Choline: The Forgotten Nutrient in Eggs

An Essential Nutrient Across the Lifespan

Eggs are one of the richest dietary sources of choline.¹ Choline is an essential nutrient involved in cell membrane structure, methylation, neurotransmitter synthesis (e.g. acetylcholine), and lipid metabolism.² Despite its importance, awareness of the value of choline is low, and average daily intakes are below optimum in Australia.

Clinical Summary

Choline is an essential nutrient commonly under-consumed in Australia.
Eggs provide more choline per 100g than any other commonly consumed food.
Adequate intake is particularly relevant during pregnancy, early development and ageing.
Dietary strategies may be a practical way to improve intake.

Why Choline Matters

Choline functions as:

A methyl donor (like folate)
A precursor to acetylcholine, supporting brain and nervous system function²
A structural component of all cell membranes
A contributor to normal liver and muscle function

Choline therefore provides an essential role in health and wellbeing.

Choline Intake in Australia

Although some choline can be made by the body, dietary intake is required to meet daily needs.³ The National Health & Medical Research Council (NHMRC) Adequate Intake (AI) recommendations for choline are³:

Adult men: 550 mg/day
Adult women: 425 mg/day
Pregnancy: 440 mg/day
Lactation: 550 mg/day

Research shows average intakes are well below these recommendations with national data showing¹:

Fewer than 4% of Australian adults meet the AI for choline
Up to 80% of children aged 4–8 years fall below the AI
Between 61–99% of pregnant women do not meet recommended intakes

Key Point: Choline is one of the most common shortfall nutrients in the Australian diet.

Eggs play an important role in addressing this shortfall as they provide more choline per 100g than any other commonly eaten food.⁴

Choline Across the Life Stages

Conception & Pregnancy

Choline plays an important role in foetal brain and spinal cord development.^4,5,6 Adequate maternal intake has been associated with reduced risk of neural tube defects, particularly alongside other nutrients such as folate and B vitamins.⁷

Australian research has shown that pregnant women consuming more than six eggs per week were seven times more likely to meet choline AI recommendations compared to those consuming fewer eggs.⁸

Learn more here.

More detail on eggs and pregnancy can be found here.

Infants & Children

Choline is present in breast milk and infant formula, but intake may decline as solids are introduced. Emerging evidence suggests adequate dietary choline supports neurodevelopment and cognitive outcomes in early life.⁹

Dietary modelling studies demonstrate that including eggs significantly increases the proportion of children meeting choline recommendations.10 Eggs also rank among the most cost-efficient sources of choline and protein in children’s diets.¹¹

Older Adults

Observational studies have reported associations between higher dietary choline intake and better cognitive performance, as well as lower risk of incident dementia.^12,13 Lower choline intakes have also been associated with reduced strength and lean mass gains in older adults.¹⁴

While further research is needed to establish causality, maintaining adequate choline intake may support healthy ageing.

Probst, Y, et. al. Development of a Choline Database to Estimate Australian Population Intakes. Nutrients 2019, 11, 913.
Blusztajn, J.K., Slack, B.E. & Mellott, T.J. Neuroprotective Actions of Dietary Choline. Nutrients 9(2017).
National Health and Medical Research Council; Australian Government Department of Health and Ageing; New Zealand Ministry of Health. NHMRC Nutrient Reference Values for Australia and New Zealand, online document [Accessed 20 Jul 2019]. 2006 (updated 2017).
Obeid, R., Derbyshire, E., & Schön, C. (2022). Association between maternal choline, foetal brain development and child neurocognition; systematic review and meta-analysis of human studies. Advances in nutrition (Bethesda, Md.), nmac082. Advance online publication. https://doi.org/10.1093/advances/nmac082
Cheatham, C.L. Nutritional Factors in Fetal and Infant Brain Development. Ann. Nutr. Metab. 2019, 75 (Suppl. 1), 20–32.
Christifano DN, Chollet-Hinton L, Hoyer D, Schmidt A, Gustafson KM. Intake of eggs, choline, lutein, zeaxanthin, and DHA during pregnancy and their relationship to fetal neurodevelopment. Nutr Neurosci. 2022 Jun 17:1-7. doi: 10.1080/1028415X.2022.2088944.
Petersen JM, Parker SE, Crider KS, Tinker SC, Mitchell AA, Werler MM. One-Carbon Cofactor Intake and Risk of Neural Tube Defects Among Women Who Meet Folic Acid Recommendations: A Multicenter Case-Control Study. Am J Epidemiol 2019;188:1136-43.
Green, T., Best, K., Gould, J.F., & Makrides, M. Eggs to Improve Choline Intakes in Pregnancy? Providing the Evidence. SAHMRI Women & Kids Final Project Report for Australian Eggs. Unpublished (2022).
Mun JG, Legette LL, Ikonte CJ, Mitmesser SH. Choline and DHA in Maternal and Infant Nutrition: Synergistic Implications in Brain and Eye Health. Nutrients 2019;11.
Fulgoni VL & Papanikolaou 2020. Modeling the Removal and Addition of Eggs in the Current US Diet is Linked to Choline and Lutein + Zeaxanthin Usual Intakes in Childhood. Current Developments in Nutrition 10.1093/cdn/nzaa181
Papanikolaou Y, Fulgoni VL 3rd. Eggs Are Cost-Efficient in Delivering Several Shortfall Nutrients in the American Diet: A Cost-Analysis in Children and Adults. Nutrients. 2020 Aug 11;12(8):2406. doi: 10.3390/nu12082406.
Yuan, J., Liu, X., Liu, C., Ang, A., Massaro, J., Devine, S. A., Auerbach, S. H., Blusztajn, J. K., Au, R., & Jacques, P. F. (2022). Is dietary choline intake related to dementia and Alzheimer's disease risk: results from the Framingham Heart Study. The American journal of clinical nutrition, nqac193. Advance online publication. https://doi.org/10.1093/ajcn/nqac193
Liu L, Qiao S, Zhuang L, Xu S, Chen L, Lai Q, Wang W. Choline Intake Correlates with Cognitive Performance among Elder Adults in the United States. Behav Neurol. 2021 Oct 29;2021:2962245. doi: 10.1155/2021/2962245.
Lee, C.W., Galvan, E., Lee, T.V. et al. Low Intake of Choline Is Associated with Diminished Strength and Lean Mass Gains in Older Adults. J Frailty Aging (2022). https://doi.org/10.14283/jfa.2022.50