Choline is one of the few nutrients where the US population is genuinely under-consuming by intake. NHANES data show only 6.6% of US adults aged 19 and above meet the Adequate Intake (Wallace and Fulgoni, J Am Coll Nutr 2016). The shortfall is even larger in adolescents.
That matters because choline is not optional metabolism. It is the precursor for phosphatidylcholine (the major phospholipid in every cell membrane and the carrier that packages VLDL out of the liver), for the acetylcholine that runs cholinergic neurotransmission, and for betaine, a methyl donor that backstops the folate-dependent methylation system.
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