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The Neurocognitive Effects of Choline

Our group was the first to show that 90% of Americans and 92% of pregnant women fall short of meeting dietary recommendations for choline. Since then, our team has worked to investigate how high maternal and early life choline intakes may affect the developing brain and how higher intakes across the lifespan may help prevent Alzheimer's disease.

Written by Dr Taylor Wallace -

May 6, 2024

Background

Choline has been recognized as an essential nutrient byt he Food and Nutrition Board of the National Academies of Medicine since 1998. Its metabolites have structural, metabolic, and regulatory roles within the body. Humans can endogenously produce small amounts of choline via the hepatic phosphatidylethanolamine N-methyltransferase (PEMT) pathway. However, the nutrient must be consumed exogenously to prevent signs of deficiency. The Adequate Intake(AI) for choline was calculated at a time when dietary intakes across the population were unknown for the nutrient. Unlike the traditional National Academy of Medicine approach of calculating an AI based on observed or experimentally determined approximations or estimates of intake by a group (or groups) of healthy individuals, calculation of the AI for choline was informed in part by a depletion-repletion study in adult men who, upon becoming deficient, developed signs of liver damage. The AI for other gender and life-stage groups was calculated based on standard reference weights, except for infants 0 to 6 months, whoseAI reflects the observed mean intake from consuming human breast milk. Our recent analyses indicate that large portions of the population (ie, approximately 90% of Americans), including most pregnant and lactating women, are well below the AI for choline. An individual’s requirement for choline is dependent on common genetic variants in genes required for choline, folate, and 1-carbon metabolism, potentially increasing more than one-third of the population’s susceptibly to organ dysfunction. The American Medical Association and American Academy of Pediatrics have both recently reaffirmed the importance of choline during pregnancy and lactation. New and emerging evidence suggests that maternal choline intake during pregnancy, and possibly lactation, has lasting beneficial neurocognitive effects on the offspring. Our new research also shows higher dietary intakes during adulthood to be associated with a reduced risk of clinical and pathological diagnosis Alzheimer's. Because choline is found predominantly in animal-derived foods, vegetarians and vegans may have a greater risk for inadequacy.

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Our Ongoing Research

The Rush Memory and Aging Project
The Memory and Aging Project is a longitudinal, epidemiologic, clinical-pathologic cohort study of common chronic conditions of aging with an emphasis on decline in cognitive and motor function and risk of Alzheimer's disease. Our group has demonstrated that higher choline intakes are associated with a decreased risk of both clinical and pathological diagnosis of Alzheimer's. We are further investigating mechanisms by which choline may promote cognitive maintenance into post-menopause and older adulthood.

The Collaborative Study of Genes, Nutrients, and Metabolites
Our team is working to better understand the influence of genetic variants on circulating choline-related metabolites in normal, healthy individuals.

The Saqmolo' Project
An individually randomized, partially blinded, controlled comparative effectiveness trial to evaluate the influence of adding delivery of a single whole egg per day to local standard nutrition care (ie, growth monitoring, medical care, deworming medication, multiple micronutrient powders for point-of-use food fortification [chispitas], and individualized complementary and responsive feeding edu-cation for caregivers) for 6 months, compared with the local standard nutrition care package alone, on child development, growth, and diet quality measures in rural indigenous Mayan infants aged 6 to 9 months at baseline (N 1⁄4 1,200). The study is being executed in partnership with the Wuqu’ Kawoq/Maya Health Alliance, a primary health care organization located in central Guatemala. Details of The Saqmolo' Project can be found here.

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