For serving size for specific foods see the Nutrient Rating Chart.

Basic Description Role in Health Support Summary of Food Sources Nutrient Rating Chart Impact of Cooking, Storage and Processing Risk of Dietary Deficiency Other Circumstances that Might Contribute to Deficiency

Relationship with Other Nutrients Risk of Dietary Toxicity Disease Checklist Public Health Recommendations References

Basic Description

Choline is one of the newest nutrients to be added to the list of human vitamins. It was only added to the list of required nutrients by the National Academy of Sciences (NAS) in 1998. While the NAS does not officially recognize choline as a vitamin specifically belonging to the B-complex family of vitamins, it is officially recognized as a required nutrient that you need in your everyday meal plan.

It was once believed that we made enough choline in our bodies from other nutrients to meet our need for this important substance. More recent research using choline-depleted diets has demonstrated that we really do require some outside help from our food to keep our bodies running well.

Now that we have established a need for choline, the next question we have to answer is how much of it do we require each day. This is still an open question in the nutrition world. We do know, however, that the current National Academy of Sciences standards listed below in the Public Health Recommendations section are a pretty good place to start.

Luckily, choline is widely distributed throughout different types of foods. Given the focus on variety, the World's Healthiest Foods recipes should make it pretty easy to get the choline you need. We detail below in both the Summary of Food Sources and Risk of Dietary Deficiency sections how to carve a path to the daily requirements using recipes and foods from our site.

We list eggs as an excellent source of choline. But even if you don't do well with eggs and choose to avoid them in your diet, we also have 10 very good and 15 good choline sources. This should give you plenty of choices to ensure a strong intake.

Role in Health Support

Methylation

Many of the signaling processes in the human body involve passing a methyl group—sort of like the biochemical version of a penny—from place to place. This is one of the most basic processes of life, and no cellular organism could survive without the process of methylation. Building DNA, exchanging signals in the brain, and detoxification in your liver are just some of the important processes dependent on methylation. Deficits in methylation have been linked to memory loss and cardiovascular disease.

Perhaps speaking to the central importance of methylation in normal body function, there are a number of different nutrients that are important for this process to work smoothly. The most important are folate and its partners vitamins B6 and B12.

You can think about choline as a key partner in this process. For example, when folate is not available in sufficient amounts to assure adequate methylation, choline can provide its assistance and help assure that methylation continues.

Membrane Structure

Choline is an essential nutrient in the production of phosphatidylcholine, one of the most important structural building blocks of a living cell. Its unique soap-like structure helps to keep the membrane fluid, yet mostly impermeable.

Given importance of phosphatidylcholine to all cellular forms, it's not surprising that we find choline so widespread in different foods. In most diets, phophatidylcholine is the single most common form of choline provided by foods.

Nervous System Activity

Choline is the backbone of a nervous system signal molecule—or neurotransmitter—called acetylcholine. The importance of acetylcholine cannot be overstated. The part of your nervous system that runs your heart and keeps your intestines moving along runs largely on acetylcholine. Similarly, any muscle you move requires a signal of acetylcholine to tell it to contract.

Like the action of the heart itself, you really don't need to think or worry about this action of choline. Even in medically supervised situations where people eat diets bizarrely restricted in choline, we don't see these activities break down.

Summary of Food Sources

Choline is widely available in most things you eat. It is found in plant and animal foods, and in whole as well as processed foods. (Of course, we always recommend whole over processed foods.)

If you have already heard people talk about foods that are high in choline, the one food that you are mostly likely to have heard them mention is eggs. You'll get one-quarter to one-third of your daily intake requirement from a single egg (this range is gender-dependent given that males and females are noted to have different optimal intake levels). Since over 99% of an egg's choline is located in the yolk, the whites alone aren't very helpful for boosting your choline intake.

Of course, we include eggs as one of our 10 Most Controversial Foods, and we know that some people choose to avoid them. If you fall into that category, but still incorporate other animal foods in your meal plan, you still have many good sources to choose from. Given our top 8 WHFoods rich in choline, all 8 are animal foods.

However, even if you avoid all animal foods in your meal plan, you can still get good and very good amounts from many plant foods. Vegetables are by far your best plant sources of choline! At least 15 WHFoods rank as good or very good sources of choline in our rating system. Your most nutrient-rich options here include collard greens, Brussels sprouts, broccoli, Swiss chard, cauliflower, and asparagus. One serving of any vegetable in this list will provide you with over 10% of the WHFoods recommended daily intake for choline. Also, for anyone who enjoys fish in their meal plan but avoids land animal foods, three of our WHFoods seafoods—shrimp, scallops, and cod—qualify as very good sources of choline.

An average American gets about 100 mg of extra choline per day from food additives. The most common of these is soy lecithin, which is widely used as an emulsifying agent. These emulsifying agents help to keep oil- and water-soluble ingredients from separating in packaged foods. At WHFoods, we recommend 425 mg of choline each day, and so you can see how this extra choline from food additives represents about one-fourth of that amount. So while it can be helpful to you in meeting your choline requirement, you are still going to need a lot more choline from your food. (Also, it is very easy to see how this average amount of choline from food additives is not likely to put you into the "excess" category of 3500 mg (3.5 grams) for choline even if your meal plan contains numerous choline-rich foods.

Nutrient Rating Chart

Introduction to Nutrient Rating System Chart

In order to better help you identify foods that feature a high concentration of nutrients for the calories they contain, we created a Food Rating System. This system allows us to highlight the foods that are especially rich in particular nutrients. The following chart shows the World's Healthiest Foods that are either an excellent, very good, or good source of choline. Next to each food name, you'll find the serving size we used to calculate the food's nutrient composition, the calories contained in the serving, the amount of choline contained in one serving size of the food, the percent Daily Value (DV%) that this amount represents, the nutrient density that we calculated for this food and nutrient, and the rating we established in our rating system. For most of our nutrient ratings, we adopted the government standards for food labeling that are found in the U.S. Food and Drug Administration's "Reference Values for Nutrition Labeling." Read more background information and details of our rating system.

Impact of Cooking, Storage and Processing

Given the relatively small amount of research on choline, we do not have as strong a body of evidence to demonstrate the magnitude of changes with cooking or storage. Still, at this time, we can say that choline appears to be a fairly stable nutrient to heat and storage compared with many other vitamins. We do not currently believe that you need to alter your food storage habits or cooking techniques in order to obtain substantial amounts of choline from your foods.

Risk of Dietary Deficiency

Our knowledge of exactly how much choline an average person eats in a day is limited by an incomplete understanding of how much of it is found in commonly eaten foods. Still, researchers have published ballpark estimates of between 700 and 1000 mg of choline as an average American adult intake. This amount clearly exceeds our WHFoods recommendation of 425 mg per day.

Let's go through an example of a daily meal plan that is rich in choline. We can start the morning with Poached Eggs Over Spinach and Mushrooms. This will provide at least 350 mg of choline, well over half of the WHFoods recommended daily amount.

At lunch, we'll have Italian Navy Bean Soup and some cantaloupe. This light plant-based meal will have less choline than breakfast and dinner but will still make a substantial contribution of over 100 mg, or close to a quarter of the daily requirement.

For dinner, we'll enjoy the 3-Minute Scallops with a side of steamed broccoli. This provides at least 200 mg of choline, which adds up to about 650 mg and takes us well beyond our 425 mg WHFoods daily requirement.

Note that each of these meals contains "at least" a certain amount of choline because some of the ingredients have not been formally assessed for choline content. While this daily menu contains plenty of choline, it may actually contain even more than we are aware.

Other Circumstances that Might Contribute to Deficiency

The only circumstance documented in research studies under which symptoms clearly related to choline deficiency occurs is in prolonged tube feeding. Needless to say, prolonged tube feeding is a medical necessity in certain situations but unrelated to our everyday food choices. .

Relationship with Other Nutrients

As noted above, the process of methylation is very important for the brain, for cancer prevention, and for reproduction, among other things. Choline is one of many methyl donors in the body, and as such, it can help fill in when the levels of other important methylators like folate and S-adenosylmethionine get low. Pantothenic acid (also referred to as vitamin B5) is necessary for the production of acetylcholine from choline in nerves. Luckily, neither one of these nutrients is commonly deficient in the U.S. diet.

Risk of Dietary Toxicity

At intake amounts exceeding several grams per day, choline can cause significant drops in blood pressure. Also, intake of excessive choline can cause a fishy body odor due to a metabolite formed during excretion. The National Academy of Sciences has established 3.5 grams per day as aTolerable Upper Intake Level (UL) for choline. This amount would almost certainly require intake of choline supplements and would be highly unlikely to be provided by food intake alone.

Disease Checklist

• Pregnancy support
• High homocysteine
• Depression
• Bipolar disorder
• Memory loss / cognitive decline
• Gallstones
• High cholesterol

Public Health Recommendations

In 1998, the National Academy of Sciences (NAS) established Adequate Intake (AI) standards for choline. These AIs are as follows:

• 0-6 months: 125 mg
• 6-12 months: 150 mg
• 1-3 years: 200 mg
• 4-8 years: 250 mg
• 9-13 years: 375 years
• 14-18 years, female: 400
• 14-19 years, male: 550 mg
• 19+ years, female: 425 mg
• 19+ years, male: 550 mg
• Pregnant women: 450 mg
• Lactating women: 550 mg

The NAS also established a Tolerable Upper Intake Level (UL) of 3.5 grams per day for most adults. While it would be possible to eat more than this occasionally, it would be very hard to do. None of the reported cases of toxicity related to high doses of choline cited by the FNB were from dietary intake alone.

For our WHFoods recommended daily amount of choline, we chose the Dietary Reference Intake (DRI) standard of 425 milligrams for women 19 and older. You can click here for more information about our rating system and nutrient recommendations.

References

• Busby MG, Fischer L, daCosta KA, et al. Choline and betaine defined diets for use in clinical research and for the management of trimethylaminuria. J Am Diet Assoc 2004;104:1836-45.
• Fischer LM, daCosta KA, Kwock L, et al. Sex and menopausal status influence human dietary requirements for the nutrient choline. Am J Clin Nutr 2007;85:1275-85.
• Fischer LM, Scearce JA, Mar MH, et al. Ad libitum choline intake in healthy individuals meets or exceeds the proposed adequate intake level. J Nutr 2005;135:826-9.
• Food and Nutrition Board, 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;58-86.
• Konstantinova SV, Tell GS, Vollset SE, et al. Dietary patterns, food groups, and nutrients as predictors of plasma choline and betaine in middle-aged and elderly men and women. Am J Clin Nutr 2008;88:1663-9.
• Zeisel SH, daCosta KA. Choline: an essential nutrient for public health. Nutr Rev 2009;67:615-23.
• Zeisel SH, Mar MH, Howe JC, et al. Concentrations of choline-containing compounds and betaine in common foods. J Nutr 2003;133:1302-7.