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The trend toward plant-based eating has grown considerably in recent years, fueled in large part by consumers’ concerns for their health and the good of the environment. But a recent article published in the online journal BMJ Nutrition, Prevention & Health, warns that individuals who favor plant-based and vegan diets may be lacking in choline, a nutrient essential for brain health.

Found predominantly in animal food, choline is particularly critical during fetal development. In addition to supporting cognitive health, it also influences liver function, with shortfalls linked to irregularities in blood fat metabolism as well as excess free radical cellular damage, writes nutritionist Emma Derbyshire of Nutritional Insight, a consultancy specializing in nutrition and biomedical science.

The primary dietary sources of choline are beef, eggs, dairy products, fish, and chicken, with much lower levels found in nuts, beans, and cruciferous vegetables, such as broccoli. Although choline is an essential dietary nutrient, the amount produced by the liver is not enough to meet the requirements of the human body.

In 1998, recognizing the importance of choline, the U.S. Institute of Medicine recommended minimum daily intakes. These range from 425 mg/day for women to 550 mg/day for men, and 450 mg/day and 550 mg/day for pregnant and breastfeeding women, respectively, because of the critical role the nutrient has in fetal development. In 2016, the European Food Safety Authority published similar daily requirements. Yet national dietary surveys in North America, Australia, and Europe show that habitual choline intake, on average, falls short of these recommendations.

Derbyshire finds the information on shortfalls “concerning given that current trends appear to be towards meat reduction and plant-based diets.” In light of the fact that choline is presently excluded from UK food composition databases, major dietary surveys, and dietary guidelines, she suggests that it may be time for the UK government’s independent Scientific Advisory Committee on Nutrition to consider including choline as part of UK Dietary Guidelines.

“More needs to be done to educate healthcare professionals and consumers about the importance of a choline-rich diet, and how to achieve this,” she writes. “If choline is not obtained in the levels needed from dietary sources per se, then supplementation strategies will be required, especially in relation to key stages of the life cycle, such as pregnancy, when choline intakes are critical to infant development.”

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