Reviewed by nutritionist Jessica Ball, MS, RD
Design elements: Getty Images. Eddingwell Design.
Main points
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Choline is an essential micronutrient for a healthy brain and nervous system.
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Low blood choline levels are associated with a higher risk of Alzheimer’s disease.
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Choline is found in seafood, meat, dairy products, nuts, potatoes, legumes and whole grains.
Choline is an underrated micronutrient that we rarely hear about—in fact, most Americans don’t get enough choline. But every nutrient, no matter how tiny, is essential – and choline is no exception. It is necessary for a healthy brain and nervous system, helps regulate mood, memory and muscle control, and is also critical for forming the membranes that surround cells. It is also crucial for proper brain development of babies in utero and after birth.
In addition to being undervalued, choline is also a commonly deficient nutrient. Lack of this micronutrient comes with several potential hazards. For example, a recent study showed that low choline intake is associated with a higher risk of dementia, including Alzheimer’s disease, the most common form of dementia.
Researchers from across Arizona, including Arizona State University and the Mayo Clinic in Arizona, set out to further elucidate the link between choline and Alzheimer’s disease. They published their findings aging and disease. Let’s break down their findings.
How was this research conducted?
The researchers wanted to compare choline levels in obese people with those in people with a healthy body mass index. Previous research has shown that obese people tend to have lower blood choline levels, they said. They also note that obesity is linked to insulin resistance, a condition that predisposes people to type 2 diabetes. Insulin resistance is also a major risk factor for Alzheimer’s disease.
A total of 30 participants aged 29 to 36 years were recruited for this study: 15 (7 men, 8 women) with a BMI considered healthy (18.5 to 24.9 kg/m2) and 15 (8 men, 7 women) with a BMI considered obese (>30 kg/m2). All participants were deemed healthy based on medical history, routine physical examination, electrocardiogram, standard blood tests, and urinalysis. None of the participants smoked, had diabetes, or had a history of liver, kidney, or heart disease. They also were not taking any prescription or over-the-counter medications or nutritional supplements, and were not on a weight loss regimen.
Body composition was measured and fasting blood samples were collected. The researchers measured choline levels and factors associated with diabetes, including glucose, glycated hemoglobin and insulin, as well as blood components associated with inflammation and cognitive decline. In addition, liver enzymes were measured, as some liver enzymes can indicate dysfunctional glucose metabolism and cranial nerve damage.
Additionally, the researchers performed autopsies on people known to have mild cognitive decline and Alzheimer’s disease. This allowed them to compare blood levels of the same components in 30 healthy individuals with those with known Alzheimer’s disease and cognitive decline.
What did this study find?
After statistical analysis, the researchers found:
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Obese people have lower blood choline levels, which in turn is associated with poorer metabolic markers.
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Inflammation and liver enzyme markers are elevated in obese people.
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As choline levels in the blood decrease, neurofilament light (NfL), a marker of Alzheimer’s disease, increases. Higher NfL levels indicate damage to brain cells and increase the risk of dementia.
Overall, the researchers found that obesity was associated with reduced blood choline levels, dysregulated inflammatory markers, and elevated markers of metabolic dysfunction. All of these factors are associated with the risk of Alzheimer’s disease.
A major limitation of the study is that dietary intake of choline was not assessed, so the researchers cannot conclude whether obese people consume less choline-rich foods or whether other factors contribute to lower choline levels. The number of participants in this study was considered moderate. Since more participants tend to improve the accuracy of results, the researchers note that larger sample sizes will be helpful in the future. The study also did not include cognitive assessments, so comparisons of blood work between living participants and those with postmortem cognitive decline should be interpreted with caution.
How does this apply to real life?
While you can supplement with choline, we think it’s best to try to get the nutrients through food. Like most nutrients, choline is found in many foods, which is why we recommend eating a variety of foods to ensure you get all the nutrients you need. Choline is found in eggs, beef, poultry, pork, fish and dairy products. Cruciferous vegetables, soybeans (including tofu), shiitake mushrooms, peanuts, wheat germ, almonds, kidney beans, lima beans, sweet potatoes and quinoa are all plant-based sources of choline.
These researchers note that following a Mediterranean diet eating pattern will help ensure you get enough choline. The MIND diet is a fusion of the Mediterranean and DASH diets and is rich in brain-healthy foods containing choline, powerful antioxidants, and healthy fats, including seafood, chicken, berries, whole grains, and leafy green vegetables (to name just a few). To get familiar, try our 30-day MIND cognitive health eating plan. Follow as is or choose a recipe that looks appealing.
Other lifestyle factors also play a role in brain health, including regular physical activity, getting enough quality sleep and reducing stress levels. Your brain also needs water for optimal cognitive function. Even socializing and volunteering can help keep your brain healthy.
Our expert opinion
The study adds to growing evidence linking low blood choline levels to Alzheimer’s disease. It also suggests a link between obesity and low choline, although the researchers admit they can’t yet confidently say why the link exists. Although choline is found in a variety of foods, many people are deficient in it. Evaluate your eating habits and start replacing ultra-processed foods with whole foods, such as seafood, meat, dairy, nuts, eggs, legumes, cruciferous vegetables, potatoes, and whole grains. Following a meal plan designed for cognitive health can help take the guesswork out of it.
Read the original article on EatWell
