The key nutrient that you probably don't get enough

    Abdulaziz Sobh

    Choline is a vital nutrient found in eggs, meat and dairy products.
    But researchers find that many people do not get enough nutrients.
    Vegans and vegetarians are at greater risk of having lower choline levels, but experts say people can take steps to supplement their diet.
    Despite decades of dietary advice, new research finds that we still may not get enough key nutrients.

    A nutrient that many of us are losing?

    Present in eggs, dairy, and meat, choline was recognized as a reliable source of the Institute of Medicine as an essential nutrient in 1998.

    For the past 21 years, the institute has recommended a daily intake of choline 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 does not seem to be too difficult, given that a hard-boiled egg has approximately 113 mg of choline.

    But according to data from the National Health and Nutrition Examination Survey, 90 percent of children (but not babies), pregnant women and adults do not get 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 necessary to form the membranes that surround the cells of your body.

    Although the body produces some choline in the liver, most of the choline we need comes from the food we eat.

    Choline is found naturally in egg yolks, fish (such as salmon), meat and dairy. The best source is eggs. A large egg can provide 25 percent of a pregnant woman's daily choline needs and more than half of the choline required for children ages 4 to 8.

    A discussion paper published Thursday in BMJ addresses why the change to plant-based diets has made this problem worse, putting unborn children at risk.

    "Choline is transported to the fetus in the womb. It is an important nutrient because it is involved in the development of the brain and spinal cord. Deficiencies could affect the cognitive development of children after birth," Emma Derbyshire, BSc, Ph .D., RNutr, and author of the article, told Healthline.

    She emphasizes that the body does not produce enough choline alone.

    "The concept that the body will adapt is a myth," Derbyshire said. "Choline can be compared to omega-3 fatty acids in that it is an 'essential' nutrient that must be obtained from dietary or supplementary sources since the body does not produce enough to meet human needs."

    Recent research Trusted Source finds that less than 9 percent of pregnant women meet the minimum daily requirement.

    Dr. Praveen S. Goday, CNSC, FAAP, professor of pediatric gastroenterology and nutrition at the Medical College of Wisconsin, points out that the nutrient is key not only for the development of the brain in the uterus but also when a newborn develops In a small child.

    "Currently, 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 the womb plus the first 2 years of life, "Goday said.

    He warned: "There is a concern that the failure to provide key nutrients such as choline during this critical period of brain development can cause lifetime deficits in brain function despite subsequent nutrient replacement."

    Cholesterol Fears and Eggs
    Low choline intake rates may be related to the fight against cholesterol.

    In the 1970s, the American Heart Association began recommending Trusted Source Americans to reduce their dietary cholesterol intake to less than 300 mg per day and no more than three eggs per week.

    This advice dramatically reduced the intake of choline, since the foods that people avoided to reduce cholesterol levels were also the best sources of this critical nutrient: eggs, dairy, and meat.

    Today, that advice has been reversed. Eggs, along with healthy meats and some dairy products, are no longer considered a harbinger of dizzying cholesterol.

    But many people still do not eat enough of these foods to reach the recommended intake of choline.

    Vegans and vegetarians who avoid fish and dairy products are, particularly at risk.

    While vegetables such as Brussels sprouts, broccoli, cauliflower, wheat germ, peanuts and many varieties of beans have some choline, it is difficult, but not impossible, to eat enough of these foods to meet our requirements daily minimums

    Half a cup of broccoli has just over 31 mg of choline.

    "The general population should think about whether they are getting some of the main suppliers of choline in the diet, such as meat, milk, and eggs. If they are not consumed, supplementation strategies will be required," Derbyshire said.

    "This becomes particularly important in key stages of life, such as pregnancy and postpartum if you are breastfeeding, when choline is critical for fetal and child development," he added.

    Goday says older children can follow a vegan diet as long as care is taken to ensure they get nutrients that could be lost if they avoid animal products.

    "Children and adults who are vegan 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 babies may be at particular risk.

    "In addition, choline is not a common ingredient in most childhood 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 a lower risk of a variety of health problems, especially conditions that can affect the brain.

    Choline protects against age-related cognitive impairment. A sufficient amount of choline in the brain will preserve neurons, brain size and neural networks to prevent memory loss in aged brains.

    Research Trusted Source shows that brain abnormalities seen in people with dementia and Alzheimer's may be partly related to choline deficiency.

    A 2011 study, Trusted Source of the Boston University School of Medicine, found that higher choline intake was strongly associated with better cognitive function. It even prevented the deterioration of the brain in the elderly.

    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 depend mainly on dietary choline to function properly.

    In addition, medications called anticholinergics have been associated with 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 older people should avoid medications that can negatively affect choline.

    "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 have choline deficiency.

    According to experts, this may be due both to the recommendations made by the American Heart Association in the 1970s and to a general movement towards plant-based diets.

    Choline deficiency can have serious consequences for cognitive health from before birth to old age.


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