Wallace · Journal of the American College of Nutrition 2016 · Cross-sectional survey analysis · n=16,809

Assessment of Total Choline Intakes in the United States.

Cited 132 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional population survey analysis

PubMed 26886842 · doi:10.1080/07315724.2015.1080127 · record verified 2026-08-26

What was done

Usual dietary choline intakes from foods were evaluated using the National Cancer Institute method applied to 2009–2012 National Health and Nutrition Examination Survey (NHANES) data from 16,809 US residents aged ≥ 2 years. Intakes were compared against the established Dietary Reference Intake Adequate Intake (AI) thresholds.

What was found

Only 10.8 ± 0.6% of participants aged ≥ 2 years achieved the AI for choline (15.6 ± 0.8% of males and 6.1 ± 0.6% of females). The proportion meeting or exceeding the AI decreased markedly with age: 62.9 ± 3.1% in children aged 2–3 years, 45.4 ± 1.6% in children aged 4–8 years, 9.0 ± 1.0% in children aged 9–13 years, 1.8 ± 0.4% in adolescents aged 14–18 years, and 6.6 ± 0.5% in adults aged ≥ 19 years. Across all age groups, males consumed significantly more choline than females.

Why it matters

This study shows that suboptimal dietary choline intake is widespread across most age groups in the US population, especially among adolescents and adults, highlighting a substantial gap between actual consumption and nutritional recommendations.

Limits

The study is observational and cross-sectional, relying on self-reported dietary intake data subject to recall error and reporting bias. Intakes were assessed from foods only without accounting for dietary supplements, and no biochemical markers of choline status or related health outcomes were measured.

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