How much choline do you need per day?
Studies show that a daily intake of 350–400 mg of choline is associated with better long-term brain health. Most people, and certainly pregnant women and those following a plant-based diet, do not reach that amount.
The official recommendation for choline is called an 'adequate intake' and varies by age and sex. For adult men it is higher than for women, and during pregnancy the need rises further. In practice, only a small minority of the population reaches that threshold. Research from Australia found that fewer than 10% of any age or sex group meets the recommendation. Average intake ranges from around 150 mg per day in young pregnant teenagers to just over 310 mg per day in adult men.
Pregnant women fare worst worldwide: more than 88% do not reach the recommended amount. Several international guidelines, including those of the United States, Canada and Australia, specifically highlight the importance of sufficient choline during pregnancy. There are indications that higher choline levels in the mother are linked to a lower risk of unfavourable pregnancy outcomes, and that supplementation may positively influence a child's cognitive development. That last finding has not yet been conclusively confirmed.
For brain health in later life, studies involving more than 200,000 people show that a daily intake of around 350 to 400 mg is associated with a lower chance of cognitive decline and Alzheimer's disease. Whether choline is the direct cause of this is not known, but the association has been found repeatedly. Similar associations also appear in relation to maintaining muscle strength and independence in older age, and to the risk of urgency incontinence in younger women.
The best dietary source is eggs: people who eat eggs tend to have the highest intake. Those who eat a largely plant-based diet need to pay extra attention: plant-based foods generally contain considerably less choline, making the gap with the recommendation larger. Choline is also found in meat, fish, dairy and nuts, but in smaller amounts than in eggs. If you follow a fully plant-based diet or are pregnant, it is worth consciously estimating your intake and discussing it with your doctor or dietitian if needed.
This answer draws on many studies combined, including a combined analysis of twelve studies on how common choline deficiency is among pregnant women worldwide and an analysis of nine groups of people followed for years, involving more than 200,000 participants, looking at cognition. The evidence on actual intake versus the recommendation is strong; the evidence that choline itself causes the observed health benefits is weaker, because most studies only followed people over time without giving them anything specific. The researchers themselves point to the limited number of studies where something was actively given to participants, particularly in the areas of cognitive development in children and Alzheimer's disease.