Food sources of choline and their contribution to choline adequacy in U.S. older adults

Choline is an essential nutrient, yet most Americans fail to meet the Adequate Intake (AI). This cross-sectional study investigated dietary choline sources and adequacy among 203 adults ≥ 65 years in the Midwestern U.S. Three-day food records were analyzed using the Nutrition Data System for Research, with choline intake adjusted for energy. Participants were classified into quartiles based on their choline nutrition adequacy ratio (NAR). ANOVA assessed differences in participant characteristics, while food group contributions to total choline intake were normalized within each quartile. Only 10 % of participants met the AI for choline. Choline intake was positively correlated with energy intake ( p < 0.0001), yet choline adequacy was not associated with body mass index, waist circumference, or diet quality. Whole eggs were the largest contributor to choline intake, accounting for 22 % in the highest NAR quartile versus ∼17 % in lower quartiles. These findings highlight the need for targeted dietary strategies to improve choline intake in older adults. While eggs remain the predominant source of choline, combining choline-rich, nutrient-dense foods is key to meeting the AI. For older adults with low caloric intake or following plant-based diets, particularly vegans, prioritizing choline-dense foods or considering supplementation may be necessary to maintain adequate choline status. • Whole eggs were the greatest contributor to choline intake. • Only 10 % met the AI for choline, and just 7 % used supplements with minimal intake. • Choline intake was positively correlated with energy intake. • Choline adequacy was not associated with BMI, waist circumference, or diet quality.