Much Ado about Choline

I have finally finished my article on choline! It is posted at VeganHealth.org.

After all was said and done, it was much ado about not much. Still, it is important that the issue of choline in vegan diets has now been researched.

Here is the summary from the article:

Choline is found in a wide range of plant foods in small amounts. Eating a well-balanced vegan diet with plenty of whole foods should ensure you are getting enough choline. Soymilk, tofu, quinoa, and broccoli are particularly rich sources.

The Dietary Reference Intake (DRI) for choline is 550 mg/day for men and 425 mg/day for women. It is based on only one study comparing those amounts to 50 mg/day, with no intermediary amounts examined. Eating less than 50 mg/day can result in liver damage, but it is very unlikely that a vegan would have such a low intake.

Some people have genetic mutations that increase the need for choline; it is not clear how much choline such people need but the DRI is probably adequate for almost everyone. If you suspect any sort of liver dysfunction, it might be worth talking to your physician about boosting your choline intake or supplementing with it in moderate amounts.

The data on choline and chronic disease (cardiovascular disease, dementia, and cancer) is somewhat mixed. Ideal amounts appear to be about 300 mg per day. Most vegans probably get about that much from the foods they eat.

Vegan women who are considering getting pregnant should make sure they are meeting the DRI for choline to reduce the risk of neural tube defects, and might need a modest supplement.

End summary.

As part of writing this article, I recorded everything I ate from one day and then calculated the amount of choline. When I recorded the food I ate, I didn’t know how much choline was in any of it as I had never done more than casually browse the USDA’s list of the choline content of foods. I actually expected it to be quite low, so it came as a nice surprise to find I met the recommendations I had already formulated before conducting the diet analysis. You can see my diet record in Table 2 of the article.

My choline intake came to 343 mg. However, there was no amount listed for hummus (or garbanzo beans) in the USDA database. Based on other legumes, I would assume at least 20 mg for 1/2 cup of hummus which would boost my intake to 363 mg. I was pretty surprised that after I plugged everything into the database, the only foods without values were hummus, canola oil, and grapeseed oil.

I list eating .5 cup of tofu. That was actually my estimate for the amount of tofu in Tofurky (4 slices for lunch and a 1/2 sausage for dinner). Tofurky is made from pressed tofu.

Not too long before I started writing this article, I purchased a bottle of choline supplements and started taking 300 mg twice a day (600 mg total). As I got further along in the choline research, I decided it might not be such a good idea to take so much. And since doing my diet analysis, I haven’t seen much need to to take any at all. It had been an experiment to see if taking choline would make me feel any different and I didn’t notice any change after a few weeks.

In conclusion, most vegans are probably getting enough choline in their diets.

I’d like to give special thanks to Jean Bettanny for doing another fantastic job in proofing the choline article!

21 Responses to “Much Ado about Choline”

  1. beforewisdom Says:

    Back in the 90s I got into the “smart drug” thing for a while. Supplementing with Choline was one of the big things. My roommate and I tried a batch. We *think* we felt smarter, but we were quite sure about the headaches we had afterwards…..perhaps from doing too much homework spurred on by placebo effects.

  2. Kenworthey Says:

    The conclusion that most vegans are getting enough choline may well be right–but your own accounting of a day’s worth of food doesn’t give me confidence about that. You say you ate almost 2800 calories–that’s over double what I typically eat (a 5’3″, small woman). You got about 360 mg of choline; I’d be getting more like 180 mg. Is that enough? It is less–by a lot–than the DRI, and I suspect is typical for female vegans of average weight.

  3. Jack Norris RD Says:

    Kenworthey,

    You make a good point. My reading of the research is that the less someone eats, the less choline they need, because they are taking in less fat and the liver, therefore, needs to clear less fat. Getting about 200 mg per day might be enough for someone your size, particularly for preventing any liver dysfunction. But, it might not be optimal for preventing chronic disease.

    The 2009 case-control study from the Long Island Breast Cancer Study Project found that higher free choline intakes were associated with a lower risk of developing breast cancer. The lowest and highest quintiles of total choline Intake were ≤ 123 and ≥ 247 mg/day, respectively. So, it didn’t take much more than 123 mg/day to be protective for women. And in another study done on women and colon cancer, intakes as high as 383 mg were harmful.

    If you want to write down everything you eat for one day, I will calculate your choline intake. If so, I will email you some instructions on how to do it in order to make measuring it as accurate as possible. The instructions aren’t too difficult.

    Jack

  4. Kate Scott Says:

    Thanks, Jack for that hugely helpful and thorough overview of the choline research.Yesterday I used your pea counter website (also very helpful – thank you!) to calculate my nutritional profile for a day’s typical food. I easily meet the RDAs for everything (apart from the obvious nutrients like B12 and D that I supplement for) except choline. With 2200 kcal consumed my choline was approx 250 mg. Your overview makes it hard to know whether to take that up or not (expecially since my husband has a strong family history of prostate cancer so I always plan our diet with that in mind) but I think I will add a little soy lecithin to the bread I make to bring my daily total up to about 300 and leave it at that.
    Thanks again for the work you do in posting these blogs and reviews – you provide such a balanced, sane voice, and there are too few of those in the web discussions of diet.

  5. Jack Norris RD Says:

    Kate,

    Thank you for your kind words. I’m skeptical that you have anything to worry about regarding choline, but it’s probably best to be safe and add the lecithin to get up to 300 mg/day. I’m sorry we don’t have more precise info.

  6. Jessica Says:

    Thanks for this info. I’ve been tracking my food intake for the past couple weeks, just to see how I’m doing, and my choline intake was below the DRI, but similar to yours. I’m relieved to know this probably does not warrant any changes to my diet. (BTW, have you noticed the USDA “SmartTracker” doesn’t have an entry for tempeh – how annoying!)

  7. Jack Norris RD Says:

    Jessica,

    Do you mean “SuperTracker”? I did not know that. I find it odd given that Tempeh is in the USDA database. You should use PeaCounter.com instead! 🙂 (That’s my nutrient analysis website.)

  8. Jen Says:

    Thanks for the great info.

    Curious about your comment “some people have genetic mutations for increased need for choline”

    Are you aware of any genetic mutations for DECREASED need for choline?

  9. Jack Norris RD Says:

    > Are you aware of any genetic mutations for DECREASED need for choline?

    I’m not.

  10. Jutta Luna Says:

    Dear Mr. Norris,
    I am one of those people who have the genetic mutation. My grandfather who also had it, and had no other risk factors such as alcohol abuse or fatty food, died of liver cancer at the age of 63. I am really worried about it because here in Germany supplements for various deficencies are hard to find. After reading your article, I will do my best to find a supplement because I really am one of those “pudding’ vegans. I don’t like to cook at all. Thank you for all the hard work you do to educate the public. I have been following and supporting VO for years even though I have left the US many years ago.
    Sincerely, JL

  11. Jack Norris RD Says:

    Jutta,

    Good luck. Can you order supplements from overseas? That might be one option. Soy lecithin is a pretty common product in processed foods in the U.S. Not sure if you can find anything in Germany made with it.

  12. Dan Says:

    Jack, I just read through your column “Much Ado about Choline”. It seems there is some consensus in the literature that choline intake is a critical factor in the development of some forms of liver disease, particularly in postmenopausal women (here is one of the more recent studies, which looked at a NASH trial cohort: http://www.ncbi.nlm.nih.gov/pubmed/22338037).

    Given that I am only eating about 230 mg of choline per day, I wonder if it would be advisable to supplement with soy lecithin granules (a tablespoon of one brand contains about 217 mg of choline — http://www.nutritionexpress.com/home+page/topsellers/lindberg/see+all/lindberg+lecithin+granules+unflavored+1+pound.aspx#ingredients). Against this, an analysis of the Physicians Health Study showed that high intake of choline led to a 70% increase in the risk of lethal prostate cancer; my father has this disease (successfully treated). Also, the Hazen work on atherosclerosis is another concern, but if I am reading his work correctly, vegans should have protective gut microbiota and need not worry as much about their intake of TMAO precursors (choline and phosphatidylcholine).

    By the way, I noted that the USDA Nutrient Database contains information on almond milk, but the peacounter, which I thought was based on the USDA database, does not. Is that an update issue, or something else?

  13. Jack Norris RD Says:

    Dan,

    > By the way, I noted that the USDA Nutrient Database contains information on almond milk, but the peacounter, which I thought was based on the USDA database, does not. Is that an update issue, or something else?

    It is likely an update issue. The USDA just came out with another release and I will try to get it loaded into PeaCounter as soon as I can.

  14. Silvia Says:

    In the peacounter database, both tofu and tempeh are described as having 0 choline. Since I seem to fall short of recommendations for choline, I’m wondering if this is a mistake? Since I did read on the website that tofu is a rich source, and the peacounter does state 59 mg of choline for 250 ml unfortified soy milk. How could tofu and tempeh both contain 0 choline (For 50 gram servings) if soy milk does contain it?

  15. Jack Norris RD Says:

    Silvia,

    The USDA database doesn’t include the choline amounts for most foods (and so neither does PeaCounter). That is a problem with the whole choline issue. But for items that show no choline, I extrapolate from other sources. Hopefully the USDA will include them in the future.

  16. Jack Norris RD Says:

    Silvia,

    Also, you can download an Excel spreadsheet for any day’s menu in PeaCounter, and then you can manually add in the choline amounts for whatever foods you want and let the spreadsheet calculate for you. If you don’t have access to Excel, you can download the file and then import it into Google docs as a spreadsheet and use it there.

  17. Silvia Says:

    Ah, thanks for the tip! I didn’t realize I could download a customizable file, I assumed it would be like a pdf or screenshot. That’s very handy indeed!

  18. Brandon Becker Says:

    I’m glad to see your comment about choline not being accurate on peacounter.com. I couldn’t understand why I was able to meet or exceed the RDA for all vitamins/minerals in the average day but then end up so low on choline. You may want to mention this issue in the FAQ

  19. Jack Norris RD Says:

    Thanks, Brandon. I don’t actually have an FAQ for the site. 🙁 Problem is, that’s true of a lot of the more obscure nutrients in the USDA DB and if I start listing which ones, it could get pretty complicated and tedious. I’m not sure if there’s a efficient solution to this problem.

  20. Brandon Becker Says:

    You have this FAQ: http://peacounter.com/faq.php

    I’ve worried about choline for the last year and half, taking supplements for periods of time, then stopping, then starting again, then stopping again. Is it safe to assume I’ll get enough choline from my diet if I’m meeting the DRI for all the other vitamins/minerals?

  21. Jack Norris RD Says:

    Oops – I thought I had an FAQ, but didn’t see it because I wasn’t logged in. I have added a note about choline to it. Thanks for the suggestion. I hope it doesn’t cause people to ask about a lot of the other obscure nutrients because I can’t really make a blanket statement about them.

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