Choline: The Forgotten Nutrient in Eggs

Eggs are one of the highest food sources of choline.¹ This essential and mostly unknown micronutrient is vital for health and wellness across all life stages. Choline plays an important role in brain and spinal cord development during pregnancy² and research indicates a role in preventing cognitive decline and Alzheimer’s disease in older adults.^3,4,5,6,7,8  Most recently, research has linked lower choline intakes with reduced muscle mass and strength gains in adults over 60 years.⁹

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• What is Choline? 
• Australian Choline Recommendations
• Choline Intake in Australia
• Choline Across the Life Stages
• Information about Choline
• Video Explanations

What is Choline?

Choline is a methyl donor, similar to folate, and is found in foods such as eggs, meat, fish and milk, as well as some green vegetables and wholegrains. Eggs, even when cooked, are the richest food source of choline providing more than double the amount of choline per 100g than any other commonly eaten food source.⁷

Australian Choline Recommendations

Although some choline can be synthesised in the body, the quantities are insufficient to meet all requirements. As such, sufficient dietary intake is important to maintain choline levels. The NHMRC published Australian daily nutrient reference values in 2006 (see Table).¹¹

 The values presented are adequate intake (AI) values. 

Choline Intake in Australia

Despite choline being one of a few essential nutrients vital for the structure and function of all cell membranes, up to 90% of Australians are consuming inadequate amounts of this essential nutrient.¹

Research based on consumption data from the Australian Health Survey found that less than 4% of Australian adults are consuming the recommended Adequate Intake (AI) of choline as set by the National Health and Medical Research Council (NHMRC).¹

With respect to children, 33% of children aged 2-3 years and 80% of children aged 4-8 years are falling below the AI recommendation for choline.

Furthermore, specific research in pregnant women indicates 61-99% of pregnant woman in Australia are not getting enough choline in their diet to meet the AI recommendations.¹

For consumer-friendly information about choline in eggs click here.

Choline Across the Life Stages

Conception & Pregnancy

Low maternal choline intake has been identified as a factor associated with a higher risk of neural tube defects.⁷ Even in pregnant women who have sufficient folic acid, increased intake of vitamins B6 and B12, choline, methionine and betaine may reduce the risk of neural tube defects.²  Furthermore, a body of research is accumulating which indicates choline, along with other nutrients including folate, iodine, iron, vitamin D, lutein/zeaxanthin and omega-3 fats, play an important role in foetal neurodevelopment and cognition.^7,12,14

However, most prenatal supplement do not contain choline. Although choline is available as a separate supplement, purchasing and consuming an additional supplement during pregnancy may be prohibitive for some. As choline is readily available in inexpensive whole-foods such as eggs, meat and fish, this is considered the simplest and most affordable way for most people to increase their choline levels. In fact, Australian research (conducted by the South Australian Health and Medical Research Institute), found pregnant women who consumed more than 6 eggs per week, were seven times more likely to meet the adequate intake (AI) recommendations for choline compared to those who ate fewer eggs.¹³

New peer-reviewed research findings from the South Australia Health and Medical Research Institute (SAHMRI) found that pregnant women who consumed more than 6 eggs per week were 7 times more likely to meet AI recommendations than those consuming less eggs. Currently, pregnant women are consuming 2.6 eggs per week but if they consumed one extra egg a day, the percentage of women with adequate choline intakes would increase from 39% to 80%. The research also found that a serve of eggs can deliver 74% of the adequate intake for choline during pregnancy.¹³

Latest Research on Choline

To find out more about eggs and pregnancy click here.

Infants

There is emerging evidence, from both animal and human studies, that adequate dietary choline may play an important role in neurodevelopment and cognitive outcomes from early life.^15,16,17,18 As infants make the transition from breast or formula milk, both of which are rich sources of choline, to solid foods, it's important for parents and carers to have an awareness of choline-rich food choices as an important part of the diet. Eggs are an inexpensive source of choline that can be easily incorporated into the diet at the appropriate age. Milk, fish and meat also contain choline. For consumer-friendly information about feeding eggs to babies and children click here.

Children and Adolescents

Dietary modelling studies from the US have demonstrated the importance of regularly consuming eggs in order to help meet daily choline recommendations at this important stage of growth and development.^19,20,21 Removing eggs from the diets of children and adolescents showed a significant decrease in the proportion of children meeting adequate intake recommendations for choline. When eggs were included regularly (at least 7 eggs per week), significantly more children and adolescents met the requirements for choline and a range of other nutrients. Furthermore, eggs ranked as the most cost-efficient food for delivering protein, choline, and vitamin A in children and adolescents’ diets.²² These findings highlight the important role eggs have in delivering substantial amounts of nutrients, particularly choline in the diet of children and adolescents.

Older Adults

Choline may play a role in preventing Alzheimer’s disease and delaying cognitive decline, although more research is needed to better understand this area.²³ It has been reported that individuals with Alzheimer’s disease have lower levels of choline in their brain and spinal fluid²⁴ and lower intakes of dietary choline are associated with an increased risk of developing dementia, including Alzheimer's disease.⁸ Research in older adults has also demonstrated that lower choline intakes lead to reduced muscle mass and strength gains, compared to higher intakes.⁹

Choline metabolism gene polymorphisms (ApoE4) have also been associated with Alzheimer’s disease. Eggs, as part of a healthy and varied diet, have been associated with improved cognitive function in older adults.²⁵ There is also evidence that a choline-rich diet is associated with stronger bones.²⁶ Furthermore, for older adults carrying some extra weight (above standard adult healthy weight range) actually offers some protection against health and functional declines.