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Yes, choline is a nutrient

Yes, choline is a nutrient

Last month I attended an online conference. One of the speakers promoted meatless burgers. One reason: unlike beef burgers, meatless burgers contain little choline. Why is this important? Some gut microbes can metabolize choline into a chemical linked to increased risk for heart disease. I raised a question: choline is a nutrient. Why is it being described as a dangerous substance?

The dismissive reply: “Oh choline isn’t a vitamin.” Was I shocked? A bit, but ignorant statements from scientific researchers are nothing new.

Maybe technically choline isn’t a vitamin. Neither is protein. Neither is calcium. Yet they’re still nutrients. Here’s what the National Institutes of Health has to say:

Choline is an essential nutrient that is naturally present in some foods and available as a dietary supplement. … The body needs choline to synthesize two major phospholipids vital for cell membranes. Therefore, all plant and animal cells need choline to preserve their structural integrity. In addition, choline is needed to produce acetylcholine, an important neurotransmitter for memory, mood, muscle control, and other brain and nervous system functions. Choline also plays important roles in modulating gene expression, cell membrane signaling, lipid transport and metabolism, and early brain development.

Fact Sheet for Health Professionals, Office of Dietary Supplements, National Institutes of Health

I rest my case. We need choline. All cells need it to maintain cell membrane structures. It’s critical for brain and nerve functioning. Furthermore, choline deficit is linked to non-alcoholic fatty liver disease, and might also be associated with cardiovascular and neurologic disorders. Studies of older adults show that people with lower choline levels in their blood score lower on tests of cognitive function. Other studies show better verbal and visual memory in people with higher blood choline.

How Much Choline?

There are no RDAs for choline. Instead, there are so-called “Adequate Intake (AI)” suggestions. The AI is used when there is insufficient research to determine a daily intake recommendation. For adults, the AI is:

  • Men – 550 mg/day
  • Women – 425 mg/day

These sorts of generalized values do not account for age, health status, body size, activity level or anything else that might be important for a person’s nutrient requirements. But the One-Size-Fits-All dogma is par for the course when it comes to nutrient recommendations.

Choline Sources

What’s a significant and readily available source of choline? Egg yolks. What have we been doing for the past 60-70 years? Avoiding egg yolks due to the now-debunked belief that egg yolks cause heart attacks. But the belief persists and food manufacturers continue to pump out god-awful stuff like fake egg substitutes and egg white omelets.

Food servingmg Choline/serving
beef liver, 3 oz cooked356
egg, large, hard boiled147
oysters, 3 oz cooked110
soybeans, 1 cup cooked37
chicken, white meat 3 oz72
beef, 93% fat ground 3 oz72
pork chop, 4 oz cooked meat83
turkey, 3 oz cooked82
milk, 1%, 1 cup43

Liver is a clear standout source of choline, but how many people eat liver anymore? Many other foods have some choline. Soy and whey protein powders are significant sources. Other food sources include fish, dairy foods, meats and beans. But you can see that eating a couple of eggs will put you very close to the AI value for the day. The rest of the foods you eat can make up the difference.

Eggs are a very efficient source of choline. They’re easy to add to your daily diet, versatile, easy to prepare, relatively inexpensive and a source of many other key nutrients like protein, B12 and vitamin A.

What about that theoretical increased risk for heart disease from choline? It turns out almost all of the scary studies were done on mice. When you look at actual heart disease incidence in actual humans, there’s no association between cardiovascular or vascular disease risk and choline intake. Choline avoidance isn’t a great argument for choosing meatless burgers.

Things that make you go “Hmmmmm…”

I found this in the NIH Fact Sheet:

Premenopausal women might need less choline from the diet than children or other adults because estrogen induces the gene that catalyzes the biosynthesis of choline 

Fact Sheet for Health Professionals, NIH (see above)

Why does this make me go “Hmmmm…”? Well if estrogen affects choline synthesis, and POST-menopausal women don’t have that estrogen anymore, what does that say about an older woman’s need for choline from the diet? It says to me: We need to be sure to consume adequate choline as we age.

Do I recommend supplements? I do not right now. There’s currently no evidence that extra choline will improve health, but that could change if researchers ever ask the question. It’s relatively easy to get significant choline from your diet, if you include eggs, meat and dairy. You don’t need vast amounts of these. It’s just another nutrition-based argument against being a strict vegan as you age.