Featured article in the September, 2017 Issue of Nutrition Research Update; written by Taylor Wallace, PhD, CFS, FACN, food and nutrition expert, faculty at George Mason University and blogger at www.drtaylorwallace.com.
Did you know that eggs provide the most choline to the U.S. diet? Each egg yolk contains about 147 mg of choline or about one-fourth of that recommended on the food label. Our prior research indicated that about 90% of Americans fall short of their choline intake goals. The 2015 Dietary Guidelines for Americans for this reason identified choline as an under consumed nutrient in the U.S. diet. Building on our previous work, our recent analysis “Usual Choline Intakes Are Associated with Egg and Protein Food Consumption in the United States” showed that 92% of pregnant women and 99% of teenagers fail to meet intake recommendations for choline.
Women are more likely not to get enough choline in their diet as compared to men during all life stages, and only 4% of non-pregnant women of childbearing age get enough choline from the diet. This is alarming given that choline is critical to neuronal and brain development in the fetus almost immediately after conception as well as in infants and young children. As such, the American Medical Association recently recommended that all pregnant women supplement with choline because the nutrient is so critical to development of healthy cognition during the first 1000 days of life. The only subpopulation we found to have semi-adequate choline intakes were children 2-3 years-old, which is likely driven by consumption of fortified infant formula products.
Choline is also important post early-childhood as it plays an active role in several metabolic processes related to cell communication, muscle function, and perhaps even cognition throughout the lifespan. Intakes of choline seems to increase with age in adults, but only incrementally. Therefore, it is essential that new dietary interventions and policy strategies be put into place to help increase the general population’s intake of choline. Our data is convincing that recommending moderate egg intake is the easiest way to eliminate insufficiencies in choline. Egg-consumers had almost double the intake of choline in their diets as compared to those who don’t consume eggs. Protein food (meat, poultry and seafood) consumption also increased intakes of choline, but to a lesser degree, and did not result in substantial increases in the number of individuals meeting recommended intake levels. Replacing red/processed meat in exchange for one or two whole eggs per day resulted in a food pattern model that was sufficient in choline. Our analyses did not identify any subpopulation that exceeded the tolerable upper intake level (UL) for choline (3500 mg/d for adults); even those with extremely high egg intakes above the 95th percentile were almost 3000 mg shy of reaching the UL. Those consuming eggs were more likely to have a higher Healthy Eating Index 2010 score. Therefore, recommending higher egg consumption and/or fortification of staple food products may be appropriate given the large disparities present among the U.S. population. Our data show that these strategies are not likely to increase choline intakes anywhere near levels of excess.