Everything You Need To Know About Choline

Choline is an essential nutrient often grouped with the B vitamins due to its similar functions in the body. While it is classified as a chemical compound rather than a vitamin, choline is just as vital.¹ Studies suggest that this nutrient is particularly important for pregnant people.²

The liver makes some choline naturally, but the body gets most of its choline from food. Certain animal products and plant proteins are the best sources of choline. Most people in the United States do not get enough choline in their diet, though true deficiency is rare. However, severe choline deficiency can lead to health problems such as muscle and liver damage.¹

Potential Benefits of Choline

Choline plays a crucial role in many important bodily functions. For example, the body turns choline into acetylcholine, a neurotransmitter involved in muscle control, memory, mood, and many other functions in the nervous system. Choline is also crucial to breaking down and transporting fats from the liver. It’s also important for metabolism, cell structure, and early brain development.¹

Getting enough choline can help keep your metabolism, nervous system, and liver working properly. Pregnant people and people at risk of cognitive decline may experience particular benefits from getting higher levels of choline.¹

May Benefit Both Parent and Child During Pregnancy

Studies have shown that pregnant people with high choline intake may have healthier placentas. This reduces the risk of preeclampsia in the mother as well as later stress-related diseases in the child.²

Other studies have shown that high choline intake during pregnancy may improve babies’ cognitive abilities. In one study, higher maternal choline intake was linked to higher infant processing speeds. A follow-up study indicated that these benefits carry into childhood, with the children showing better attention, memory, and problem-solving years later.²

May Protect From Cognitive Decline

Studies with human subjects have not established a clear relationship between choline and Alzheimer’s disease. However, some healthcare professionals think choline may have a protective effect from it and other age-related cognitive decline.¹

Higher choline levels in the body seem to correspond to lower levels of certain markers of Alzheimer’s disease and other age-related cognitive impairments.² Also, people with Alzheimer’s disease have lower levels of the enzyme that turns choline into acetylcholine in the brain. Plus, a few small studies have shown that people with low choline intake had worse outcomes on sensory and cognitive tests.¹

How Much Do You Need?

The amount of choline you need depends on your age and gender, whether you are pregnant or breastfeeding, and other possible factors. In general, the following are the recommended adequate intake (AI) values of choline in milligrams (mg). The AI reflects the amount of choline needed to prevent certain health problems that result from a deficiency.¹

• Birth to age 6 months: 125 mg
• Infants 7-12 months: 150 mg
• Children 1-3 years: 200 mg
• Children 4-8 years: 250 mg
• Children 9-13 years: 375 mg
• Boys 14-18 years: 550 mg
• Girls 14-18 years: 400 mg
• Men 19 years and older: 550 mg
• Women 19 years and older: 425 mg
• Pregnant people: 450 mg
• Breastfeeding people: 550 mg

Your healthcare provider can also help you determine the best choline intake for you depending on your individual health needs.

Good Sources of Choline

Because the body does not make enough choline, you must get a significant portion of the recommended daily amount from food. However, most people do not get enough choline from their diet. An estimated 90% of people in the U.S. do not meet the AI for their group.²

Animal products such as meat, eggs, and dairy, as well as plant proteins from certain beans and vegetables, are the richest sources of choline. A food’s nutrition label may show how much choline it contains compared to the recommended daily value (DV). The recommended daily value for choline used on nutrition labels is 550 mg.³

Examples of foods that are rich in choline include:¹³

• Beef liver: 356 mg per 3 ounces (oz), or 65% of the daily value (DV)
• Hard-boiled egg: 147 mg per egg, or 27% of the DV
• Roasted soybeans: 107 mg per ½ cup, or 19% of the DV
• Roasted chicken breast: 72 mg per 3 oz, or 13% of the DV
• Atlantic cod fish: 71 mg per 3 oz, or 13% of the DV
• Baked red potatoes (including skin): 57 mg per large potato, or 10% of the DV
• 1% milk: 43 mg per cup, or 8% of the DV
• Boiled Brussels sprouts: 32 mg per ½ cup, or 6% of the DV

If you do not eat animal products, you can focus on eating cruciferous vegetables, shiitake mushrooms, beans, nuts, and whole grains to get choline.¹

Supplements

Choline supplements may be beneficial for people who are at risk for choline deficiency. Supplementation is especially important for pregnant and breastfeeding people, who need more choline than the general population. Because prenatal vitamins often contain little to no choline, pregnant people may need to take a separate choline supplement.¹

Choline supplements may come as choline by itself, combined with a B vitamin, or as part of a multivitamin. On the supplement label, choline may be listed as choline bitartrate, phosphatidylcholine, or lecithin.¹

Before starting a new supplement, ask your healthcare provider which form may be right for you. Also, make sure any supplement you take is tested by a third party for purity and potency. This is important because the U.S. Food and Drug Administration (FDA) does not regulate supplements the way it regulates other drugs.⁴

Potential Risks and Side Effects

Reaching a healthy, balanced level of choline in the body is important. This is because either too little or too much choline can lead to health complications.

Choline Deficiency

While most people do not get the recommended AI of choline, they are not truly deficient. This is likely because their bodies make enough choline to meet their needs. However, some groups of people are at higher risk for choline deficiency, including:²¹

• Pregnant people: Most pregnant people do not get enough choline. When this is the case, the child is at higher risk for neural tube defects and cleft palates.
• People with certain genetic variants: Having changes to certain genes involved in the metabolism of choline, folate, and methionine may mean that some people need to get more choline from their diet than others.
• Vegans and vegetarians: Because animal-derived products are the best source of choline, vegans and vegetarians are less likely to get adequate choline from their diet.
• Infants and adults on parenteral solutions: Liquid nutrition formulations that are given through an intravenous (IV) tube do not always include choline.

The main potential complications of true choline deficiency are:¹

• Liver damage
• Muscle damage
• Nonalcoholic fatty liver disease, a condition in which fat builds up in the liver

Toxicity

Just as there are health risks of getting too little choline, there are also risks linked to getting too much choline. For adults, the tolerable upper intake level for choline—the most you should have per day—is 3,500 mg. Taking more than this amount may lead to:¹

• Side effects like fishy body odor, vomiting, excessive sweating and salivation, and low blood pressure
• Increased production of trimethylamine N-oxide (TMAO), a risk factor for cardiovascular disease
• Higher overall risk of death (mortality) over time

A Quick Review

Choline is an essential nutrient with many functions, ranging from supporting brain health and liver function to aiding in fetal development during pregnancy. Adequate intake of choline is crucial for maintaining overall health and well-being. By incorporating choline-rich foods into your diet and taking a supplement if necessary, you can avoid the complications of choline deficiency.