This Nutrient Deficiency Raises Alzheimer’s Risk

Choline is one of those underrated micronutrients we don’t hear much about—in fact, most Americans aren’t eating enough of it. But every nutrient, no matter how micro, is essential—and choline is no exception. It’s necessary for a healthy brain and nervous system and helps regulate mood, memory and muscle control, plus it’s essential for forming the membranes surrounding your cells. It’s also vital for the proper brain development of babies in utero and after birth.

Besides being underrated, choline is also a commonly deficient nutrient. And deficiency of this micronutrient comes with some potential harm. For example, one recent study linked low choline intake with a higher risk of dementia, including the most common type of dementia, Alzheimer’s disease.

Researchers from Arizona, including Arizona State University and Mayo Clinic Arizona, set out to shed more light on the connection between choline and Alzheimer’s disease. They published their findings in Aging and Disease. Let’s break down what they found.

How Was This Study Conducted?

Researchers wanted to compare choline levels in people with obesity to those with a healthy BMI. They state that previous studies suggest that people with obesity tend to have lower blood choline levels. They also state that obesity is linked with insulin resistance, a condition that predisposes people to type 2 diabetes. Insulin resistance is also a major risk factor for Alzheimer’s disease.

For this study, a total of 30 participants, ages 29 to 36, were recruited: 15 (7 males, 8 females) with what is considered a healthy BMI (18.5 to 24.9 kg/m2) and 15 (8 males, 7 females) with a BMI that is considered obese (>30 kg/m2). All participants were deemed healthy based on their medical history, routine physical examination, electrocardiogram, standard blood tests, and urinalysis. Participants were all nonsmokers, free of diabetes and had no history of liver, kidney or heart disease. They also took no prescription or over-the-counter medications or nutritional supplements, and were not engaging in a weight loss regimen.

Body composition was measured and fasting blood samples were collected. Researchers measured choline levels and factors related to diabetes, including glucose, HbA1c and insulin, as well as blood components associated with inflammation and cognitive decline. In addition, liver enzymes were measured, as certain ones can indicate dysfunctional sugar metabolism and brain nerve damage.

In addition, researchers also drew blood postmortem from people with known mild cognitive decline and Alzheimer’s disease. With this, they could compare blood levels of the same components in the 30 healthy individuals with those of individuals with known Alzheimer’s disease and cognitive decline.

What Did This Study Find?

After running statistical analyses, researchers found:

• Individuals with obesity had lower levels of blood choline, which, in turn, were associated with poor metabolic markers.
• Markers of inflammation and liver enzymes were elevated in people with obesity.
• As choline levels in the blood decreased, neurofilament light (NfL), a marker of Alzheimer’s disease, increased. Higher levels of NfL suggest that damage to brain cells has occurred, and increases the risk of dementia.

Overall, researchers found that obesity was associated with lower blood levels of choline, dysregulated inflammatory markers and elevated markers of metabolic dysfunction. And all of these factors are related to Alzheimer’s disease risk.

One major limitation of this study is that the dietary intake of choline was not assessed, so researchers cannot conclude whether people with obesity eat fewer choline-rich foods or if there’s some other factor involved concerning the lower levels. The number of participants for this study is considered moderate. Since more participants tend to increase the accuracy of the results, researchers note that larger sample sizes in the future will be helpful. This study also did not include cognitive assessments, so comparing blood work between the living participants and those who were post-mortem with cognitive decline should be interpreted with caution.

How Does This Apply to Real Life?

While you could supplement with choline, we believe it’s best to try to get your nutrients through food. Like most nutrients, choline is found in many foods, which is 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.

These researchers note that following a Mediterranean diet eating pattern will help ensure you get enough choline. The MIND diet is a fusion of the Mediterranean and DASH diets, and is chock-full of brain-healthy foods that contain choline, powerful antioxidants and healthy fats, including seafood, chicken, berries, whole grains and leafy greens (to name a few). To get acquainted, try our 30-Day MIND Diet Meal Plan for Cognitive Health. Follow it as-is or choose recipes that look appealing.

Other lifestyle factors also play a role in brain health, including regular physical activity, plenty of quality sleep and reducing stress levels. Your brain also requires hydration for optimum cognitive function. Even socializing and volunteering can help keep your brain healthy.

Our Expert Take

This study adds to the growing body of evidence that suggests a connection between low choline blood levels and Alzheimer’s disease. It also indicates a link between obesity and low choline, though researchers admit that they can’t yet say with confidence why this link exists. Many people are deficient in choline, despite it being found in a variety of foods. Evaluate your diet and start swapping ultra-processed foods with whole foods, like seafood, meats, dairy, nuts, eggs, legumes, cruciferous vegetables, potatoes and whole grains. Following a meal plan designed for cognitive health can help you take the guesswork out of it.