Choline Intakes and Recommendations are Suboptimal Nutrition

Choline is a nutrient similar to B-vitamins, often lumped in with them, but not officially a B-vitamin.  It helps our livers avoid accumulating fat, aids in neurotransmission and is a structural component of our cell membranes.

Have you ever considered how much choline is in your diet?  The fact is that most consumers and even health professionals are “in the dark” when it comes to knowledge on this vital nutrient.  Choline has several important functions in the body; it is essential for proper liver and brain function across the lifespan.  Deficiency typically results in liver and muscle damage in adults.  Women with lower intakes of choline have a much higher chance of having a baby with a neural tube defect, since choline is highly involved in fetal growth and brain development.  Achieving adequate choline intake during pregnancy and lactation is even more important since the mother’s reserves may be easily depleted (i.e. low intake by mom equals low intake by baby) (1).

The U.S. Institute of Medicine (IOM) last reviewed and established Dietary Reference Intakes for choline over 15 years ago (see table) (2).  The Adequate Intake (AI) is a calculated “target value” to achieve for optimal health.  The Tolerable Upper Intake Level (UL) is the value a healthy individual should not exceed.  When these values were established by IOM in 1998, it was assumed that less than 5% of the population needed more than the established AI, due to genetic differences among individuals.  Since then, it has been reported that as much as 50% of the population may require a higher level of choline (3).

Table 1: Dietary Reference Intakes for Choline as defined by IOM in 1998.

Choline DRI
According to my recent research, over 91% of the population does not meet the current recommended intake (i.e. the AI) for choline, even when the use of multivitamins are considered (4).  This is because most mainstream multivitamins do not contain choline (SHOCKING given the widespread insufficiency across the population and the link to neural tube defects in infants).  Choline is found in a number of food products, but it is most common in animal-derived products.  Eggs, beef and pork are among the best sources of dietary choline.  One egg provides about 125 mg of choline (5) or about 1/3 of the daily recommendation.  Also note that choline is present in the egg yolk and not egg whites! Whole eggs, therefore, can be a great option for health professionals to suggest to their clients to help them achieve desirable choline intakes.

References:

  1. Yan J, Jiang X, West AA, Perry CA, Malysheva OV, Brenna JT, Stabler SP, Allen RH, Gregory JF 3rd, Caudill MA. Pregnancy alters choline dynamics: results of a randomized trial using stable isotope methodology in pregnant and nonpregnant women. Am J Clin Nutr. 2013; 98:1459-67.
  2. Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin and Choline. Washington, DC: National Academy Press, 1998.
  3. Kohlmeier M, da Costa KA, Fischer LM, Zeisel SH. Genetic variation of folate-mediated one-carbon transfer pathway predicts susceptibility to choline deficiency in humans. Proc Natl Acad Sci USA. 2005; 102:16025-16030.
  4. Wallace TC, McBurney M, Fulgoni VL III. Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010. J Am Coll Nutr. 2014; 33(2):94-102.
  5. U.S. Department of Agriculture, Agriculture Research Service.  USDA National Nutrient Database for Standard Reference.  Available at: http://ndb.nal.usda.gov/.  Accessed on April 25, 2014.

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