Can vegans get enough choline, and from which foods?

The objection

“Choline is vital for the brain and liver, and the richest sources are eggs, liver and meat. Researchers who analysed US diets concluded that the target is extremely hard to reach without eggs or a supplement, surveys find vegans eating less of it than meat-eaters, and pregnancy, when a baby’s brain is being built, is exactly when a shortfall would matter. A vegan diet simply can’t hit the target.”

The answer

A vegan diet can supply enough choline, but it takes more deliberate choices than a diet with eggs in it, and in pregnancy, since most prenatal multivitamins supply little or none, it means planning choline-rich foods and asking a midwife about a supplement if intake looks low. Choline is an essential nutrient that the body uses to build cell membranes and the neurotransmitter acetylcholine, and although the liver makes some, it doesn’t make enough, so the rest has to come from food [1]. A deficiency can cause muscle and liver damage, including fatty liver disease [1]. Beef liver and eggs are the densest sources, and in the food table of the NIH’s fact sheet, last updated in 2022, a large hard-boiled egg carries 147 mg [1].

Plant foods carry less per portion, but several carry a useful amount. The same table gives 107 mg for half a cup of roasted soya beans, 45 mg for half a cup of canned kidney beans and 43 mg for a cup of cooked quinoa, and the NIH names cruciferous vegetables and certain beans as rich sources, with nuts, seeds and whole grains adding more [1]. An ordinary vegan menu won’t reach the official targets by chance, though. When US Department of Agriculture researchers built a five-day vegan menu from common recipes in 2022, it supplied 314 mg a day, short of the US targets for both women and men, and they noted that foods such as roasted soya beans could be added to close the gap [11]. Favour soya, legumes and cruciferous veg such as broccoli, Brussels sprouts and cauliflower. Using the NIH’s per-serving figures, half a cup of roasted soya beans (107 mg), a cup each of canned kidney beans (90 mg), boiled broccoli (62 mg) and cooked quinoa (43 mg), a large baked red potato (57 mg) and an ounce of toasted wheat germ (51 mg) come to 410 mg between them [1], enough for EFSA’s 400 mg though short of the US figures of 425 mg for women and 550 mg for men [1][2].

How much choline do you need?

The official reference figures for adults run from 400 mg of choline a day in Europe to 425 mg for women and 550 mg for men in the US. The European Food Safety Authority (EFSA) set its figure for all adults in 2016 [2], and the US figures were set in 1998 by the Food and Nutrition Board of the US Institute of Medicine, as the NIH’s fact sheet records [1]. Both are Adequate Intakes, the kind of figure set when the evidence is too thin to work out an average requirement [1][2], and the authors of the US survey analysis cited below point out that without one it is hard to tell whether eating less than the Adequate Intake harms health [4].

According to EFSA, the US figures rest on a single 1991 trial in 16 healthy men housed in hospital, an estimate the US panel itself called uncertain, while EFSA took the midpoint of the range of average intakes in healthy European populations, about 370 mg a day, and weighed it against a depletion and repletion study [2].

Who	EFSA (2016) [2]	US (1998) [1]
Adults	400 mg a day	425 mg (women), 550 mg (men)
Pregnancy	480 mg	450 mg
Breastfeeding	520 mg	550 mg

For children the US figures rise with age: 200 mg a day at 1 to 3 years, 250 mg at 4 to 8, 375 mg at 9 to 13, and at 14 to 18, 400 mg for girls and 550 mg for boys [1]. The US panel couldn’t set an upper limit for babies for lack of data, and the NIH says breast milk, formula and food should be their only sources of choline [1].

Need also varies from person to person. The NIH lists folate, betaine and methionine in the diet among the things that change it, along with sex, pregnancy and common gene variants, one of which, in the PEMT gene, reduces the extra choline that oestrogen prompts women’s bodies to make [1]. It says the need for choline rises when folate runs short, because choline then becomes the main methyl donor [1]. EFSA describes a 1999 feeding study in 21 adults in which an adequate folate intake kept plasma choline steady on choline intakes of about 150 to 250 mg a day [2]. Vegetarians and vegans eat more folate than meat-eaters, as a 2021 systematic review of 141 studies by two Unilever scientists found [3], which may spare some choline, although the 1999 study looked only at plasma choline, a poor guide to the body’s stores [10]. Low vitamin B12 status could pull the other way, since the NIH says it may raise the risk of inadequate choline status in pregnant and breastfeeding women, as going without folic acid supplements does [1].

Do vegans get less choline than meat-eaters?

Vegans eat less choline than meat-eaters on average in the few studies that compare them, though most meat-eaters miss the target too. In a 2017 analysis of US survey data for 2009 to 2014, only 8% of adults reached the Adequate Intake [4]. Adults who had eaten eggs on the first survey day were far more likely to reach it than those who hadn’t (57.3% against 2.4%), and the authors, one of whom was an academic consultant to the Egg Nutrition Center, concluded that the target is extremely difficult to reach without eggs or a supplement [4]. By their figures, the US government’s own Healthy US-Style eating pattern, meat included, supplies 349 mg at 2,000 kcal a day [4].

A 2024 review found intakes no higher than 80% of EFSA’s figure in most European studies published after 2015, and only one study comparing vegetarians with meat-eaters [5]. That study and two published since point the same way. The figures are daily intakes, medians in the German studies, and the Israeli abstract doesn’t say which average it used.

Study	Plant eaters	Comparison group
Germany, 2022: 283 pregnant women [6]	205 mg (vegetarians and vegans together)	270 mg (meat-eaters)
Germany, 2025: 108 healthy adults [12]	257 mg (vegans)	329 mg (meat-eaters)
Israel, 2026: 230 pregnant women [7]	270 mg (vegans)	394 mg (all non-vegans)

The 2022 survey was done online, and its questionnaire left out meat and dairy alternatives, which its authors say may have understated the plant eaters’ intake [6]. The 2025 study counted food alone from four-day weighed diaries and found 237 mg in vegetarians [12], while the Israeli women reported their diets in the third trimester and were compared with all non-vegans [7]. That observational study’s main finding was a higher rate of small-for-gestational-age babies among the vegan mothers, which its authors suggest may be partly related to their lower protein intake (60 g a day against 82 g), and it found lower intakes of vitamin B12, vitamin D, calcium and DHA as well as choline [7]. All three are small, but with the US figures they suggest that reaching the target on plants takes deliberate choices or a supplement.

Trial evidence points the same way. In a 2026 Finnish trial, 102 healthy men were split at random between keeping red meat at about 760 g a week and cutting it to 200 g with non-soy legumes in its place, and after six weeks the legume group had lower levels of choline compounds in their plasma [15]. The legume group still ate some meat, and soya, the richest legume in the NIH’s table [1], was left out, so the trial says more about swapping meat for beans than about a planned vegan diet [15].

Should vegans take choline in pregnancy or while breastfeeding?

In pregnancy the target rises (EFSA puts it at 480 mg a day, and 520 mg while breastfeeding) [2] and very few women of any diet reach it, so a vegan who is pregnant or breastfeeding should plan choline-rich foods into meals often and, if intake still looks low, ask a midwife, GP or dietitian about a separate supplement, since most pregnancy multivitamins contain little or no choline [1][18]. Among plant foods, Ireland’s health service, the HSE, lists edamame, broccoli, Brussels sprouts, peas, cauliflower, shiitake mushrooms and navy or pinto beans as sources [18], and the label of any multivitamin shows whether it adds choline at all. The NIH puts the share of pregnant women eating less than the US figure at 90% to 95% [1], and only 7% of the women in the German survey reached EFSA’s [6].

When USDA researchers modelled the US government’s healthy vegetarian eating pattern for breastfeeding women in 2023, the standard version with eggs and dairy and all four adaptations, vegan included, fell short of the US choline target even with a typical prenatal supplement added, and the researchers noted that such supplements don’t generally provide choline [8]. Their 2025 models for pregnancy found that the vegan and vegetarian versions could supply most nutrients, with challenges similar to those of diets that include meat, but choline stayed among the few nutrients below recommendations even with a prenatal supplement added [13]. Breast milk itself seems to hold up: a 2020 US study of 74 breastfeeding women, each giving a single sample, found no difference in its water-soluble choline between vegans, vegetarians and meat-eaters [9].

Whether extra choline in pregnancy helps the child is still unsettled. A 2024 rapid review by the Canadian Agency for Drugs and Technologies in Health found mixed evidence on children’s development when healthy pregnant people took choline supplements and little to no difference in safety outcomes, and it noted that the guidelines urging all pregnant people, vegans included, to raise their intake rest mostly on low-quality evidence or expert opinion [14]. A 2025 systematic review of four trials and five observational studies came to a similar conclusion, that the evidence can neither support nor refute the idea that more choline in pregnancy improves a child’s neurodevelopment [16]. Whether too little does harm is a separate question, and a 2023 scoping review written for the Nordic Nutrition Recommendations judged that observational studies in people, supported by intervention studies and animal experiments, strongly suggest that enough choline in pregnancy is necessary for normal brain development in the child [17].

Choline supplements usually provide 10 to 250 mg [1], far below the US upper limit for adults of 3,500 mg a day, which was set to avoid the low blood pressure and fishy body odour seen at much higher intakes [1]. The NIH also notes that choline raises the body’s production of TMAO, a compound linked to a higher risk of cardiovascular disease, in a dose-dependent way in adults. Several large observational studies it describes found no link between choline intake and cardiovascular disease, though a later one found a higher risk of death among people eating more choline [1]. It says choline is not known to have any clinically relevant interactions with medicines [1].

How common is choline deficiency?

Outright choline deficiency is very rare in healthy men and non-pregnant women, the NIH says, even though most Americans eat less than the Adequate Intake, possibly because the body makes some of its own [1]. The authors of the 2025 German food-diary study above concluded that there is no evidence that a healthful plant-based diet leads to choline deficiency, and that the need for plant-based eaters to raise their intake is far from proven [12].

A randomised trial in 72 healthy vegans in Germany, published in 2025, gave about half of them a set of supplements that included a soya lecithin powder supplying about 320 mg of choline a day, and the rest placebos, for four months [10]. At the start, only 54% to 57% of the vegans in each group had plasma choline within or above the laboratory’s reference range, so nearly half were below it, yet four months on the supplements did not raise it significantly more than the placebos did [10]. The authors suggest the vegans’ diets may already have supplied enough, but plasma choline doesn’t reliably track intake or the body’s stores, only 54% to 60% of each group took the powder every day as instructed, and the trial was mainly funded by a company that markets the multinutrient supplements [10]. They also write that it is not yet fully established that choline is a critical nutrient for vegans, and with plasma choline so unreliable a marker, their trial reassures without settling the question [10].