Diet Rich in Choline Aids Memory and Lowers Risk of Dementia, Study Suggests

A diet rich in phosphatidylcholine, a form of the choline found in foods like eggs and meat, was linked to a lower risk of dementia and better memory skills in middle-aged men in Finland, a recent study reports.

These findings suggest that choline helps to support cognitive processing, and verbal and visual memory.

The study “Associations of dietary choline intake with risk of incident dementia and with cognitive performance: the Kuopio Ischaemic Heart Disease Risk Factor Study” was published in the American Journal of Clinical Nutrition.

Environmental factors such as diet are associated with the risk of developing Alzheimer’s disease. Previous studies have shown that consumption of choline-rich foods — like eggs (egg yolk), liver and other meats, dairy, and fruits/vegetables — are associated with better outcomes on cognitive tests.

Choline, an essential vitamin-like nutrient, is used by cells to build key components (certain fats) of cell membranes. It is also used by the body to produce acetylcholine, an important neurotransmitter essential for brain and nervous system functions, including memory. (Neurotransmitters are chemicals that allow nerve cells in the brain to communicate.)

Choline is mostly found in foods in its phosphatidylcholine form, and is currently part of a multinutrient drink given to people with early Alzheimer’s disease.

Researchers at the University of Eastern Finland investigated whether dietary intake of choline might affect dementia risk and cognitive performance in middle-age men.

They used data from the Kuopio Ischaemic Heart Disease Risk Factor Study, or KIHD (NCT03221127), a prospective population-based study into the impact of nutrition on the risk of chronic disorders, such as cardiovascular diseases and atherosclerosis.

The study included 2,682 finish men (ages 42 to 60) in its initial years (1984–89). Researchers analyzed data from 2,497 of them, all with no history of dementia or mental problems at the study’s opening. After a follow-up of 21.9 years, 337 of these men (13.5%) were diagnosed with dementia.

Diet information was obtained with guided food recording of four days, including one weekend day. Here, participants reported their intake by comparing foods or drinks and their proportions to a picture book that contained 126 of the most common foods and drinks consumed in Finland.

Results showed that, on average, participants ingested 431 milligrams (mg) of choline per day, of which 188 mg (43.5%) included phosphatidylcholine. Almost 40% of phosphatidylcholine intake came from an egg source. Additional common sources were meats and dairy products.

Participants who had a daily phosphatidylcholine intake higher than 222 mg, compared to those with a daily intake below 144 mg, had 28% lesser risk of developing dementia. Each 50 mg intake a day of phosphatidylcholine was associated with a 10% lower dementia risk.

Neither phosphatidylcholine nor choline total intakes were relevant for the risk of Alzheimer’s disease, even when accounting for mutations in the apolipoprotein E (APOE) gene, a known risk factor for Alzheimers.

“One explanation could be that the protective mechanisms of phosphatidylcholine may be more vascular than neurodegenerative,” the researchers suggested, adding “however, these mechanisms tend to interplay” so that “the association between phosphatidylcholine intake and AD [Alzheimer’s disease] risk cannot be excluded.”

In a subgroup of participants who underwent memory and cognitive performance tests, researchers observed that higher choline intake led to better verbal fluency, memory, and visual memory test scores. A higher intake of phosphatidylcholine correlated with a better performance in processing speed, verbal fluency, and visual reproduction tests.

Other nutrients, like vitamin B12 or folate and the source of phosphatidylcholine, did not impact memory and speaking ability, the study found.

“Higher phosphatidylcholine intake was associated with lower risk of incident dementia and better cognitive performance in men in eastern Finland,” the researchers wrote, adding that consuming an adequate amount of food high in choline could be “an easy, effective, and affordable way to maintain cognitive functioning, among other means.”

“However, this is just one observational study, and we need further research before any definitive conclusions can be drawn,” Maija Ylilauri, the study’s first author and a PhD student at the University of Eastern Finland, said in a press release.