A deficiency of choline (a B vitamin) may prompt a variety of health problems

Off to a Good Start

What the heck is choline?

My friend Ella put that question to me after she saw a TV report about the best foods to feed kids for breakfast to help them stay alert in school.

But it doesn’t matter if you’re school age or an age where you drive your grandkids to school, foods that contain choline are an important choice for breakfast or any meal.

Count the ways

The news feature Ella asked about actually had good nutrition recommendations from Baylor University. You can’t go wrong with foods that contain omega-3 fatty acids, antioxidants, protein, whole grains (provided they’re genuine whole grains, of course), and choline.

Choline (pronounced “ko-leen”) is part of the B vitamin complex. But researchers estimate the average choline intake in the U.S. is only about 315 mg per day – well below the recommended adequate intake (AI) of 425 mg per day for women and 550 mg per day for men. This is a concern because choline deficiency can play a role in raising homocysteine – the amino acid that promotes plaque buildup on artery walls.

But choline benefits go far beyond heart health. Your body uses choline to maintain healthy cell membranes, and to facilitate memory storage and muscle control. In addition, choline helps prevent fatigue, insomnia, and the build up of fats in the liver. And studies have shown that low levels of choline have been associated with poor kidney function and memory loss, while more advanced cases of deficiency may contribute to anemia, high blood pressure, heart disease, and kidney failure.

The best source of choline is a food that many mainstream doctors still insist is bad for you: egg yolks. In fact, eggs safely deliver an abundance of key nutrients.

Other choline sources include organ meats, peanuts, toasted wheat germ, cod, salmon, broccoli, Brussels sprouts, milk, and flaxseed. Many multivitamins contain choline, but not enough to even approach the recommended AI.

Dysfunction reversed

Last year, researchers at Penn State University presented a study that demonstrates the dangers of low choline intake.


  • Nearly 60 healthy adult subjects were recruited – 26 men, 16 premenopausal women, and 15 postmenopausal women
  • In the first phase of the study, each subject followed a diet that delivered 550 mg of choline daily for 10 days
  • In phase two, each subject followed a diet that contained less then 50 mg of choline per day for six weeks
  • Throughout the study, researchers monitored toxicity in blood and urine, and measured liver fat with magnetic resonance imaging (MRI)
  • Results showed that 77 percent of men, 80 percent of postmenopausal women, and 44 percent of premenopausal women developed muscle damage or fatty liver during phase two
  • Six men developed some amount of fatty liver or muscle damage during phase one

In the American Journal of Clinical Nutrition, the Penn State team offered this post-trial note: “Subjects who developed organ dysfunction during this diet had normal organ function restored after incremental amounts of choline were added back to the diet.” Choline levels as high as 850 mg per day were required to avoid liver and muscle damage in about 20 percent of the subjects who were at risk.

Researchers believe that their results demonstrate that the current recommended AI for choline is too low, especially for men and postmenopausal women. Talk to your doctor about this study before adding extra choline to your daily supplement regimen.

“Sex and Menopausal Status Influence Human Dietary Requirements for the Nutrient Choline” American Journal of Clinical Nutrition, Vol. 85, No. 5, May 2007, ajcn.org