milligrams (mg). The following list gives the recom-
mended AL and UL levels of choline for each age
group.
children birth–6 months: AI 125 mg; UL not estab-
lished. All choline should come from breast milk and
infant formula or infant food.
children 7–12 months: AI 150 mg; UL not estab-
lished. All choline should come from food, not diet-
ary supplements.
children 1–3 years: AI 200 mg; UL 1,000 mg
children 4–8 years: AI 250 mg; UL 1,000 mg
children 9–13 years: RDA 375 mg; UL 2,000 mg
boys 14–18 years: IA 550 mg; UL 3,000 mg
girls 14–18 years: IA 400 mg; UL 3,000 mg
adult men age 19 and older: RDA 550 mg; UL
3,500 mg
adult women age 19 and older: RDA 425 mg; UL
3,500 mg
pregnant women all ages: RDA 450 mg; UL 3,500 mg
breastfeeding women all ages: RDA 550 mg; UL
3,500 mgSources of choline
Research suggests that the body makes only
between 10% and 20% of the choline it needs to
maintain health. The rest comes from diet. Foods
rich in choline include beef liver, egg yolks, peanuts,
and soybeans. Most choline in foods is in the form of
phosphatidylcholine, which is also known as lecithin.
Much less information is available about the choline
content of specific foods than is available for other
nutrients. Most people can meet the AI levels of chol-
ine through their normal diet. Some foods that have
been analyzed for choline are listed below.
beef liver, 3 ounces fried: 355 mg
wheat germ, 1 cup toasted: 172 mg
egg, 1 large: 126 mg (choline is concentrated in the
yolk)
cod, 3 ounces cooked: 71 mg
Brussels sprouts, 2 cup cooked: 63 mg
broccoli, 1 cup cooked: 62 mg
peanut butter, 2 Tablespoons: 20 mg
milk chocolate, 1.5 ounces: 20 mg
Choline chloride and choline bitartrate are also
sold as adietary supplements. Choline is also found
in dietary supplements marketed as lecithin. Soy-
beans are the most common source for lethicin in
dietary supplements. These supplements contain a
much smaller and more variable amount of choline
than choline chloride or choline bitartrate supple-ments. Consumers should read the lethicin labels
carefully. Some children’s multivitamins also contain
choline.Precautions
Moderate choline deficiency is associated with an
increase in the blood levels of homocysteine. High
levels of this molecule are known to increase the risk
of cardiovascular disease. Extreme choline deficiency
can result in a condition called fatty liver. Fat accu-
mulates in liver cells where, in the absence of choline, it
cannot be packaged and transported through the
body. As a result,fatsin the blood calledtriglycerides
increase, creating an increased risk of heart disease
and other health problems. Choline deficiency in preg-
nant women appears to have a negative effect on the
development of the fetal brain and may cause learning,
memory, and attention problems for affected children
later in life.
Large excesses (10 g or more) of choline can cause
nausea and extreme sweating. However, the most
noticeable symptom of excess is the development of a
highly unpleasant fishy body odor that results from
the excretion of a choline breakdown product from the
skin, urine, and breath. Large doses of choline dietary
supplements do not appear to improve either physical
or mental performance, nor do they appear to confer
any specific health benefits.Interactions
Methotrexate, a drug used to treatcancer, psor-
iasis, and rheumatoid arthritis causes choline defi-
ciency in laboratory animals. Individuals taking this
drug should discuss possible side effects with their
physician. Choline also is involved in many of the
same metabolic pathways as other B-complex vita-
mins. Deficiencies or excesses of any of these B vita-
mins may potentially alter cholinemetabolism.Complications
No complications are expected when choline is
taken in amounts equal to or exceeding the AI level.
Doses much higher than the UL level have been tol-
erated without any obvious serious negative side
effects (but also without any observed benefits).Parental concerns
Animal studies suggest that choline has a positive
effect in stimulating the developing brain of the fetus
and that choline supplements given after birth may off-
set some of the effects of fetal alcohol exposure. SomeCholine