It’s hard to overstate the importance of choline to your health. At the extreme, its presence in your body is the difference between you and a puddle of goo on the ground. That’s because one form of choline, phosphatidylcholine, is a key component of the flexible membranes that surround and define every cell in your body. You need a steady supply of choline to build and repair these cells, including your brain cells.
And that’s far from choline’s only essential function. Your body transforms choline into acetylcholine, a neurotransmitter partly responsible for the encoding of episodic memories (that is, the stuff that happens to you in your life). That compound is also vital for muscle control, mood, heartbeat, and various other neurological functions that rely on brain-body communication.
Choline is also involved in the process that breaks down fats in your liver, which helps to regulate your metabolism. When you eat foods that contain fat, choline helps transport fats out of the liver and into cells where they’re used for energy or stored for later use.
The good news is that humans can produce choline in the liver, mostly in the form of phosphatidylcholine. (Is it just me, or does that sound like the name of a very small dinosaur?). Scientists estimate that you synthesize somewhere between 5 and 20 grams of phosphatidylcholine a day.
The less good news is that your body may not make quite enough to meet your daily needs. One theory for this discrepancy is that the liver’s choline production serves as an emergency backup designed to prevent you from falling apart when food is scarce.
Whatever the reason, that leaves you with the apparent requirement to obtain some of your choline from dietary sources. Even the liver’s synthesis of phosphatidylcholine mostly relies on dietary choline, so it’s very important to include foods that contain choline in your diet. But are vegan choline sources inferior? Or is that just a myth perpetuated by the meat and dairy industries?
In addition to keeping every cell in your body intact, choline is also associated with cardiovascular, neurological, and metabolic health. The word “associated” in that last sentence hides some complexity.
On the one hand, some research suggests that choline can protect cardiovascular health by reducing blood pressure, lowering levels of plasma homocysteine, and altering lipid profiles. (I’m imagining a portrait photographer here: “Excuse me, triglycerides, could you tilt your chin down just a bit?”) And on the other hand, higher levels of plasma choline may be associated with a greater risk of cardiovascular disease. So we’re definitely dealing with a Goldilocks situation here: both too little and too much choline can be problematic.
On the neurological front, we’ve seen that choline is a precursor of the neurotransmitter acetylcholine. Along with B vitamins, choline helps to optimize brain energy metabolism, contain oxidative stress and inflammation, maintain DNA stability, regulate gene expression, and prevent vascular damage.
And choline protects liver health by transporting lipids from the liver into cells, where they can be stored for later use. So sufficient choline intake can help prevent nonalcoholic fatty liver disease (NAFLD), especially in those at risk of liver dysfunction.
How Much Choline Do You Need?
Given that not enough choline is bad, and too much appears to be bad as well, you might be interested in knowing how much is “just right.” Unfortunately, we don’t really know how much is optimal. There’s no official RDA (recommended daily allowance) for choline. And figuring out how much any person needs is complicated.
According to the National Institutes of Health (NIH) Office of Dietary Supplements, it depends on “the amount of methionine, betaine, and folate in the diet; gender; pregnancy; lactation; stage of development; ability to produce choline endogenously; and genetic mutations that affect choline needs.”
To the rescue, sort of, is the National Academy of Medicine (NAM), which publishes recommendations for adequate daily intake (AI) of various nutrients.
For choline, they suggest the following amounts:
- 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
- 14–18 years — 550 mg/day (males), 400 mg/day (females)
- 19+ years:
- Males: 550 mg/day
- Premenopausal females: 425 mg/day
- Lactating females: 450 mg/day
- Pregnant females: 550 mg/day
- Postmenopausal females: 550 mg/day
You’ll notice that premenopausal women need less dietary choline than men (unless they’re pregnant). That’s because higher estrogen levels in premenopausal women stimulate the creation of choline in the body.
As we’ve seen, those numbers are subject to change for a variety of reasons. For example, people with a genetic variation that interferes with the normal metabolism of choline may need more than the listed AI.
There’s another caveat to taking these numbers at face value. Despite decades of new research, NAM hasn’t revised (or even revisited) the dietary requirement for choline since 1998. (To give you some perspective on how long ago that was, that was the year that Siemens introduced the first cell phone with a color display).
Are Plant-Based Eaters at Risk for Choline Deficiency?
Some of the foods richest in choline come from animals, so it’s been argued that vegans and other plant-based eaters are at risk of choline deficiency. This concern reached peak media frenzy in 2019, with the publication in the prestigious British Medical Journal (BMJ) of an editorial provocatively titled, “Could we be overlooking a potential choline crisis in the United Kingdom?”
The author argued that most people are already not getting enough choline from food sources. And that the trends of less meat and more plant-based eating are only going to make things worse. The media then engaged in a clickbait feeding frenzy with headlines like “Vegan diets risk insufficient intake of nutrient critical for brain health,” “Meat-free diet lacks vital nutrient for healthy brain,” and “Plant-based diets risk dumbing down the next generation, nutritionist warns.”
Oh my! That sounds pretty scary, especially for parents who don’t want to be responsible for their children’s underpowered brains.
But before you start freaking out, let’s put this editorial in perspective. For one thing, the author inexplicably doesn’t account for the choline we naturally produce without the need for food. For another, the editorial was not reporting on a clinical trial, an observational study, or even any new research of any kind. The author of this editorial was simply giving her opinion.
And despite claiming no conflicts of interest, she may not be entirely neutral on the topic. It turns out that she’s been paid to consult for The Meat Advisory Panel, the British Egg Information Service, and other organizations that might just possibly represent a conflict of interest.
In reality, it seems clear that you can get enough choline on a well-balanced plant-based diet. The NIH states that certain vegetables and beans are a “rich source” of choline, with grains, nuts, and seeds being reliable sources in general.
And choline deficiency appears to be a case of theory diverging from reality. Although most people in the United States consume less than the National Academy of Medicine’s suggested AI of choline, choline deficiency in healthy, nonpregnant individuals is very rare, possibly because of the contribution of choline that the body makes naturally. There really isn’t enough dedicated research to draw a confident conclusion about choline needs at this point.
Foods Rich in Choline
Choline is found in both animal products and plants, which makes sense since it’s required for cell membranes. Animal products tend to have higher concentrations of choline. Here’s how much choline you’ll find in 100 grams (about ¼ pound) of the following animal products:
- eggs: 230 mg
- beef: 110 mg
- salmon: 91 mg
- milk: 18 mg
But since plants are also made up of cells, you’ll find choline in plant foods as well. Using that same 100 grams as a benchmark, here’s a cool infographic showing how plants stack up in the vegan choline department:
Why Plant-Based Choline Might Be Better for You
Given that some animal foods tend to be higher in choline, you might think that adding some of these to your diet is the safest way to ensure you’re taking care of your choline needs. But it turns out that while plant-based foods deliver choline in lower amounts than many animal products, that may actually be better for your health.
That’s because the source of choline seems to matter, perhaps as much as the amount. There’s robust research showing that dietary choline from animal products can actually lead to health problems because it can contribute to the formation of TMAO, a phenomenon not seen with choline from plants.
Elevated TMAO levels have been linked to a higher risk of heart disease in clinical trials. And a study in the journal Circulation directly linked dietary choline to an increased risk of heart disease as well.
But do you know who was protected from the harmful effects of choline in those studies? Vegans and vegetarians, that’s who — potentially because they were consuming lower amounts of choline.
Another reason to consider choosing plant-based sources of choline over animal sources has to do with the effects of those classes of foods on your gut microbiome. Vegan gut microbiomes contain bacterial communities very different from those of omnivores. And one of those differences is key here: When you don’t eat red meat on a regular basis, your gut lacks the bacteria that promote the creation of TMAO.
For more information on TMAO and its role in cardiovascular disease, see our comprehensive article here.
Is Choline Supplementation Necessary?
At the moment, there is no test that measures either choline levels or nutritional status. We can test for choline markers in the blood, but that’s not particularly informative since the body can produce its own choline in the face of deficiency. Researchers at the University of North Carolina are working on a clinically useful test that can actually answer the question, “Are you getting enough choline?”
In the absence of such a test at present, there are clear early signs of choline deficiency, such as muscle loss when exercising and the onset of nonalcoholic fatty liver disease. For the average healthy person, based on the current status of nutritional research, it appears that supplementation is not usually necessary or recommended.
Remember, too much choline may be as problematic as too little, and supplementation is an easy way to overconsume the nutrient. High doses (10,000–16,000 mg/day) of choline have been associated with a fishy body odor, vomiting, excessive salivation, and increased sweating. And if that catalog of yuckiness isn’t enough to deter you, don’t forget that increased risk of TMAO-mediated heart disease.
To be on the safe side, adults should take no more than 3,500 mg/day, the tolerable upper intake level (UL) set by the Food and Nutrition Board (FNB) of the Institute of Medicine.
When You May Want to Supplement Choline
Certain populations may see benefits from choline supplementation. The American Medical Association and the American Academy of Pediatrics both emphasize the importance of choline during pregnancy and lactation. Getting enough choline during these crucial days of fetal and infant development can have lasting positive neurocognitive effects. And low maternal choline intake during pregnancy has been shown to increase the risk of neural tube defects and cleft palates.
People at increased risk of Alzheimer’s disease may also want to take supplemental choline. For some reason, Alzheimer’s patients exhibit lower levels of choline. And in rodent studies, choline supplementation was able to influence Alzheimer’s progression by modulating the accumulation of amyloid plaques. (Our view on the use of animals in medical research is here.)
In general, people who fall into either of these groups may want to opt for a vegan choline supplement like this one. And, of course, if you have concerns about your choline status, you may want to discuss the pros and cons of supplementation with a qualified health care professional.
B Vitamins and Choline
No nutrient lives in a vacuum. And it appears that there are important interrelationships between choline and folate (B9) and B12, in particular. In fact, choline is so closely related to the B vitamins that it is sometimes almost thought of as an honorary B vitamin (sometimes referred to as B4).
For example, when a body has an inadequate supply of B12, it may use choline to “fill the gap,” creating problems with homocysteine metabolism and a deficiency of choline for other uses. But if someone is low in choline due to a B12 deficiency, the answer is probably to supplement with B12. This should remedy both the B12 and choline deficiencies.
Plant-Based Choline-Rich Recipes
Looking for plant-based recipes that not only taste good but also provide essential choline for your brain and body? Look no further! These three recipes are not only mouthwatering but also provide plant-based sources of choline, essential for brain and nervous system function.
From the visually stunning Almond Ricotta Pear Toast with Balsamic Fig Jam to the nutrient-dense Wheat Berry and Brussels Sprout Harvest Salad and the savory Buckwheat Tofu and Broccoli Curry, each of these recipes provides a delicious way to incorporate choline (and lots of other plant-based goodness) into your diet. So why not try them all and give your brain and body the nourishment they need to thrive?
Almond Ricotta Pear Toast with Balsamic Fig Jam may get your neurons firing on all cylinders — literally! Not only is this toast aesthetically beautiful, but both the almonds and the figs, thanks to their choline content, may also support neurological functions that control brain-body communications. So as you find yourself marveling over the appeal of this toast, don’t be surprised if, after just one bite, your brain signals a happy dance to commence!
Wheat Berry and Brussels Sprouts Harvest Salad is the ideal fill-you-up meal that is as satisfying as it is nourishing. It’s chock-full of B vitamins and magnesium from the wheat berries, and vitamin C, choline, and fiber from the Brussels sprouts. Not to mention, you’ll get even more of each of those nutrients from the pistachios, cranberries, mixed greens, and pomegranate dressing. This salad may be the tastiest way to make sure your choline intake is “just right.”
Buckwheat, Tofu, and Broccoli Curry is a satisfying and savory way to get creative with a few choline-rich, plant-based sources. Both buckwheat and broccoli are considered to be valuable sources of choline, and, when combined with other nutrient-rich ingredients such as tofu, cashews, and herbs and spices, this meal may supply you with just the right amount of choline to help you meet the adequate intake recommendation.
The Bottom Line on Choline
Choline is an essential nutrient that plays a crucial role in many bodily systems, including brain function, metabolism, and cellular health. Although there is no official dietary recommendation for how much you should consume from food, getting a sufficient amount is beneficial for your cells, metabolism, and liver health. However, it’s also possible to get too much, which can lead to a buildup of TMAO and increase your risk of cardiovascular disease.
Although choline is more concentrated in animal products, there are plenty of plant-based sources of choline available, including nuts, legumes, whole grains, vegetables, and even fruits. So yes, vegans can get enough choline. And consuming a modest but adequate amount from plant sources may be preferable to larger concentrations from animal foods.
Tell us in the comments:
What do you think about choline?
Has a health care provider ever discussed choline with you?
What are your favorite plant-based sources of choline?
Featured Image: iStock.com/KucherAV
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