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The Key Nutrient You Probably Don’t Get Enough Of
By George Citroner
- Choline is a vital nutrient found in eggs, meat, and dairy products.
- But researchers find many people aren't getting enough of the nutrient.
- Vegans and vegetarians have more risk for lower choline levels, but experts say people can take steps to supplement their diet.
Despite decades of diet advice, new research finds we still might not get enough key nutrients.
One nutrient many of us are missing out on? Choline.
Present in eggs, dairy, and meat, choline was recognizedTrusted Source by the Institute of Medicine as an essential nutrient in 1998.
For the last 21 years, the institute has recommended daily choline intake of 550 milligrams (mg) per day for men and 425 mg per day for women, increasing to 450 mg during pregnancy and 550 mg for women who breastfeed.
That amount of choline intake doesn't seem like it would be too difficult, considering that one hard-boiled egg has about 113 mg of choline.
But according to National Health and Nutrition Examination Survey data, 90 percent of children (but not infants), pregnant women, and adults aren't getting enough.
Essential for Health
According to the National Institutes of Health, choline is an essential nutrient found in many foods. The brain and nervous system use it to regulate functions that include memory, mood, and muscle control. Choline is also needed to form the membranes that surround your body's cells.
Although the body produces some choline in the liver, most of the choline we need comes from the food we eat.
Choline is naturally found in egg yolks, fish (like salmon), meat, and dairy. The best source is eggs. One large egg can provide 25 percent of a pregnant woman's daily choline needs and more than half the choline required for 4- to 8-year-old children.
A discussion paper published Thursday in BMJ addresses why the move to plant-based diets has worsened this problem, placing unborn children at risk.
"Choline is transported to the fetus in utero. It's an important nutrient because it's involved in the development of the brain and spinal cord. Shortfalls could impact the cognitive development of children after they're born," Emma Derbyshire, BSc, PhD, RNutr, and author of the paper, told Healthline.
She emphasizes that the body doesn't produce enough choline on its own.
"The concept that the body will adapt is somewhat of a myth," Derbyshire said. "Choline can be likened to omega-3 fatty acids in that it is an 'essential' nutrient that needs to be obtained from dietary or supplemental sources, as the body doesn't produce enough to meet human requirements."
Recent research Trusted Source finds less than 9 percent of pregnant women meet the minimum daily requirement.
Dr. Praveen S. Goday, CNSC, FAAP, professor pediatric gastroenterology and nutrition at the Medical College of Wisconsin, points out that the nutrient is key not just for in utero brain development, but as a newborn becomes a toddler as well.
"At the present time, the American Academy of Pediatrics has included choline among the critical nutrients that support brain growth in the first 1,000 days of a child's life. In other words, life in utero plus the first 2 years of life," Goday said.
He cautioned, "There is a concern that failure to provide key nutrients such as choline during this critical period of brain development may result in lifelong deficits in brain function despite subsequent nutrient repletion."
Cholesterol Fears and Eggs
The dropping rates of choline intake may be linked to the fight against cholesterol.
In the 1970s, the American Heart Association began recommending Trusted Source Americans reduce their intake of dietary cholesterol to less than 300 mg per day and no more than three eggs per week.
This advice drastically reduced choline intake, since the foods people avoided to reduce cholesterol levels were also the best sources of this critical nutrient: eggs, dairy, and meat.
Today, that advice has been somewhat reversed. Eggs, alongside healthy meats and some dairy products, are no longer looked as a harbinger of skyrocketing cholesterol.
But many people still aren't eating enough of these foods to get to the recommended choline intake.
Vegans and vegetarians who avoid fish and dairy products are particularly at risk.
While vegetables like Brussels sprouts, broccoli, cauliflower, wheat germ, peanuts, and many varieties of beans have some choline, it's difficult — though not impossible — to eat enough of these foods to meet our minimum daily requirement.
Half a cup of broccoli has just over 31 mg of choline.
"The general population should think about whether they are obtaining some of the major dietary choline providers, such as meat, milk, and eggs. If these are not being consumed, then supplementation strategies will be required," Derbyshire said.
"This becomes particularly important at key life stages, such as pregnancy and postpartum if breastfeeding, when choline is critical to fetal and infant development," she added.
Goday says older children can stay on a vegan diet as long as care is taken to ensure they get nutrients that might be missed if they avoid animal products.
"Children and adults who are vegans need some form of supplemental vitamins, particularly vitamin B-12 and potentially others, and may also need supplemental minerals," Goday said.
He points out that infants may be at particular risk.
"Additionally, choline is not a common ingredient in most infant vitamin preparations, although it is an ingredient in some pediatric and prenatal vitamins," Goday said.
Choline and Alzheimer’s Risk
The nutrient is associated with decreased risk of a variety of health issues, especially conditions that can affect the brain.
Choline protects against age-related cognitive decline. Sufficient choline in the brain will preserve neurons, brain size, and neural networks to prevent memory loss in aging brains.
Research Trusted Source shows that brain abnormalities seen in people with dementia and Alzheimer's can be linked in part to choline deficiency.
A 2011 study Trusted Source from Boston University School of Medicine found higher choline intake was strongly associated with better cognitive function. It even prevented deterioration of the brain in senior citizens.
One reason is that choline is a precursor to the neurotransmitter acetylcholine Trusted Source.
This neurotransmitter is responsible for maintaining neurons in certain neural networks of the brain. These networks are important for memory. They rely mostly on dietary choline to function properly.
Additionally, drugs called anticholinergics have been associated Trusted Source with an increased risk of Alzheimer's because they reduce acetylcholine in the brain.
Dr. James Pickett, head of research at the Alzheimer's Society, said in a statement that choline levels are so important that drugs that can negatively affect choline should be avoided for older people.
"Current guidelines for doctors say that anticholinergic drugs should be avoided for frail older people because of their impact on memory and thinking," Pickett said.
"But doctors should consider these new findings for all middle aged and older people as we continue to learn more about long-term use and the risk of dementia," he said.
The Bottom Line
Choline is an essential nutrient for many bodily functions, especially brain health. But up to 90 percent of Americans are choline-deficient.
According to experts, this can be due to both recommendations made by the American Heart Association in the '70s and a general move toward plant-based diets.
Choline deficiency can have serious consequences for cognitive health from before birth to old age.
Reposted with permission from our media associate Healthline.
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