You often hear that fish is brain food. True, but so are eggs, pork loin and Brussels sprouts. That's because they're rich in choline, a nutrient related to B vitamins.
"Choline is critically important for a variety of body and brain functions," says Ramon Velazquez, an assistant professor at the Arizona State University-Banner Neurodegenerative Disease Research Center in Tempe. It's part of all cell membranes, and in recent years there's been increasing evidence linking it to better cognitive function and even a lower risk of Alzheimer's disease. But about 90 percent of people don't get enough of it.
The brain needs choline to make acetylcholine, a neurotransmitter. "These [neurotransmitters] are chemicals that build and connect neurons [nerve cells] in the brain and body, and allow them to communicate with each other," says Thomas B. Shea, a professor of biological sciences at UMass Lowell.
Research has found that levels of acetylcholine naturally decline with age and that people with Alzheimer's disease have lower-than-normal levels. "The connection is seen both in age-related cognitive decline and Alzheimer's," Velazquez says. "Lower levels of acetylcholine may affect your ability to form and recall memories, as well as affect word recall and focus." A 2021 study published in Behavioral Neurology found that people who got 188 to 400 mg per day of choline had a 40 percent reduced risk of experiencing low cognitive function than those who got less.
Some research suggests that specific types of choline may be more beneficial than others. For example, in a 2019 study involving almost 500 men, published in the American Journal of Clinical Nutrition, every 50 mg intake per day of phosphatidylcholine was linked to a 10 percent decrease in dementia risk. Eggs were the main source of it in the men's diet. A large egg has 169 mg of choline, about 70 percent of which is phosphatidylcholine.
There's even the potential that increasing choline intake after an Alzheimer's diagnosis may help. "In studies of people with early-stage Alzheimer's disease," Velazquez says, "we've seen that supplementing with choline may slow the progression of the disease."
There are other benefits to making sure that your diet contains plenty of choline. It plays a role in both fat and glucose metabolism. "Not getting enough choline can increase the risk of fatty liver disease, Type 2 diabetes and other metabolic diseases," Velazquez says. Adequate choline may also protect against heart disease and strokes by helping to control the inflammation that contributes to those conditions.
"Your body produces some choline, but it's nowhere near enough to perform all of these critical functions," Velazquez says. The Daily Value for choline is 550 mg, and that needs to come from food or supplements.
"It's not hard to get the choline you need through diet," Shea says. Many foods contain at least some, and there are several that provide substantial amounts (see below). "But sometimes older adults start eating fewer calories or less variety of foods. In that case, supplementation may be in order." Supplements can also be a good idea for people who eat a mostly plant-based diet because many of the foods highest in choline are animal products.
You might not be able to rely on a multivitamin to help meet your choline needs, though; some brands contain little to none of the nutrient. If you're going to take a supplement, Shea recommends choosing one that has about 300 mg. As with any supplement, you should discuss it with your doctor beforehand.
You can find choline in a variety of foods, including:
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