pause to consider the relationship between choline and heart health as an unsettled question. Especially since there’s a known mechanism by which choline might contribute to heart disease. Some people’s gut microbiome converts choline into a compound called TMA, which the liver then converts into TMAO. TMAO is linked to heightened cardiovascular risk. To learn more about TMAO, see our article here.
So choline doesn’t belong in the heart-protective column, and the evidence doesn’t necessarily convict it either. One possible explanation for the mixed findings in Western diets is that much of the choline comes packaged with processed and red meat, which carry cardiovascular risks of their own. If that’s what’s going on, getting your choline from beans, soy, and whole grains, or even from eggs, could deliver the benefits without the baggage. That’s a hypothesis, not a finding. One more time on the chorus: “More research is needed.”
How Much Choline Do You Need?
Choline is a tricky nutrient to pin down in terms of daily requirements. In fact, there isn’t a Recommended Dietary Allowance (RDA), which is how most nutrients get treated. Instead, the National Academies set an Adequate Intake (AI, and not the kind that everyone’s talking about).
The difference is that an RDA is set when there’s enough research to calculate how much most people need confidently; an AI is used when the evidence isn’t yet sufficient to establish a formal RDA, so scientists set a reasonable estimate based on the best available data.
The baseline choline AI for adults is 425 milligrams per day for women and 550 milligrams per day for men. The gap represents the average difference in body size, and not a difference in biological need. These figures rise during pregnancy (450 milligrams per day) and lactation (550 milligrams per day). You may remember the trial mentioned earlier, where mothers getting 930 milligrams per day in the third trimester had infants with faster information-processing speed. That’s a promising result from one small study of 26 women, but not necessarily enough evidence to turn that number into a target. If you’re pregnant and thinking about going above the AI, that’s a conversation to have with your health care provider.
Part of the trickiness is that the liver can synthesize small amounts of choline via a pathway called PEMT, short for phosphatidylethanolamine N-methyltransferase. If that last sentence was fun for you, here’s more: The pathway is so named because it converts phosphatidylethanolamine into phosphatidylcholine. (If this article ever gets turned into an audiobook, I feel sorry for the narrator.)
People with common variants in the PEMT gene may need more choline, especially postmenopausal women.
Estrogen turbocharges PEMT, so postmenopausal women generally synthesize less of their own choline than premenopausal women or men.
Plus, people with certain MTHFR gene variants may need more choline when folate intake is limited.
But regardless of the efficiency of your PEMT pathway or other genetic considerations, you still need to get some from food. And how much varies widely, so it’s a good idea to get to know choline-rich foods that you can add to your diet on a regular basis.
If that weren’t complicated enough, other factors also influence how much choline you need. One is betaine, which your body can make from choline, and which is also found in foods like beets, spinach, quinoa, and whole grains. And it can partially substitute for choline in the methylation pathway, meaning that if you get a lot of these foods, you can get by with a bit less dietary choline.
For another, different foods contain different choline-containing compounds. Choline can exist as free choline salts, or bound in forms like phosphatidylcholine, glycerophosphocholine, and phosphocholine (and again, apologies to the audiobook narrator). The form matters once it reaches your gut. Free choline that isn’t absorbed in the small intestine can be broken down by gut bacteria into trimethylamine, the compound behind the fishy body odor seen at very high intakes and the raw material for TMAO. Phosphatidylcholine, a fat-bound form found in whole foods like soybeans and eggs, produces much less of it. That’s one reason the form of a supplement matters too, which we’ll come back to below.
Foods That Contain Choline
While lots of foods contain choline, beef liver and eggs are the most concentrated sources. In fact, 4 eggs more than cover your entire daily AI. (For more on eggs, see our article here). Roasted soybeans are the choline champs of the plant kingdom, outranking most meats and fish per serving.
Animal-Based and Plant-Based Sources of Choline
https://ods.od.nih.gov/factsheets/Choline-HealthProfessional
| Animal Foods | Milligrams per serving |
Percent DV |
|---|---|---|
| Beef liver, pan-fried, 3 ounces | 356 | 65 |
| Egg, hard-boiled, 1 large | 147 | 27 |
| Beef top round, separable lean only, braised, 3 ounces | 117 | 21 |
| Chicken breast, roasted, 3 ounces | 72 | 13 |
| Beef, ground, 93% lean meat, broiled, 3 ounces | 72 | 13 |
| Fish, cod, Atlantic, cooked, dry heat, 3 ounces | 71 | 13 |
| Milk, 1% fat, 1 cup | 43 | 8 |
| Yogurt, vanilla, nonfat, 1 cup | 38 | 7 |
| Cottage cheese, nonfat, 1 cup | 26 | 5 |
| Fish, tuna, white, canned in water, drained, 3 ounces | 25 | 5 |
| Plant Foods | Milligrams per serving |
Percent DV |
|---|---|---|
| Soybeans, roasted, ½ cup | 107 | 19 |
| Potatoes, red, baked, flesh and skin, 1 large potato | 57 | 10 |
| Wheat germ, toasted, 1 ounce | 51 | 9 |
| Beans, kidney, canned, ½ cup | 45 | 8 |
| Quinoa, cooked, 1 cup | 43 | 8 |
| Brussels sprouts, boiled, ½ cup | 32 | 6 |
| Broccoli, chopped, boiled, drained, ½ cup | 31 | 6 |
| Mushrooms, shiitake, cooked, ½ cup pieces | 27 | 5 |
| Peanuts, dry roasted, ¼ cup | 24 | 4 |
| Cauliflower, 1" pieces, boiled, drained, ½ cup | 24 | 4 |
| Peas, green, boiled, ½ cup | 24 | 4 |
| Sunflower seeds, oil roasted, ¼ cup | 19 | 3 |
| Rice, brown, long grain, cooked, 1 cup | 19 | 3 |
| Bread, pita, whole wheat, 1 large (6½ inch diameter) | 17 | 3 |
| Cabbage, boiled, ½ cup | 15 | 3 |
| Tangerine (mandarin orange), sections, ½ cup | 10 | 2 |
| Beans, snap, raw, ½ cup | 8 | 1 |
| Kiwi fruit, raw, ½ cup sliced | 7 | 1 |
| Carrots, raw, chopped, ½ cup | 6 | 1 |
| Apples, raw, with skin, quartered or chopped, ½ cup | 2 | 0 |
Do You Need a Choline Supplement?
The most recent national figures, from NHANES 2015–2018, put average choline intake at 284 milligrams per day for women and 390 milligrams per day for men, both well under the AI. (By the way, NHANES stands for the National Health and Nutrition Examination Survey, and is an ongoing survey of U.S. dietary patterns and health status. It has nothing to do with what brand of underwear people buy.)
And as we’ve already seen, only 6% of women and 11% of men take in more than the recommended amount, and fewer than 9% of pregnant women do.
That doesn’t sound good. Should we be running to the supplement aisle?
For most people, food is the place to start. Whatever your eating style, a diet that regularly includes soy foods, legumes, cruciferous vegetables, and whole grains can meet the AI for most adults who aren’t pregnant or breastfeeding and don’t have a genetic predisposition to higher needs.
Plant foods are where people most often wonder whether that’s possible, so here’s what a day built entirely from plants could look like. Let’s aim for the 425 milligrams target for women:
- Breakfast: Oatmeal with an ounce of toasted wheat germ (51 milligrams) and a quarter cup of peanuts (24 milligrams)
- Lunch: A cup of cooked quinoa (43 milligrams) with half a cup each of kidney beans (45 milligrams), broccoli (31 milligrams), and Brussels sprouts (32 milligrams)
- Afternoon snack: Half a cup of roasted soybeans (a whopping 107 milligrams)
- Dinner: A large baked potato (57 milligrams) with half a cup each of shiitake mushrooms (27 milligrams), green peas (24 milligrams), and cauliflower (24 milligrams)
Add it all up, and you get 465 milligrams, which is comfortably over the choline line (the “cho-line”?). Aiming for the 550 milligrams target for men? Turn dinner into a loaded potato by adding half a cup each of kidney beans (45 milligrams) and broccoli (31 milligrams), then sprinkle on a quarter cup of sunflower seeds (19 milligrams). That brings the day to 560 milligrams.
I need to point out that this meal plan is built around choline on purpose. Most people won’t reach the AI by accident, unless they’re already big fans of roasted soybeans, quinoa, and kidney beans.
If you’re pregnant or breastfeeding, talk to your health care provider about supplementation. Needs rise to 450 milligrams per day during pregnancy and 550 milligrams per day while breastfeeding, which is hard to reach through food alone, and many prenatal vitamins contain little or no choline. The same conversation makes sense if you know you carry PEMT or MTHFD1 gene variants that raise choline needs.
What about if you’re a postmenopausal woman, and you’re vegan or a vegetarian who doesn’t eat eggs? Women make less of their own choline after menopause, when estrogen no longer boosts the liver’s production, and studies of plant-based eaters find they tend to take in less choline than people who eat eggs and meat. That’s worth knowing, but it isn’t cause for alarm. Although most people eat less than the AI, outright choline deficiency in healthy adults who aren’t pregnant is very rare, likely because the body makes some of its own.
Plant-based eaters also tend to get plenty of folate and betaine, which can take on part of choline’s workload. So if you fit one of these descriptions (or both), the practical step is to make choline-rich foods like soy, beans, cruciferous vegetables, and whole grains a regular part of your week. If you have liver concerns or a very restricted diet, that’s a good reason to ask your health care provider whether a supplement makes sense.
For healthy adults who aren’t pregnant, there’s no good evidence that a choline supplement improves outcomes. The U.S. National Institutes of Health’s consumer fact sheet notes that studies have shown choline supplements do not improve cognition in healthy adults or in people with Alzheimer’s disease, Parkinson’s disease dementia, or other memory problems.
The bottom line for most plant-forward eaters: include choline-rich plant foods in your diet (with eggs as an option if you eat them), and use supplements in consultation with a healthcare provider if you’re pregnant, lactating, or have reason to be concerned.
If you decide supplementation makes sense, the two most common options are choline salts (bitartrate or chloride) and phosphatidylcholine. A small 2021 study found that choline bitartrate supplements raised TMAO levels in healthy adults, while choline from eggs and phosphatidylcholine supplements did not.
If you do supplement, bear in mind that the Tolerable Upper Intake Level for adults is 3.5 grams per day. Higher doses can cause fishy body odor and low blood pressure, while very high doses could harm the liver.
Recipes & Food Tips to Get Choline Naturally
A choline-rich meal is easier to put together than you might think. Here are a few simple recipes built around some of the highest plant-based sources of choline, delivering serious flavor and nutrition in every bite. And for even more variety, consider adding a shiitake-lentil soup or a beet-and-spinach salad with chickpeas and walnuts for a betaine boost to your weekly meal rotation!
Creamy and dreamy Smashed Edamame Avocado Toast is one of the easiest ways to enjoy a refreshingly light yet satisfying meal any time of day. Bright, slightly sweet edamame is mashed together with creamy avocado and topped with vibrant vegetables, herbs, and spices for a breakfast or lunch you will want to make on repeat. What makes this toast extra special is that edamame is one of the most choline-dense foods in the plant kingdom, making it a delicious way to support your health any time of day. Plus, it brings protein, fiber, healthy fats, and a nourishing lineup of phytonutrients to every single bite!
Marinated shiitake mushrooms, kale, edamame, green onion, pumpkin, and sesame seeds come together in one seriously nourishing bowl. Savory mushrooms transform into crunchy bacon bits that complement the kale, edamame, and seeds perfectly, for a salad with outstanding flavor and impressive nutrient density. With edamame and shiitake mushrooms both contributing choline, and pumpkin seeds adding a respectable boost, this salad does more than just taste incredible. We’re sure it will leave you feeling plant-powered and deeply nourished!
Tofu and Broccoli Stir-Fry is a protein-packed, phytonutrient-rich dish you’ll enjoy time and time again. The crunchy-on-the-outside, soft-on-the-inside tofu and slightly sweet, spicy stir-fry sauce are the perfect complements to the crisp broccoli. Broccoli brings a useful amount of choline (31 milligrams per half cup), and tofu adds more, making this dish as nourishing for your brain and liver as it is satisfying. Want to push it further? Scatter a handful of roasted soybeans over the top: at 107 milligrams per half cup, they’re the strongest plant source on our list. With plenty of vitamins C, K, and A, as well as folate, potassium, iron, manganese, and calcium, this powerhouse meal is one of the most nutritious and delicious stir-fries around!
The Takeaway on Choline
Choline may be a newcomer to the essential-nutrient club, but your brain has been relying on it all along. Your body uses it to make acetylcholine, the chemical messenger behind memory and muscle control, and the most promising research on choline centers on the brain, from memory in older adults to brain development before birth. That research is still unfolding.
Most people, no matter what they eat, take in less than the AI, though outright deficiency in healthy adults is rare. Plant-based eaters tend to get a bit less, which makes choline worth a little planning. Soy foods, beans, cruciferous vegetables, quinoa, and whole grains can get you there, with eggs as a solid source if you eat them. If you’re pregnant or breastfeeding, ask your health care provider whether you need more.
Dolly begged Jolene to stay away. Choline is one you’ll want to keep close.
Featured image: istock.com/kasia2003
Tell us in the comments:
- Have you ever tracked how much choline you eat?
- Do you regularly eat choline-rich plant foods like tofu, quinoa, or cruciferous vegetables?
