Key Takeaways
Choline supports brain health through acetylcholine production, a neurotransmitter linked to memory, attention, and communication between brain cells.
Higher choline intake is linked to better mental health outcomes, including improved mood and fewer markers of brain aging.
Most people don’t get enough, but it’s fixable through diet.
When we think of nutrition and mental health, a few familiar nutrients come to mind: omega-3 fatty acids, vitamin D, and probiotics. These well-researched supports can help turn around a sour mood or low motivation, but prioritizing only these nutrients can cause deficits in other areas.
There’s another essential nutrient that many people don’t immediately associate with mental health—and you may not even recognize it: choline. We asked registered dietitians to explain why this underrated nutrient deserves more attention, what happens to your brain when you’re not getting enough of it, and how to eat more of it.
Meet the Experts
Eric Ciappio, PhD, RD, registered dietitian and senior manager of nutrition science at Balchem Human Nutrition & Health
Erin Clifford, JD, LPC, NBC-HWC, certified wellness coach, licensed professional counselor, and author of Wellness Reimagined: A Holistic Approach to Health, Happiness, and Harmony
Kelly Gonderman, PsyD, licensed clinical psychologist and clinical director at We Conquer Together
Chacha Miller, RD, LDN, maternal and pediatric registered dietitian and founder of The Cardamom Nutrition, LLC
Related: Here’s What Happens When You Eat Broccoli Every Day, According to Registered Dietitians
The Nutrient You Didn’t Know Your Brain Needed
Experts think choline deserves more attention in the mental health world. “One underrated nutrient that supports mental health is choline,” says Erin Clifford, JD, LPC, NBC-HWC, certified wellness coach and licensed professional counselor. “Choline helps regulate mood and brain cell repair, which reduces anxiety responses.” It’s found in every cell in your body, and according to Clifford, it is crucial for brain health because it is responsible for producing acetylcholine, a chemical that helps send messages from the brain to the body.
According to the clinicians we spoke to, the general lack of awareness around choline and its function is common. “A nutrient I don’t hear discussed enough in the mental health context is choline,” says Kelly Gonderman, PsyD, licensed clinical psychologist and clinical director at We Conquer Together. “Most people have never heard of it, but it’s critical for memory, attention, and mood regulation.”
Chacha Miller, RD, LDN, maternal and pediatric registered dietitian and founder of The Cardamom Nutrition, LLC, did the majority of her graduate research on choline and worked closely with Dr. Steven Zeisel, one of the physicians responsible for the discovery of choline as an essential nutrient. That background has shaped how she thinks about its role across the lifespan.
“Choline is an incredibly important nutrient at all stages of life for brain health, but particularly during pregnancy and early infancy as the brain develops,” Miller says. “It’s estimated that 90% of the population doesn’t get enough choline, but it is fairly accessible and easy to fit into the diet.” So what exactly is choline doing behind the scenes to support brain health?
The Science Behind How Choline Improves Brain Health
While research on choline is ongoing, current evidence highlights its importance for brain health. “There is actually a lot of really robust research to support the benefit of choline for brain health,” Miller says. “Choline has been shown to help slow cognitive decline and has been linked to improvements in both memory and mood.” One study she cites used dietary data and brain scans to evaluate the impact of choline intake on brain aging. The results show that higher choline intake was associated with better verbal and visual memory, along with lower levels of white matter hyperintensities, a marker of brain aging.
As far as anxiety goes, Clifford points to research published in Molecular Psychiatry that analyzed data from 25 studies. It compared the levels of neurometabolites (chemicals produced during brain metabolism) in people with anxiety disorders to people without anxiety. “They found the levels of choline are approximately 8% lower in those with anxiety disorders,” she explains. “The evidence for low choline was especially consistent in the prefrontal cortex, the part of the brain that helps control thinking, emotions, and behavior.” The science suggests that nutritional interventions or supplementation may help restore brain chemistry and reduce anxiety symptoms.
Choline intake has also been associated with depression outcomes. “Using data from over 12,900 U.S. adults, researchers found that dietary choline intake was inversely associated with depressive symptoms,” Gonderman says. “The highest intake quintile showed roughly 43% lower odds of depression compared to the lowest.” While much of this research isn’t causal (meaning it shows associations rather than direct cause-and-effect), the mechanism is well understood. “Choline promotes memory, mood, muscle control, and many more cellular functions,” says Eric Ciappio, PhD, RD, registered dietitian and senior manager of nutrition science at Balchem Human Nutrition & Health. “Our bodies produce naturally small amounts of choline, but nowhere near the recommended levels we need for peak performance.” Without enough choline, neurons have less substrate available to synthesize acetylcholine, which can impair signaling involved in encoding new memories and maintaining attention.
How to Get More Choline in Your Diet
For many people, low choline intake isn’t intentional. (It’s hard to prioritize a nutrient that rarely comes up in everyday nutrition conversations.) And while Miller notes that up to 90% of people fall short, some groups are at even greater risk of critically low intake. “Choline intake is particularly relevant for clients who are avoiding eggs and meat, since those are the primary dietary sources,” Gonderman says. “I raise this frequently with clients in eating disorder recovery who have been restricting animal products for years and arrive with significant cognitive symptoms.”
Clifford thinks the issue often comes down to overall diet quality. “Many people don’t get enough choline because the standard American diet tends to include more processed foods and fewer nutrient-dense whole foods,” she says. “Choline is mostly found in animal foods like eggs, beef, fish, milk, and chicken, but is also in soybeans, peanuts, and some vegetables like broccoli.”
Miller recommends eating more eggs since they are one of the most accessible sources of choline (one large egg contains about 150 mg of choline). “Organ meats, cauliflower, red potatoes, and soy-based foods are also good options when eggs aren’t available or preferred,” she says, adding that the average adult needs about 425-500 mg of choline daily.
Read the original article on Real Simple