The Hidden Nutrient Deficiency Impacting 90% of Americans: Why Choline Matters for Your Brain and Body

Imagine if a nutrient so essential that your brain, liver, and nervous system depend on it was under-recognized, under-consumed, and quietly undermining your health. That is the case with choline, a compound often overshadowed by vitamins and minerals, but one whose deficiency may be hurting far more people than we realize.

The Scale of the Problem: A Nutrient Gap Nobody Talks About

• Nutrition Today called choline “underconsumed and underappreciated,” with the majority of Americans falling short of recommended levels [1].
  
• National survey data (NHANES) suggest that about 90 percent of Americans do not reach the adequate intake for choline [2].
  
• Today’s Dietitian reports that only 8 percent of adults meet or exceed recommended levels [3].
  
• A European study found a mean intake of about 287 milligrams per day, when many adults require 425 to 550 milligrams depending on sex and life stage [4].

Taken together, the evidence points to a large and systemic deficiency, one that does not get the same public health attention as Vitamin D or Omega-3.

Who is Most Vulnerable and Why It Matters

1. Pregnant and Expectant Mothers

• A study from the Brain & Behavior Research Foundation found that 54 percent of pregnant women were deficient in choline based on blood levels [5].

• Stanford University research analyzing 180,000 blood samples linked low maternal choline with a higher risk of neural tube and brain development defects [6].

• Preclinical models confirm that maternal choline deficiency can disrupt fetal brain development, altering neurogenesis and vascular growth [7].

Despite this evidence, choline is rarely emphasized in prenatal care. Most doctors and prenatal supplement guidelines focus on EPA and DHA for brain and eye development, but choline is often overlooked or not even discussed. This leaves many expectant mothers unaware that their diets may not provide enough of this critical nutrient for both their own health and their baby’s development.

2. Individuals Recovering from Traumatic Brain Injury (TBI)

Traumatic brain injuries affect millions of people every year, with long-term impacts on memory, focus, and daily functioning. Recovery is complex and often focuses on rehabilitation therapies, rest, and sometimes medications that address symptoms like headaches or mood changes. Yet one area that receives far less attention is nutritional support for brain repair.

• NIH reviews indicate that citicoline (CDP-choline) can reduce neuronal loss after injury, decrease lesion volume, and support functional recovery [8].

• Clinical trials continue to test whether citicoline improves working memory and cognitive outcomes in TBI survivors [9].

• Mechanistic studies suggest citicoline supports brain healing by restoring phospholipid membranes, reducing inflammation, stabilizing mitochondria, and promoting neuroplasticity.

Despite this evidence, nutritional interventions like choline are rarely prioritized in TBI recovery protocols. Doctors and rehabilitation teams often focus on physical therapy, medications, and symptom management, while overlooking the biochemical building blocks the brain requires to repair itself. For many patients, this means an opportunity for added support goes unexplored.

3. Vegans and Vegetarians

Plant-based diets can provide many health benefits, but one of their hidden challenges is supplying enough choline. Because the richest sources are animal-based foods like eggs, fish, poultry, and liver, individuals who avoid these foods are far more likely to fall short of recommended intake levels.

• Nutrition Today highlights that vegetarians and vegans have among the lowest choline intakes of any dietary group [2].

• Data shows that the average intake for vegetarians is about 192 milligrams per day, which is less than half of the adequate intake recommendation of 425 milligrams for women and 550 milligrams for men [2].

Although plant foods like broccoli, Brussels sprouts, beans, and peanuts contain some choline, the amounts are relatively small. It would require very large daily servings of these foods to meet adequate intake through plants alone.

Despite this, nutrition conversations for vegans and vegetarians often center on protein, vitamin B12, iron, and omega-3 fats. Choline is rarely mentioned, even though deficiency can influence cognitive health, liver function, and long-term brain performance.

This lack of awareness has consequences. Without enough choline, individuals following plant-based diets may experience issues with memory, focus, and energy, and over time may also be at greater risk for fatty liver disease or impaired neurological resilience. For those committed to vegan and vegetarian lifestyles, closing the choline gap is essential for protecting both brain and body health.

Why Choline Matters for Brain and Body Function

Choline is not only important for at-risk groups like expectant mothers, individuals recovering from brain injury, or those following plant-based diets. It is essential for everyone because it supports nearly every major system in the body.

• Cognitive Health — Choline is the direct precursor to acetylcholine, the neurotransmitter central to memory, learning, and attention. Without enough choline, acetylcholine production drops, which can show up as brain fog, reduced focus, or slower recall [3].

• Liver and Metabolic Health — Choline plays a critical role in transporting fats out of the liver. Low intake is strongly linked with fatty liver disease, even in people who are not overweight or who do not drink alcohol. Studies show women with higher choline intake have a significantly lower risk of nonalcoholic fatty liver disease [10].
  

• System-Wide Resilience — Beyond the brain and liver, choline contributes to methylation, cell membrane integrity, and energy metabolism. These processes influence how well the body handles stress, repairs tissues, and maintains long-term health [10].

In other words, choline is not a “niche” nutrient. It is a cornerstone for healthy function across the lifespan, and deficiencies ripple out into multiple systems of the body.

What Deficiency Looks Like

Because deficiency is widespread but subtle, people often miss the signs. Symptoms may include:

• Brain fog or difficulty focusing
  

• Slower memory recall

• Persistent fatigue

• Difficulty recovering from injury

• Higher risk during pregnancy for fetal brain and spinal cord concerns

• Potential liver health complications
  
  
  

The Solution: Food First, Then Strategic Support

Food Sources of Choline

The richest dietary sources include:

• Eggs

• Beef liver and other organ meats

• Poultry

• Fish and shellfish

• Dairy products

• Legumes and cruciferous vegetables (lower levels)

Studies confirm that eggs, milk, fish, and bread are the top contributors to choline intake in most populations [4].

Why Food May Not Be Enough

Even if you try to eat a balanced diet, getting enough choline from food alone can be surprisingly difficult. Organ meats and eggs are some of the richest sources, but most people do not eat these foods often enough to meet daily needs.

Modern food processing also makes the problem worse. Research shows that preservatives, additives, and heavy processing can reduce nutrient quality and affect how well your body absorbs what you eat [11]. Even fresh or organic foods can lose nutrients during storage or cooking. This means the gap between what you consume and what your body can actually use is often larger than you realize.

That is why supplementation can play such an important role. Procera® Vital Choline† is formulated with clinically studied forms of choline, using pure and potent ingredients designed for effective absorption. Our formula is also vegan and vegetarian friendly, designed to meet your health needs no matter your dietary preferences. By delivering three highly bioavailable forms in one formula, it helps close the nutrient gap and gives your brain and body the support they need.

Conclusion: Making Choline a Priority

Choline is not a fringe nutrient. It is essential for cognition, recovery, pregnancy, and liver health. Yet more than 90% of Americans do not get enough, which makes this one of the most overlooked health issues of our time.

The good news is that once you understand the gap, you can take action. Through smarter food choices and targeted supplementation, you can support your brain, protect your body, and invest in long-term resilience.

Taking control of your health starts with the nutrients that fuel your foundation. Choline is one of the most important nutrients, and it is never too late to make it a priority. Try Procera® Vital Choline† today!

References:

1. Nutrition Today. Choline: The Underconsumed and Underappreciated Nutrient. 2018.

2. National Health and Nutrition Examination Survey (NHANES); PubMed review on choline intake.

3. Today’s Dietitian. “Choline: An Essential Nutrient With Many Roles.” 2017.

4. Frontiers in Nutrition. “Dietary Choline Intake Across European Populations.” 2021.

5. Brain & Behavior Research Foundation. “Maternal Choline Levels in Pregnancy.”

6. Stanford Medicine. “Low Maternal Choline Raises Risk for Brain and Spinal Defects.”

7. Nutrients (MDPI). “Choline Deficiency Alters Fetal Brain Development.”

8. NIH. Citicoline and Traumatic Brain Injury Review.

9. ClinicalTrials.gov. Citicoline in Traumatic Brain Injury.

10. Linus Pauling Institute, Oregon State University. Micronutrient Information Center: Choline.

11. Better Health Victoria. “Food Processing and Nutrition.”

†These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.