A common nutrient deficiency may increase your risk of Alzheimer’s, a new study says

Reviewed by dietitian Jessica Ball, MS, RD

Main points

• Choline is an essential micronutrient for a healthy brain and nervous system.

• Low blood choline levels are linked to a higher risk of Alzheimer’s disease.

• Choline is found in seafood, meat, dairy, nuts, potatoes, fruits and whole grains.

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

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

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

How was this study conducted?

The researchers wanted to compare choline levels in people with obesity to those with a healthy BMI. They say previous studies show that obese people have lower blood levels of choline. They also point out that obesity is linked to 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, aged 29 to 36, were recruited: 15 (7 men, 8 women) with a BMI considered healthy (18.5 to 24.9 kg/m2) and 15 (8 men, 7 women) with a BMI considered obese (> k/30). All participants were considered healthy based on their medical history, routine physical examination, electrocardiogram, standard blood tests, and urinalysis. All participants were non-smokers, free of diabetes and had no history of liver, kidney or heart disease. They also did not take any prescription or over-the-counter medications or nutritional supplements, and were not involved in a weight loss regimen.

Body composition was measured and fasting blood samples were collected. The researchers measured choline levels and factors associated with diabetes, including glucose, HbA1c and insulin, as well as blood components associated with inflammation and cognitive decline. In addition, liver enzymes were measured, as some individuals may indicate dysfunctional sugar metabolism and brain nerve damage.

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

What did this study find?

By running statistical analyses, the researchers found:

• Obese individuals had lower blood choline levels, which, in turn, were associated with worse metabolic markers.

• Markers of inflammation and liver enzymes were higher in obese subjects.

• As blood choline levels decreased, neurofilament light (NfL), a marker of Alzheimer’s disease, increased. High levels of NfL suggest brain cell damage, and increase the risk of dementia.

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

A major limitation of this study is that dietary intake of choline was not assessed, so the researchers cannot conclude whether obese people eat less choline-rich foods or whether some other factor is involved in the association with lower levels. The number of participants for this study is considered moderate. Since more participants tend to increase the accuracy of the results, the researchers note that larger sample sizes would be helpful in the future. This study also did not include cognitive assessments, so comparisons of blood work between surviving participants and those autopsied with cognitive decline should be interpreted with caution.

How does this apply in real life?

While you can supplement with choline, we believe it’s best to try to get your nutrients through food. Like many nutrients, choline is found in many foods, so we recommend eating a variety of foods to ensure you get all the nutrients you need. You’ll find choline in eggs, beef, chicken, pork, fish and dairy products. Cruciferous vegetables, soybeans (including tofu), shiitake mushrooms, almonds, 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 can help you get enough choline. The MIND diet is a fusion of the Mediterranean and DASH diets, and it’s full of brain-healthy foods that contain choline, powerful antioxidants and healthy fats, including seafood, poultry, berries, whole grains and leafy greens (to name a few). To get familiar, 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, such as regular physical activity, plenty of quality sleep, and reducing stress levels. Your brain also needs hydration for optimal cognitive function. Socializing and volunteering can also help keep your mind healthy.

Our experts

This study adds to a growing body of evidence that suggests a link between low choline blood levels and Alzheimer’s disease. It also suggests a link between obesity and low choline, although researchers admit they can’t say with confidence why this link exists. Although found in a variety of foods, many people are deficient in choline. Evaluate your diet and start replacing ultra-processed foods with whole foods such as seafood, meat, 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.

Read the original article on EatingWell