So Choline is really necessary for your long term health. And not even on the topic of the brain, what's more important in my mind, is the effect over time on the liver:
Dietary choline intake is an important modifier of epigenetic marks on DNA and histones, and thereby modulates the gene expression in many of the pathways involved in liver function and dysfunction
https://pmc.ncbi.nlm.nih.gov/articles/PMC3729018/
Choline influences liver function, and the dietary requirement for this nutrient varies depending on an individual’s genotype and estrogen status. Understanding these individual differences is important for gastroenterologists seeking to understand why some individuals develop NAFLD and others do not
https://pmc.ncbi.nlm.nih.gov/articles/PMC3601486/
supplementation in NAFLD patients demonstrated a favorable impact on hepatic steatosis, oxidative stress, inflammatory markers, liver enzyme levels, and lipid profile. These findings suggest that choline may be a promising therapeutic option for NAFLD management
https://pmc.ncbi.nlm.nih.gov/articles/PMC12361734/
And if you find meta studies that say there's no relationship, well, most of those people are eating a diet with plenty of choline from animal-based products. Choline is much more available in those diets.
So let's go by the RDI. 550 mg/day for adult men and 425 mg/day for adult women.
Let's use the most commonly eaten, highest choline food: One cup (93 grams) of roasted soybeans contains 214 mg, or 39% of the DV.
One cup of roasted soybeans is: Around 776 to 810 calories per cup. So let's just be gentle and say double that to reach enough Choline, on face value. So 1,600 calories to meet the RDI.
But wait, there's bioavailability. There is no known concrete info on this, either. It's certainly not close to 100%. So, on the surface, you could take an easy guess to barely scrap by to hit the RDI would be 1,600 to 2,000 calories of soy per day. All vegans are not eating 4 cups of Shiitake mushrooms per day. And if you were to add up your daily food intake, I'm guessing you're not hitting the RDI, including the idea there's zero chance Choline bioavailability is at 100%. Let's pretend you're 20%-30% behind the RDI, well what does that mean over the years and decades?
So I'm not trying to find anything but the reality of this. And I'm wondering why Choline isn't a required supplementation point in this diet. Because it can have a quite dramatic effect on the liver health over time with those not meeting requirements. And to me, unless someone wants to correct the situation, it seems almost impossible to get a sufficient amount of choline over time with a plant-based diet.
by ButterflyNo8336
10 Comments
See here https://veganhealth.org/choline/
Your body also produces its own choline. I wouldnt worry about it if you eat a wfpb diet.
Is there an indication that people on plant-based diets have reduced liver function or an increase in non-alcoholic fatty liver disease?
30 seconds with a search engine can keep you from looking like an animal foods industry shill out to create FUD. In short, the RDI is ignorance-based gibberish:
“The recommendation for choline is specified as an Adequate Intake (AI) which means that there is too little information to establish an RDA. The AI for choline is 550 mg/day for men and 425 mg/day for women but these numbers are based on very limited data. They are derived from a 1991 study at the University of North Carolina at Chapel Hill (Zeisel, 1991). When subjects consumed 50 mg or less of choline per day, they experienced markers of deficiency such as increased liver enzymes, a fatty liver, or elevated creatine phosphokinase (CPK) which indicates muscle deterioration. The deficiency symptoms resolved when the subjects were given supplements providing 500 mg of choline per day. The study didn’t look at the effects of choline intakes between 50 and 500 mg….
“…it’s also been suggested that high intakes of choline could raise the risk for heart disease through its conversion to trimethylamine N-oxide (TMAO). Choline is converted to trimethylamine (TMA) by intestinal bacteria and this in turn is absorbed and converted by the liver to TMAO. Some research has linked TMAO to risk for cardiovascular disease…”
“…estimated usual choline intakes among non-pregnant, non-lactating adults is found to be just over 300 mg of choline per day (Wallace, 2016). The findings indicate that only 10% of Americans and 8% of pregnant women meet choline recommendations…”
“Given the small amount of evidence on which the DRI for choline is based and that most people don’t meet the DRI for choline, we believe it’s probably unnecessary for vegans to worry about meeting the DRI for choline as long as you’re eating a few servings of higher choline foods each day. People who might become pregnant should probably take a modest choline supplement just to be absolutely sure they’re getting enough. Although studies have not assessed choline status in vegan babies, there have been no reports of choline deficiency symptoms in infants in vegan families.”
— https://veganhealth.org/choline/
> we believe it’s probably unnecessary for vegans to worry about meeting the DRI for choline as long as you’re eating a few servings of higher choline foods each day.
– https://veganhealth.org/choline/
Vegan Health is legit in my opinion. The site is very well sourced and run by an RD.
Don’t people on plant based diets live longer.
I would want evidence of a problem first.
I wouldn’t worry about theoretical issues.
To date, there are no known cases of choline deficiency in the general/non-instititutionalized population. [The experiments](https://www.ncbi.nlm.nih.gov/books/NBK114308/) that determined the essentiality of choline were in patients on total parenteral (intravenous) nutrition, with no source of betaine, and the actual threshold for preventing ALT (a marker of liver injury) elevation remains unknown within a very wide range (2 to 7 mg/kg/day). Hence, in the US we have only an adequate intake (AI) for choline, and no estimated average requirement (EAR) or recommended daily allowance (RDA).
Take a look at the metabolic pathways in which choline is consumed, for example [this image](https://www.creative-proteomics.com/images/Choline-and-choline-metabolites-1.png). You’ll discover that betaine is the intermediate in the pathway that requires the most of these methyl- group donors, remethylating homocysteine to methionine. Betaine, abundant in plants, and particularly high in beets (from which it gets its name, spinach and wheat, and avidly absorbed by both digestion and cells, can hence supplant much of the choline requirement.
There are disparate associations of choline and betaine status on health. Higher choline intake is associated with [higher incident coronary heart disease](https://link.springer.com/article/10.1186/1471-2261-7-20), risk of [type 2 diabetes](https://www.creative-proteomics.com/services/choline-and-choline-metabolites-analysis-service.htm), risk of [lethal prostate cancer](https://www.sciencedirect.com/science/article/pii/S0002916523029921), and overall and [cause-specific mortality](https://www.sciencedirect.com/science/article/pii/S0002916523029921) (also in [another 3 cohorts](https://www.sciencedirect.com/science/article/pii/S0002916522010462)). Higher plasma choline is associated with higher triglycerides, glucose, BMI, percent body fat, and waist circumference, while higher plasma betaine [is inversely associated](https://www.sciencedirect.com/science/article/pii/S0022316622097978) with serum non-HDL cholesterol, triglycerides, BMI, percent body fat, waist circumference, systolic and diastolic blood pressure.
Of course, these are not randomized trials, so cannot determine causality. It’s possible that the results are confounded by other components of the major dietary choline source, eggs, or with the sort of dietary patterns that would increase intake of beets, spinach and wheat.
My takeaway is that, we don’t know the actual requirement for choline within a broad range, dietary betaine can fulfill the roll of choline in remethylation and hence reduce dietary choline requirements, and the health associations of choline intake and status are generally negative. So long as ALT on my routine blood panels is in the normal range, I’m not in acute choline deficiency, and if homocysteine is in the normal range, I’m getting enough choline+betaine, B2, B6, and B12 at least for the methionine cycle to proceed.
I’ve seen paleo/carnivore advocates latch onto the generally lower choline content of vegan diets to argue against its nutritional adequacy. Doesn’t faze me at all. I’ll gladly take my lower risk of heart disease, T2D, prostate cancer *and death*.
Sort of related to your point but vegans eating a whole foods plant based diet might not need as much choline as meat eaters because vegans consume higher amounts of betaine in the diet. The extra betaine can have a choline sparing effect, allowing the body to use the extra betaine for methylation and save the choline for its primary usage.
>So I’m not trying to find anything but the reality of this. And I’m wondering why Choline isn’t a required supplementation point in this diet.
Because there are no significant cases where it is low.
>Because it can have a quite dramatic effect on the liver health over time with those not meeting requirements.
Some of those effects have been found in studies where drugs have been given to suppress the dietary intake. It is not common.
>And to me, unless someone wants to correct the situation, it seems almost impossible to get a sufficient amount of Choline over time with a plant-based diet.
It is common in many foods in different doses, additional the intake of Betaine reduces the Choline demand. A balanced diet will supply enough.
The problem you are facing in debunking the claim of deficiency of Choline in vegans is that its not a problem, the meat advisory board made that claim once to incite fear but it has never been a problem or observed.
Thanks for all the research. I suggest you cruise over to [nutritionfacts.org](http://nutritionfacts.org) and, while you’re at it read Dr. Greger’s books, “How Not to Die” and “How Not to Age” as well as [https://nutritionfacts.org/daily-dozen/](https://nutritionfacts.org/daily-dozen/). Eating a plant-based diet is great, and far better than a Standard American Diet (SAD), but eating an optimized whole-food plant-diet is the bee’s knees. Moreover, for science-based supplements, check this out: [https://nutritionfacts.org/optimum-nutrient-recommendations/](https://nutritionfacts.org/optimum-nutrient-recommendations/). Lastly, doctors Fuhrman, Esselstyn, Ornish, Campbell, Barnard, Popper, and Klaper are also great resources. Best of luck!