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Are vegans choline deficient?

Vegan choline deficiency

The US National Institute of Health estimates that 90% of the American population are choline-deficient [1] so why is the spotlight on those who follow a vegan diet? The British Medical Journal published concerns over the choline density within a vegan diet based on the nutritional profile of plant-based foods [2] however, if you follow a vegan diet, you will be happy to hear that the current body of conclusive evidence is limited.

What is the evidence for choline deficiency amongst Vegans?

The current absence of clinical and longitudinal study data on vegan cohorts represents a challenge. Popular veganism is a relatively new phenomenon and over 60% of all global studies conducted into the impact of a vegan diet have been commissioned in the last 6 years. The body of data is growing, and we will have more evidence in the future.

Can you test for choline deficiency?

Traditional test methods include blood tests and identifying biomarkers in urine samples [4] [5] [6] which are only indicative of a small snapshot in time and provide no insight into brain health. Novel testing techniques are in the pipeline but rather than focusing on choline deficiency perhaps the question should be "how can I obtain adequate intake levels of choline if I follow a strictly plant-based diet?"

Table 2: Recommended adequate intakes for Choline in the United States and the European Union [14] [15].

European Union Daily Adequate Intakes (AI) for choline
Age Milligrams/mg
7 -11 months 160
1 – 14 years 140 - 340
15 -17 400
Pregnant women 480
Lactating women 520

United States Daily Adequate Intakes ( AI) for choline

Age Male Female Pregnancy Lactation
Birth to 6 months 125 mg/day 125 mg/day
7 – 12 months 150 mg/day 150 mg/day
1 – 3 years 200 mg/day 200 mg/day
4 – 8 years 250 mg/day 250 mg/day
9 – 13 years 375 mg/day 375 mg/day
14 – 18 years 550 mg/day 400 mg/day 450 mg/day 550 mg/day
19+ years 550 mg/day 425 mg/day 450 mg/day 550 mg/day

The richest sources of choline are found in animal proteins such as beef, liver, eggs, and chicken [3] so in theory, this may make the practice of obtaining choline from a vegan diet more challenging.

food sources high in choline

Figure 1: A graph showing the comparison between the choline content in the top food sources of choline [2].

Obtaining choline from a vegan diet

The great news is if you follow a vegan diet you can obtain your daily adequate intake (AI) of choline from plant-based sources. You may just need to fight a little harder to integrate more choline-dense foods. To help; here are the top 10 plant-based food sources of choline:

Table 1: Top 10 plant-based food sources for choline [7]

Plant-based food sources of choline
Food Quantity  Choline per serving (mg)
Wheat germ, toasted 100g 182
Soybeans, roasted 100g  167
Mushroom shiitake, cooked 100g 90
Brussel sprouts, chopped, boiled, drained 100g 75
Kidney beans (canned) 100g  69
Peanuts, dry roasted 100g  48
Cauliflower, pieces, boiled, drained 100g  37.5
Green peas, boiled 100g  37.5
Quinoa (cooked) 100g  33
Potatoes, red, baked, flesh and skin 100g 15

Combining a mix of choline-rich sources into every meal will give you the best chance of obtaining your AI and a quinoa and bean salad, for example, will deliver 62mg of choline per serving. (you can find a simple recipe for a Mexican Quinoa salad at allrecipes.com)

Quinoa salad

Why should I be interested in obtaining dietary choline?

Choline is a precursor to a chemical messenger called acetylcholine which is responsible for your working memory, attention, and learning [9].  A study on mild cognitive impairment showed that 71% of 2044 patients that consumed a daily dose of Alpha Glyceryl-Phosphoryl-Choline (Alpha GPC) corresponded to “no cognitive decline” or “forgetfulness” [10]. Another study showed that increased levels of acetylcholine appeared to boost attention in sustained attention performance tasks [11]. Choline may also support fetal cognitive development [2].

Not all forms of choline are equal

Food-derived choline and other forms of choline such as choline bitartrate require complex mechanisms of action in order to enter the brain which involves binding to transporter molecules [16]. Alpha Glyceryl-Phosphoryl-Choline (Alpha GPC) and Citicoline can freely cross the blood-brain barrier in order to be converted into acetylcholine. The difference between these two forms is the amount of choline they carry. Alpha GPC is 40% choline by weight which is over double the amount contained in Citicoline (18.5%). If you're considering a vegan choline supplement brain feed’s 500mg Choline (alpha GPC) supplement is the world’s first 99% 500mg alpha GPC capsule [17].

[1] Wallace et al. (2018) Choline: The Underconsumed and Underappreciated Essential Nutrient. Nutrition Today. [2] Derbyshire, E. (2019) Could we be overlooking a potential choline crisis in the United Kingdom? British Medical Journal Nutrition, Prevention and Health.  [3] Ziesel et al. (2003) Concentrations of Choline-Containing Com-pounds and Betaine in Common Foods. The Journal of Nutrition. [4] Wallace et al. (2011). Choline supplementation and measures of choline and betaine status: a randomised, controlled trial in postmenopausal women. British Journal of Nutrition.[5] Wiedeman et al. (2015) Variability in Plasma Free Choline and its Relation with Diet and Potential Plasma Biomarkers. The Federation of American Societies for Experimental Biology Journal. [6] Kirsch et al. (2010) Quantification of acetylcholine, choline, betaine, and dimethylglycine in human plasma and urine using stable-isotope dilution ultra-performance liquid chromatography–tandem mass spectrometry. Journal of Chromatography B. [7] Physics Comitte for Responsible Medicine (2019) Clearing Up Choline Confusion. [8] All Recipes (2020) Amazing Mexican Quinoa Salad Recipe. [9] Zeisel et al. (1991) Choline, an essential nutrient for humans. The Federation for American Societies for Experimental Biology Journal.  [10] Sangiorgi et al. (1994) α-Glycerophosphocholine in the Mental Recovery of Cerebral Ischemic Attacks. Annals of the New York Academy of Sciences. [11] Himmelhebar (2000) Increase in corticol acteylcholine release during sustained attention perfomance in rats.    [12] Zeisel, S.H. (2006) The fetal origins of memory: The role of dietary choline in optimal brain development. The Journal of Pediatrics. [13] Edwards et al. (2019). Dietary choline is related to neural efficiency during a selective attention task among middle-aged adults with overweight and obesity. Nutritional Neuroscience.   [14] Wiedeman et al. (2018) Dietary Choline Intake: Current State of Knowledge Across the Life Cycle. Nutrients. [16] National Institutes of Health (2020) Choline. [15] European Food Safety Authority (2016) Choline. [17] Wallace et al. (2018) Choline: The Underconsumed and Underappreciated Essential Nutrient. Nutrition Today. [18] Brain feed (2018) Choline: Alpha GPC.

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