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Choline

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Note that we want only enough information to convincingly support the assertion and counter inaccurate information. When making a point, it is important to find those sources that will result in the most convincing arguments, and to summarize findings in the most convincing manner, all without misrepresenting or exaggerating those sources.

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Is there research showing that vegans are generally not deficient in choline, or that non-vegans are?

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Fact Sheet

Assertion

  • This fact sheet supports the assertion that choline from animal sources is not necessary and may be harmful to health.

Context

  • <-- Put the article in context. State that there is confusion and the source/sources of the confusion. See Grazing's context section -->
  • In general, the nutrient choline is most highly concentrated in animal-derived foods such as eggs and meat.[1] This has led to claims that vegans are at risk of becoming deficient in choline.
  • A 2019 opinion piece published in the journal BMJ made headlines by expressing concern about choline deficiency in those eating plant-based diets. However, the author has ties to the egg and meat industries.[2]

Research

  • Choline produces a byproduct called TMAO in the body. A study in the New England Journal of Medicine found that TMAO increases the likelihood of stroke, heart disease, and even death. The study recommends that excess choline intake should be avoided and suggests that a high-fiber or vegetarian diet is an effective way to do this.[3]
  • Another study also found that high choline intake is linked to heart disease, but noted that vegans and vegetarians are protected from its effects.[4]
  • Egg consumption has been linked to an increased risk of prostate cancer, and researchers suggest that choline may be the culprit.[5][6][7]
  • TMAO has also been linked to chronic kidney disease.[8][9]
  • In some people, excess choline consumption causes a strong fishy body odor, including the breath, urine, and sweat.[10]

Conflicting Information

  • <-- if there are articles or research that contradicts the assertion, state them and their weaknesses. -->

Other Sources

  • <-- expert testimony from prestigious or credentialed people or organizations -->
  • The National Institutes for Health (NIH) states that cruciferous vegetables and some beans are "rich in choline." It shows that soybeans contain more choline than ground beef, chicken breast, or cod, while mushrooms and potatoes contain more than tuna and dairy products. Quinoa, wheat germ, and kidney beans are also good sources.[1]

See Also

Plain Text

Footnotes

  1. ↑ 1.0 1.1 “Office of Dietary Supplements - Choline.” Accessed January 20, 2020. https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/.
  2. ↑ Derbyshire, Emma. “Could We Be Overlooking a Potential Choline Crisis in the United Kingdom?” BMJ Nutrition, Prevention & Health 2, no. 2 (December 1, 2019): 86–89. Accessed January 20, 2020. https://doi.org/10.1136/bmjnph-2019-000037.
  3. ↑ Tang, W.H. Wilson, Zeneng Wang, Bruce S. Levison, Robert A. Koeth, Earl B. Britt, Xiaoming Fu, Yuping Wu, and Stanley L. Hazen. “Intestinal Microbial Metabolism of Phosphatidylcholine and Cardiovascular Risk.” New England Journal of Medicine 368, no. 17 (April 25, 2013): 1575–84. Accessed January 20, 2020. https://doi.org/10.1056/NEJMoa1109400.
  4. ↑ Zhu, Weifei, Zeneng Wang, W. H. Wilson Tang, and Stanley L. Hazen. “Gut Microbe-Generated Trimethylamine N -Oxide From Dietary Choline Is Prothrombotic in Subjects.” Circulation 135, no. 17 (April 25, 2017): 1671–73. Accessed January 20, 2020. https://doi.org/10.1161/CIRCULATIONAHA.116.025338.
  5. ↑ Richman, Erin L, Stacey A Kenfield, Meir J Stampfer, Edward L Giovannucci, Steven H Zeisel, Walter C Willett, and June M Chan. “Choline Intake and Risk of Lethal Prostate Cancer: Incidence and Survival.” The American Journal of Clinical Nutrition 96, no. 4 (October 1, 2012): 855–63. Accessed January 20, 2020. https://doi.org/10.3945/ajcn.112.039784.
  6. ↑ Richman, E. L., S. A. Kenfield, M. J. Stampfer, E. L. Giovannucci, and J. M. Chan. “Egg, Red Meat, and Poultry Intake and Risk of Lethal Prostate Cancer in the Prostate-Specific Antigen-Era: Incidence and Survival.” Cancer Prevention Research 4, no. 12 (December 1, 2011): 2110–21. Accessed January 20, 2020. https://doi.org/10.1158/1940-6207.CAPR-11-0354.
  7. ↑ Richman, Erin L, Meir J Stampfer, Alan Paciorek, Jeanette M Broering, Peter R Carroll, and June M Chan. “Intakes of Meat, Fish, Poultry, and Eggs and Risk of Prostate Cancer Progression.” The American Journal of Clinical Nutrition 91, no. 3 (March 1, 2010): 712–21. Accessed January 20, 2020. https://doi.org/10.3945/ajcn.2009.28474.
  8. ↑ Moraes, Cristiane, Denis Fouque, Ana Claudia F. Amaral, and Denise Mafra. “Trimethylamine N-Oxide From Gut Microbiota in Chronic Kidney Disease Patients: Focus on Diet.” Journal of Renal Nutrition 25, no. 6 (November 2015): 459–65. Accessed January 20, 2020. https://doi.org/10.1053/j.jrn.2015.06.004.
  9. ↑ Tang, W.H. Wilson, Zeneng Wang, David J. Kennedy, Yuping Wu, Jennifer A. Buffa, Brendan Agatisa-Boyle, Xinmin S. Li, Bruce S. Levison, and Stanley L. Hazen. “Gut Microbiota-Dependent Trimethylamine N -Oxide (TMAO) Pathway Contributes to Both Development of Renal Insufficiency and Mortality Risk in Chronic Kidney Disease.” Circulation Research 116, no. 3 (January 30, 2015): 448–55. Accessed January 20, 2020. https://doi.org/10.1161/CIRCRESAHA.116.305360.
  10. ↑ Rehman, H. U. “Fish Odour Syndrome.” Postgraduate Medical Journal 75, no. 886 (August 1, 1999): 451–52. Accessed January 20, 2020. https://doi.org/10.1136/pgmj.75.886.451.

Meta

This fact sheet was originally authored by Greg Fuller and copyedited by Isaac Nickerson. The contents may have been edited since that time by others.

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