In this article, we describe:
- the major purposes of this specific nutrient in the human body,
- its experimentally confirmed health uses,
- conventional ways to estimate nutrient status,
- nutrient’s toxicities and deficiencies,
- experimentally confirmed and approved levels of the nutrient intake for different demographics,
- dietary sources of the nutrient.
All plant and animal cells need choline, an essential nutrient, to preserve their structural integrity. Choline also provides methyl groups needed for many steps in metabolism. 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.
Humans can produce choline endogenously in the liver, but in amounts not sufficient to meet body needs. As a result, some choline should come from the diet. When a diet is deficient in folate, the need for dietary choline rises because choline becomes the primary methyl donor.
Choline is absorbed in the small intestine, enter the portal circulation, and is stored in the liver and secreted into the lymphatic circulation.
In healthy adults, the concentration of choline in plasma ranges from 7 to 20 mcmol/L. Plasma choline levels do not decline below 50% of normal, even in individuals who have not eaten for more than a week. This may be due to the hydrolysis of membrane phospholipids, a source of choline, to maintain plasma choline concentrations above this minimal level, or to endogenous synthesis.
Frank choline deficiency in healthy, nonpregnant individuals is very rare, possibly because of the contribution of choline that the body synthesizes endogenously. Choline deficiency can cause muscle damage, liver damage, and nonalcoholic fatty liver disease (NAFLD or hepatosteatosis).
The following groups are among those most likely to have inadequate choline status: pregnant women; people with genetic alterations; patients requiring total parenteral nutrition; nonalcoholic fatty liver disease sufferers.
Despite the hypothesis that choline might affect heart health, several large observational studies have found no significant associations between choline intakes and cardiovascular or peripheral artery disease risk. However, a more recent analysis found an increased risk of mortality in those consuming higher levels of choline. People with Alzheimer’s disease have lower levels of the enzyme that converts choline into acetylcholine in the brain.
Above-required choline consumption has been shown to increase production of TMAO, a substance that has been linked to a higher risk of cardiovascular disease, in a dose-dependent manner in adults.
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Adequate Intakes of Choline
The Adequate Intakes of Choline for all ages are established based on the prevention of liver damage as measured by serum alanine aminostransferase levels.
|Birth to 6 months||125 mg/day||125 mg/day|
|7–12 months||150 mg/day||150 mg/day|
|1–3 years||200 mg/day||200 mg/day|
|4–8 years||250 mg/day||250 mg/day|
|9–13 years||375 mg/day||375 mg/day|
|14–18 years||550 mg/day||400 mg/day||450 mg/day||550 mg/day|
|19+ years||550 mg/day||425 mg/day||450 mg/day||550 mg/day|
Food Sources of Choline
The main dietary sources of choline are meat, poultry, fish, dairy products, and eggs. Cruciferous vegetables and certain beans are also rich in choline, and other dietary sources of choline include nuts, seeds, and whole grains.
Many foods also contain lecithin, a substance rich in phosphatidylcholine that is prepared during commercial purification of phospholipids; lecithin is a common food additive used as an emulsifying agent in processed foods, such as gravies, salad dressings, and margarine. Choline is also present in breast milk and is added to most commercial infant formulas. Precise estimates of the percentage absorption of the different forms of dietary choline in humans are not available.
Selected Food Sources of Choline
|Pan fried beef liver, 3 ounces||356||65|
|Hard boiled egg, 1 large||147||27|
|Braised beef top round, 3 ounces||117||21|
|Roasted soybeans, ½ cup||107||19|
|Roasted chicken breast, 3 ounces||72||13|
|Ground beef, broiled, 3 ounces||72||13|
|Cooked cod fish, 3 ounces||71||13|
|Shiitake mushrooms, cooked, ½ cup pieces||58||11|
|Baked red potatoes, 1 large potato||57||10|
|Wheat germ, toasted, 1 ounce||51||9|
|Canned kidney beans, ½ cup||45||8|
|Cooked quinoa, 1 cup||43||8|
|Milk, 1% fat, 1 cup||43||8|
|Nonfat vanilla yogurt, 1 cup||38||7|
|Brussels sprouts, boiled, ½ cup||32||6|
|Boiled and drained broccoli, ½ cup||31||6|
|Cottage cheese, nonfat, 1 cup||26||5|
|Canned in water white tuna, 3 ounces||25||5|
|Dry roasted peanuts, ¼ cup||24||4|
|Boiled cauliflower, ½ cup||24||4|
|Boiled green peas, ½ cup||24||4|
|Sunflower seeds, oil roasted, ¼ cup||19||3|
|Brown rice, long-grain, cooked, 1 cup||19||3|
|Pita bread, whole wheat, 1 large (6½ inch diameter)||17||3|
|Boiled cabbage, ½ cup||15||3|
|Tangerine sections, ½ cup||10||2|
|Raw snap beans, ½ cup||8||1|
|Kiwifruit, ½ cup sliced||7||1|
|Raw carrots, chopped, ½ cup||6||1|
|Raw apples, with skin, chopped, ½ cup||2||0|
- *DV = Daily Value.
- The DV for choline is 550 mg for adults and children age 4 years and older.
- Foods providing 20% or more of the DV are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthful diet.
- Elson Haas. “Staying Healthy with Nutrition”
- U.S. Department of Health & Human Services: https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/#en5