Why choline belongs in a brain friendly diet

If you’re eating for brain health, your regular menu will likely be home to polyphenol-packed berries, lutein-rich leafy greens, and omega-3 oily fish.

But your list may be missing foods rich in choline, such as soybeans, eggs, red potatoes, and beans. Adequate intake of a B vitamin that is similar to B vitamins is associated with improved cognitive performance and, more recently, a lower risk of Alzheimer’s dementia.

Here’s what to know about these under-consuming nutrients and their benefits for brain health and beyond — and how to get enough in your diet.

Choline Basics

Although not a vitamin, choline is grouped with B vitamins due to some of their similar functions. While the liver produces a small amount of choline, most of the choline in the body must come from the diet.

Choline is vital for the proper functioning of the brain and nervous system. It is used to build strong cell membranes and the lipid sheath that protects nerve fibers.

Choline is also needed to produce acetylcholine, a brain chemical (neurotransmitter) important for memory, mood, circadian rhythm, and muscle control.

Getting enough choline also helps keep your liver healthy.

Choline and brain health

Choline plays an important role in early brain development. Some, but not all, studies have found that higher (versus lower) choline intake during pregnancy is associated with cognitive benefits in toddlers and young children.

Two large observational studies have also linked higher choline intakes to better performance on memory tasks in healthy adults.

The effect of choline on dementia risk, however, was not clear. a Great study outside Finland in 2019 reported a significantly reduced risk of dementia with increased intake of phosphatidylcholine, the most common source of choline in the diet.

New study Published August 2 in the American Journal of Clinical NutritionExamine the association between choline intake and risk of Alzheimer’s dementia among 3,224 adults. The participants, with an average age of 55, were followed for 16 years.

A daily choline intake of less than 216 mg was associated with an increased risk of Alzheimer’s dementia compared with intake between 216 mg and 552 mg. The researchers accounted for risk factors such as age, gender, education, body mass index, dietary pattern, alcohol consumption, smoking and physical activity.

Choline and Liver Health

Choline is essential for transporting fats stored in the liver to other parts of the body where it is used for energy and other functions. Without choline, fat and cholesterol build up in the liver and can lead to nonalcoholic fatty liver disease (NAFLD).

It is not known to what extent suboptimal choline intake contributes to NAFLD in healthy people. An observational study from China from 2014 linked lower choline intake to an increased risk of NAFLD in both men and women.

A 2012 US study from Johns Hopkins University School of Medicine showed that insufficient choline intake was associated with more cirrhosis in postmenopausal women. Nonalcoholic fatty liver cirrhosis occurs when excessive amounts of scar tissue build up in the liver.

Little data is available on the use of choline for the treatment of nonalcoholic fatty liver.

How much, which foods

Choline intake recommendations are based on preventing liver damage.

For adults 19 years of age or older, males are advised to consume 550 mg of choline per day; Females should get 425 mg. During pregnancy and breastfeeding, increase the recommended daily choline intake to 450 mg and 550 mg, respectively.

The richest sources of dietary choline are animal foods including eggs (147 mg per large yolk); beef (117 mg per three ounce serving); chicken (72 mg per three ounce serving); salmon (77 mg per three ounce serving); and cod (71 mg per three ounce serving). Milk and yogurt provide about 40 mg per cup.

Vegetarian sources include soybeans (107 mg per ½ cup), kidney beans (51 mg per ½ cup), chickpeas, red potatoes, quinoa, Brussels sprouts, broccoli, shiitake mushrooms, cauliflower, peanuts, and green peas.

Who is at risk of getting too little

Most adults in the United States consume less than the recommended daily intake of choline. There is no consumption data for Canadian adults, but studies show that pregnant women and young children are not getting enough.

Pregnant women are especially at risk for choline deficiency, whether because they eat too little of the food or because their prenatal vitamin supplements contain little or no choline.

About Choline Supplements

A varied diet should provide enough choline for most people. However, pregnant women and people who follow a vegan diet may benefit from supplementation.

Choline supplements are available such as citicoline, choline chloride, and choline bitartrate. Phosphatidylcholine supplements contain only 13 percent of choline by weight.

As always, consult your healthcare provider about using supplements safely.

Leslie Beck, a Toronto-based private dietitian, is Medcan’s director of food and nutrition. Follow her on Twitter Tweet embed

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