People who have switched to a plant-based, vegan diet are at risk for a deficiency in choline, an essential dietary nutrient extremely important for brain health, according to a U.K. nutritionist who published her paper in the journal BMJ Nutrition, Prevention & Health.
In the article, author Dr. Emma Derbyshire said that, to make matters worse, the U.K. government has failed to recommend or monitor dietary levels of choline, which is found predominantly in animal foods.
Choline is critical to brain health, particularly during fetal development. It also influences liver function, with deficiencies linked to irregularities in blood fat metabolism as well as excess free radical cellular damage, writes Derbyshire.
The primary sources of dietary choline are found in beef, eggs, dairy products, fish, and chicken, with much lower levels found in nuts, beans, and cruciferous vegetables, such as broccoli. The amount of choline 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.
“This is….concerning given that current trends appear to be towards meat reduction and plant-based diets,” said Derbyshire.
She commended the first report (EAT-Lancet) for compiling a healthy food plan based on promoting environmental sustainability, but says that the restricted intakes of whole milk, eggs and animal protein it recommends could affect choline intake.
And she is at a loss to understand why choline does not feature in U.K. dietary guidance or national population monitoring data.
“Given the important physiological roles of choline and authorisation of certain health claims, it is questionable why choline has been overlooked for so long in the UK,” she writes. “Choline is presently excluded from UK food composition databases, major dietary surveys, and dietary guidelines,” she adds.
According to Derbyshire, it may be time for the U.K. government’s independent Scientific Advisory Committee on Nutrition to reverse this, particularly given the mounting evidence on the importance of choline to human health and growing concerns about the sustainability of the planet’s food production.
“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,” she said.
Derbyshire is a public health nutritionist who runs a London-based health consultancy called Nutritional Insight.