The momentum behind a move to plant-based and vegan diets for the good of the planet is commendable, but risks worsening an already low intake of an essential nutrient involved in brain health, warns a nutritionist in the online journal BMJ Nutrition, Prevention & Health.
Choline is an essential dietary nutrient, but the amount produced by the liver is not enough to meet the requirements of the human body.
It is critical to brain health, particularly during foetal development.
It also influences liver function, with shortfalls linked to irregularities in blood fat metabolism, as well as excess free radical cellular damage, writes Dr Emma Derbyshire of Nutritional Insight, a consultancy specialising in nutrition and biomedical science based in the United Kingdom.
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.
In 1998, recognising the importance of choline, the US Institute of Medicine recommended minimum daily intakes.
These range from 425 milligrammes/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 foetal 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,” says Dr Derbyshire.
She commends the first report on this (the EAT-Lancet Commission on Food, Planet, Health) for compiling a healthy food plan based on promoting environmental sustainability, but suggests that the restricted intakes of whole milk, eggs and animal protein it recommends could affect choline intake.
“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 concludes.