We're All Missing the Mark On This Essential Nutrient—Not Just Vegans

Research shows more than 90% of Americans don't get enough choline on a regular basis, which is responsible for optimal brain, heart, liver and metabolism function. Here's what to do about it.

piece of steak on a white plate
Photo: Maciej Toporowicz / Getty Images

We're all learning just how vital it is for our health and the planet to eat more wholesome plant-based foods (we're talking brussels sprouts and cashews here, not processed imitation products). While no health expert would advise you to load up your plate with fewer fruits and veggies, there are several expressing caution over the risks of reducing animal and animal byproduct consumption due to a higher risk for nutrient deficiencies (learn more about how vegans can get the nutrients they need).

One of those nutrients making headlines this week? Choline. Nine out of every 10 people in our country (along with Europe, Canada and Australia) are deficient in choline, an essential nutrient responsible for proper brain, heart, liver and metabolism function. Much like omega-3 fatty acids, choline is produced by the human body—in the liver, specifically—but not in a sufficient amount to meet our daily needs entirely. Our national guidelines list Adequate Intakes for choline as 425mg/day for females over 18 and 550mg for males.

That means we have to put in the effort to meet our choline needs through diet and possibly supplementation—especially for vegans, as the highest food sources of choline are animal products. And if our nation is already vastly deficient in this nutrient, forgoing them entirely could pose an even larger issue.

"Eggs, milk and meat appear to be major dietary providers and further movements away from the consumption of these could have unintended consequences," writes Dr. Emma Derbyshire, a nutritionist based in the U.K., in BMJ Nutrition, Prevention & Health earlier this week. She even goes so far to say that one of those "unintended consequences" of a plant-based diet could be less intelligent generations after us, as choline is an essential nutrient for neural development in utero.

However, it's important to note Derbyshire is a member of the Meat Advisory Panel (which was not mentioned upon the article's original publish date, but has since been added) and shifts the focus to a very small population of people—about one percent—when there are millions more meat-eaters who don't get enough of this nutrient either.

Unfortunately, the best food sources of choline aren't foods we consume regularly—like beef liver and egg yolks—and if we do, some of the major players have potential health and environmental consequences. Ten top food sources of choline are listed below:

  • Beef Liver (3 ounces): 65%
  • Whole Eggs: 27%
  • Beef Steak (3 ounces): 21%
  • Soybeans (½ cup): 19%
  • Chicken Breast (3 ounces): 13%
  • Ground Beef (3 ounces): 13%
  • Cod (3 ounces): 11%
  • Large Baked Potato: 10%
  • Wheat Germ, Toasted (1 ounce): 9%
  • Kidney Beans (½ cup): 8%
  • Cooked Quinoa (1 cup): 8%

Statistics provided by National Institutes of Health Office of Dietary Supplements

Americans ate nearly 10 ounces of red meat and poultry each day in 2018, which is close to double the national recommendations of 5-6.5 ounces a day. While the average American probably isn't getting a lot of their meat intake from beef liver—eggs, steak and chicken are all very commonplace in our diets. So, how and where are we missing the mark when it comes to choline?

"Because choline isn't found in high amounts in lots of commonly consumed foods, if you aren't being conscious of your intake, it's easy to not hit the target amount," says Lisa Valente, M.S., R.D., Digital Nutrition Editor at EatingWell. The good news? According to Valente, "Even though most of us don't get enough, a true choline deficiency is rare (with the exception of pregnant women) because we do make some in our bodies."

Turns out, you don't have to eat like a full-on carnivore to get all the choline benefits you need each day. While meat-eaters can certainly enjoy a 3-4 ounce steak twice a week as part of a healthy diet, it's important to consume a wide variety of foods for well-rounded nutrition and to meet your dietary choline needs.

"Like with most nutrients, you don't need to obsess over choline or tally your intake. Focus on eating a variety of foods and include plenty of choline-rich options in your diet. If you're pregnant or completely plant-based, it's not a bad idea to talk to a dietitian or your doctor to get more individual recommendations based on your needs," Valente says.

Elizabeth Shaw, M.S., R.D.N, C.P.T, nutrition expert and author of Shaws Simple Swaps, is passionate about choline education and takes a similar stance.

"My personal philosophy is what I preach to my clients as well—choose foods that you enjoy and make you feel the best," Shaw says. "For some, that certainly includes meats, while for others, a plant-based diet is preferred. Point being, eating more or less red meat is not the answer to solving the choline crisis! But, rather, looking at your entire dietary picture and seeing what foods will help meet your needs based on what style of eating you enjoy best. Then, consider a supplement as a safety net for those days you fall short of meeting your needs."

Just eating two eggs, either scrambled with some veggies or in a breakfast sandwich on whole-grain bread, will already set you over half your daily needs if you are omnivorous or vegetarian. Vegans could add a glass of soymilk to a bowl of oatmeal topped with wheat germ, peanut butter and sliced banana to get 25% of their needs to start the day. Then, depending on your dietary restrictions and/or preferences, it's important to prioritize healthy protein sources like chicken, seafood and soy, along with whole grains, beans, dairy and potatoes.

Shaw also noted some vegetables contain choline—like brussels sprouts and lima beans—which she says are an excellent addition to any diet.

The moral of the story is that we could likely all use a wider range of protein sources and plant foods in our diet to help meet all our nutritional needs, not just for choline. Enjoying more whole foods over processed is a surefire way to boost your intake of a wide variety of nutrients.

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