A few days ago, I read a well-written article “The nutrient you didn’t know you were missing, by Christy Brissette; published in the Wellness section of the Washington Post on December 9, 2016. Her article is based upon findings published in the Journal of the American College of Nutrition. You can have free access to the entire study, which found that just slightly under 90% of the American population is not getting an adequate intake of choline. The headline was not really a shock for me; because I believe that many in our country don’t eat a very healthy diet. This article caught my attention because two concepts that I frequently write about came crashing together in the article – ‘nutritionism’ and ‘eating real foods’ (not eating too much highly processed food).

First, let me introduce you to choline, which is probably not well known if you’re not into biology. Usually, we define vitamins as an organic compound that is essential for normal growth and health and cannot be synthesized by the body. Choline is disqualified to be called a vitamin because it is made in the body. But don’t forget vitamin D; it too is made in the body. So who knows? We may eventually add choline to our list of vitamins.

Choline is so important to the unborn baby and the breast fed infant, that the mother’s body ramps up production of choline. The needs are so high for both baby and mother that even with the ‘ramping up’ of production, the mother is often left choline depleted. For those of us who are not pregnant, and that’s most of us, not enough choline is made in the body for optimal health. Therefore, we need to get choline from our food. If we’re eating a healthy diet most of the time, choline is probably not an issue. But if you’re one of 90% of Americans, who have replaced some of the best sources of choline by eating processed food, then you should become familiar with choline and how to increase your intake.

Choline is ubiquitous in the human body. It is part of cell membranes and cell signaling; helps nerves and nerve impulse transmission function properly; plays a role in liver functions, including the transport and metabolism of lipids (fats); and works with folic acid during pregnancy for proper development of a baby’s brain and nervous system.

With this tiny sample of the systems that need choline, you can see why the researchers who have discovered this deficiency are looking at a number of questions of systems that may be affected. One question of choline insufficiency is in brain health and nerve problems. Choline plays a critical role in processing and storing memories. The aging brain is, of course, being studied for links to choline deficiency. So those of us getting to the big numbers on the age line – we eagerly await what they learn in their research. Meanwhile, we can strive to include choline rich foods in our regular menus.

Choline is part of the chemical, acetylcholine, which is needed for nerves to signal muscles; muscles such as the heart. Choline is involved with resting heart rate regulation. Since heart problems are the leading cause of death in the U.S., we want to be sure there’s plenty of choline in our diets. Also, athletes will want to be sure their muscle/nerve connections are operating optimally.

I could write pages of what choline is involved with, but hopefully this is enough to make the point that I want to make here: The reason choline is required throughout the entire body is that it is involved in many, many functions. These functions are at the core of our health. If we are deficient, then we are very likely operating sub optimally.

Just as our bodies use choline broadly; it is available in many foods. If we’re eating a variety of real foods, we’re likely getting an adequate intake of choline for health. If we’re living on ramen and sugary cold cereal (or other highly processed/junk food); or even frequently eat it, then we’re likely risking suboptimal health.

The best sources for choline in food are foods that are not too popular. Many people are unnecessarily afraid to include egg yolks in their diets; so that takes away the best source of choline. Liver is an excellent source also; but unless you eat processed meat, now days, most people don’t eat liver. Personally, I avoid liver and rarely eat processed meat; not because I don’t care for it. But I know that the liver is the body’s filter. An animal’s liver works the same as ours. It is filtering everything that gets into its blood system. So if the animal is fed anything toxic, then it is likely that the toxic substance will be concentrated in the animal’s liver. So even though liver is an excellent source of choline, it can contain harmful toxins. Therefore, I will just pass and get choline from a different source.

The germ portions of grains are a good source of choline. Therefore, seek whole grain products, rather than refined flours that take out the germ. It seems that many people are still eating processed grains. Meat and poultry are probably the most frequently consumed, thus popular sources of choline; unfortunately, they also are generally sources of saturated fat. If you’re cutting back on red meat, consider making fish a choice for a few meals a week. Fish, including shellfish, is a good source of choline.

I’m not exactly sure why Brissette chose to use lima beans in her example of how to eat a meal high in choline. Quite a few people that I know don’t like lima beans. But as it turns out, beans, any kind of beans/legumes, including soybeans are good sources of choline. So the lowly peanut butter (a legume) sandwich (on whole grain, of course) is a nice source of choline. Certainly, tuna sandwich can also deliver a significant amount of choline to your body. Edamame is another fine and fun food that contributes nicely to your choline intake. Nuts and seeds are right up there with beans/legumes. Those who would benefit from the extra choline also miss a good chance to get it when they so frequently shun mushrooms and vegetables. But if you look through the good sources of choline, you will discover many ways to ensure choline intake.

Let me get back to the crashing together of nutritionism and processed food intake. I’ve been writing about nutritionism for years; one of the easiest ways to understand my concern is in the article, Nutritionism: Using a Single Player instead of the Entire Team. The problem with solving the problem of choline insufficiency with supplements added to staple foods, like refined flour and milk, is that it would only be targeted at solving the choline insufficiency problem. This is similar to adding folic acid supplements to foods. This helped the one important problem of certain birth defects and got around the fact that people were not voluntarily eating foods rich in folic acid. But now we discover another problem, choline insufficiency, that can clearly be solved with improved eating. How many more vitamin-like nutrients can we add to staple foods? I realize that many people don’t want whole grains, vegetables, or beans, or nuts, and so on. But it’s not just folic acid and choline, there are hundreds of micronutrients in foods; if we decide to eat a healthier diet, we are likely solving deficiencies and insufficiencies before they are even elucidated. The whole foods already have these hundreds and thousands of micronutrients in them.

One of the first ways of looking at this newly discovered insufficiency, is to get the food processors to enrich their frequently impoverish processed foods with it. That might work for choline, but again, what else is not in the ‘enriched’ food? The all too popular choice of fast, highly processed, and impoverished foods again face a collision with nutritionism. Trying to solve insufficiencies and deficiencies with an added supplement is not your best option. Try a nice tuna or peanut butter sandwich on whole grain bread.