Why choline belongs in a brain-friendly diet

If you are eat for brain healthyour regular menu likely includes polyphenol-packed berries, lutein-rich green leafy vegetables, and omega-3s from oily fish.

But your menu may be missing choline-rich foods like soy, eggs, red potatoes, and kidney beans. Getting enough of this B-like vitamin has been linked to better cognitive performance and, recently, a lower risk of Alzheimer’s dementia.

Here’s what you need to know about this under-consumed nutrient and its benefits for brain health and beyond, and how to get enough of it in your diet. diet.

hill basics

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

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

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

An adequate intake of choline also helps maintain liver health.

Choline and brain health

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

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

However, the effect of choline on dementia risk has been unclear. A large study outside Finland in 2019 reported a significantly lower risk of dementia with higher intake of phosphatidylcholine, the most common source of choline in the diet.

a new study, published August 2 in the American Journal of Clinical Nutrition, examined the link between choline intake and the risk of developing Alzheimer’s dementia among 3,224 adults. The participants, with an average age of 55 years, 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 an intake between 216 mg and 552 mg. The researchers took into account risk factors such as age, gender, education, BMI, dietary pattern, alcohol consumption, smoking and physical activity.

Choline and liver health

Choline is essential for transporting fat 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 non-alcoholic fatty liver disease (NAFLD).

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

A 2012 US study by the Johns Hopkins School of Medicine showed that inadequate choline intake was associated with more liver fibrosis in postmenopausal women. Fibrosis occurs in NAFLD when excessive amounts of scar tissue build up in the liver.

Few data are available on the use of choline to treat NAFLD.

How much, what foods

Choline intake recommendations are based on the prevention of liver damage.

For adults over the age of 19, it is recommended that men consume 550 mg of choline daily; women should receive 425 mg. During pregnancy and lactation, the recommended daily intake of choline increases to 450 mg and 550 mg, respectively.

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

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

Who is at risk of receiving too little?

Most American adults consume less than the recommended daily intake of choline. There are no consumption data for Canadian adults, but studies suggest that pregnant women and young children do not consume enough.

Pregnant women are at particular risk for choline deficiency, both because they consume too little from food and because prenatal multivitamin supplements contain little or no choline.

About Choline Supplements

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

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

As always, consult your health care provider about the safe use of supplements.

Leslie Beck, a Toronto-based private practice dietitian, is director of food and nutrition at Medcan. Follow her on Twitter @LeslieBeckRD