This Underrated Nutrient Could Help Lower Your Dementia Risk by 23%, New

Reviewed by Dietitian Annie Nguyen, M.A., RD

Similar to an automobile, your body requires fuel and specific tools to maintain top performance. From macros—carbs, protein and fats—to vitamins and minerals, your body is dependent on you to supply what it needs to work properly. While you’re likely familiar with popular nutrients, like vitamin C and calcium, there’s one you might not be as in tune with—choline.

Choline is a B-like vitamin, and most of us don’t get enough of it. It’s essential for your brain and nervous system, helping regulate memory, mood, muscle control and more. It’s also vital for the proper brain development of babies in utero.

While your liver can make small amounts of choline, it’s not enough to reach the recommended daily amount needed for good health. That means most of it must come from food or supplements. In 2017, the American Medical Association released a statement promoting choline being added to prenatal vitamins to ensure both pregnant folks and their babies were getting enough. And the American Academy of Pediatrics issued a similar statement in 2018, specifically noting the importance of including brain-building nutrients in the diet, including choline.

But early childhood isn’t the only time choline is necessary. There is mounting evidence suggesting it may play a role in brain health throughout your lifetime. Though there’s plenty more research to be done, the evidence is leaning toward a strong link between a lack of choline and dementia. Researchers in China dug into the data and published their findings in January 2025 in The American Journal of Clinical Nutrition. Here’s what they found.

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How Was This Study Conducted?

For this study, researchers hypothesized that moderate dietary intake of choline would be associated with lower odds of developing dementia and mild cognitive impairment. Mild cognitive impairment (MCI) is a condition in which people have trouble with memory and thinking—even greater trouble than what other people at their age and education level would be expected to have. MCI can lead to dementia, which is more severe memory and thinking problems and includes several conditions. Alzheimer’s disease is one type of dementia.

Data was pulled from the UK Biobank, a long-running database that houses anonymized health information and genetic data on half a million people living in the United Kingdom. For this study, more than 125,000 participants from the database met the inclusion criteria. One of these criteria included having completed a web-based 24-hour food diary at least twice during the 12-year follow-up period. This allowed researchers to determine how much dietary choline and choline-related compounds participants consumed on average. About 56% of the participants were women, and all participants had an average age of 56.

Diagnoses of MCI, Alzheimer’s disease and incident dementia—the number of new cases of dementia during the study period—were also tracked by examining hospital admission records and death certificates.

A subset of participants took cognitive tests at baseline that assessed four areas of cognition: visual attention, fluid intelligence, complex processing speed and episodic memory. Fluid intelligence is being able to think logically and solve problems in novel situations, independent of previous knowledge or experiences.

Typical demographics were collected, including sex, age, socioeconomic status and health information, like BMI, smoking status and physical activity. These also acted as potential confounders that could influence cognition and dementia and were adjusted for during the statistical analyses.

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What Did This Study Find?

Participants were grouped into one of four quartiles based on their consumption of choline, with the first quartile being the group with the lowest intake and the fourth quartile the highest. The average choline intake for each quartile was as follows—here’s how those figures compare to the recommended daily allowance, according to the National Institutes of Health (NIH):

First Quartile: 176 mg per day (41.4% female RDA; 32% male RDA)
Second Quartile: 253 mg per day (59.5% female RDA; 46% male RDA)
Third Quartile: 322 mg per day (75.8% female RDA; 58.6% male RDA)
Fourth Quartile: 465 mg per day (109.4% female RDA; 84.5% male RDA)

For dementia and Alzheimer’s, researchers found a U-shaped association with total choline intake. This means that people at the first and fourth quartiles experienced higher odds of developing dementia or Alzheimer’s. Those with the lowest odds of developing dementia and Alzheimer’s consumed, on average, about 354 mg/day and 338 mg/day of choline respectively. For context, that’s about as much choline as you would get from having two large eggs for breakfast in the morning.

Researchers then examined the relationship between choline-related compounds and dementia. Choline-related compounds are molecules made from choline. They found the second, third and fourth quartiles were associated with 17% to 23% lower odds of dementia compared to the first quartile. This applied to most of the choline-related compounds included in the analysis except the compounds phosphocholine and betaine.

When assessing cognitive performance, researchers found that moderate choline intake was associated with better performance in visual attention, fluid intelligence and complex processing speed. Compared to the first quartile, those in the second, third and fourth quartiles tested 8% to 13% better in visual attention, fluid intelligence and complex processing speed. The sweet spots for choline intake for each area were: visual attention (338 mg/day); fluid intelligence (333 mg/day) and complex processing speed (333 mg/day).

Wondering why a high intake of choline seemed to increase the odds of dementia and Alzheimer’s almost as much as the lowest intake did? Researchers explain that when choline intake exceeds the intestine’s capacity to absorb it all, the unabsorbed choline is changed into a compound called trimethylamine (TMA), which is further changed by the liver into trimethylamine N-oxide (TMAO). These substances are linked to heart disease, stroke and, yes, Alzheimer’s disease. Another explanation, according to the researchers, is that some common foods rich in choline are also high in saturated fat, and there has been a link between high saturated fat intake and dementia in previous studies.

How Does This Apply to Real Life?

According to the NIH, how much choline you need depends on your age and sex. Their guidelines state that on average, female adults need 425 mg per day and male adults should aim for 550 mg per day. But this study suggests a range between 333 and 354 mg per day to help reduce the risk of dementia and support better cognitive performance—and those numbers are quite a bit lower than the NIH recommendations.

So how much do you really need?

“It’s important to remember that these results are from just one study conducted in one region of the world. Rather than looking at one study in isolation, it’s important to consider the broader body of research on the topic,” shares Jessica Ball, M.S., RD, registered dietitian and nutrition editor at EatingWell. “Numerous studies have found that dietary choline intake can support cognitive health and help lower dementia risk. Rather than stressing over a specific amount of milligrams per day, focus on adding choline-rich foods like eggs, beef, cod and potatoes into a balanced eating pattern.”

Like most nutrients, choline is found in many foods—that’s why we recommend eating a wide variety of foods to ensure you get all the nutrients you need. You’ll find choline in eggs, beef, poultry, pork, fish and dairy products. Cruciferous vegetables, soybeans (including tofu), shiitake mushrooms, peanuts, wheat germ, almonds, kidney beans, lima beans, red potatoes and quinoa are plant-based sources of choline.

Of course, choline isn’t the only brain-healthy nutrient. Other important ones include omega-3s, fiber, vitamin D, probiotics and polyphenols (or antioxidants). Regularly consuming olive oil may also reduce your risk of dying from dementia.

The MIND diet, a fusion of the Mediterranean and DASH diets, is specifically designed to include foods high in these brain-loving nutrients. Plus, it’s good for overall health. To get you started, we’ve got a line-up of MIND-based recipes for you to try.

On the flip side, there are also foods you should avoid or limit for a healthy brain. We recently reported how regularly eating processed red meat—like bacon, sausage, ham and bologna—may increase your risk of dementia. Limiting or avoiding alcohol is better for your brain, as is reducing the amount of added sugar you consume.

The Bottom Line

Dementia is on the rise in the U.S.—and according to some stats, it will double over the next three decades. But the good news is, there are many brain-loving actions you can take that will reduce your risk. One of these is to eat plenty of foods that support brain health—including foods rich in choline, a nutrient many of us are low in. Other foods include probiotic-rich fermented foods and spices to help calm inflammation—turmeric is one of our favorites for brain health. Even sipping on green tea may have brain benefits.

And remember—food is just one piece of the brain-health puzzle. Get plenty of physical activity and quality sleep. And manage your stressors. Too much stress can increase inflammation, which affects brain health, too. Brain health is whole health—when you’re taking action for your brain, you’re also supporting your heart and overall health, too. That’s a win-win all the way around.

Read the original article on EATINGWELL

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