Biomedical Updates

Higher Choline Intake Heightens Performance

Choline is the precursor to the memory messenger molecule acetylcholine. Also known as a neurotransmitter, the production in brain and body of acetylcholine requires the cofactor vitamin B5 (pantothenic acid). In Alzheimer’s disease and other memory malfunctions, the loss of cholinergic neurons is associated with impaired cognitive function, including memory loss. Also associated with impaired cognitive function and Alzheimer’s are brain atrophy and white-matter hyperintensity.

In a new study, researchers set out to determine if a relation exists between dietary choline intake, cognitive function, and brain morphology (the brain’s form and structure) in a large community-based cohort without any signs of dementia.1

Altogether, there were 1391 subjects consisting of 744 women and 647 men. Their ages ranged from 36–83 years, with a mean standard deviation age of 60.9 ± 9.29 years. All the subjects were from the Framingham Offspring population and completed a food-frequency questionnaire administered from 1991 to 1995 and another from 1998 to 2001.

All of the participants were evaluated neuropsychologically, and given a magnetic resonance imaging (MRI) scan. MRIs use a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body, in this instance the brain. MRIs provide different information about the brain than can be seen with other scans and may show problems that cannot be seen with other imaging methods.

There were four neuropsychological measurements:

1. Verbal memory
2. Visual memory
3. Verbal learning
4. Executive function

Also included in the MRI scan measurements was white-matter hyperintensity volume.

The principal findings show that better memory performance is related to a higher concurrent choline intake (from 1998 to 2001), whereas remote choline intake (from 1991 to 1995) is associated with a significant inverse relation to larger white-matter hyperintensity in a large, nondemented, community-based population.

Verbal memory and visual memory were found to be strongly associated with choline intake in both age- and sex-adjusted models as well as in final models. Curiously, choline lost its significance when saturated fat was added into the model.

Executive function had no relation to choline intake, at least not at the levels reported. But further investigation of the individual cognitive tests for each factor considered confirmed a significant positive association between choline intake and both visual and verbal memory. Remember that memory impairment is a hallmark sign of Alzheimer’s disease and that preservation of the neurologic pathways associated with memory may be of principal importance in preventing changes in the brain that lead to Alzheimer’s.

White-matter hyperintensities are seen in up to 90% of persons with vascular dementia and Alzheimer’s and other researchers have found that subjects with large white-matter hyperintensity volumes had significantly poorer cognitive function and brain atrophy. Accordingly, large amounts of white-matter hyperintensity are pathologic in nature and prevention is important. The researcher’s findings show that early higher choline intake is significantly related to smaller white-matter hyper­intensity volume, which suggests that choline intake at midlife may be neuroprotective later in life.

In this community-based population of nondemented individuals, higher concurrent choline intake was related to better cognitive performance, whereas higher remote choline intake was associated with little to no change in intake white-matter hyperintensity volume. The message to take home is … If you are serious about preserving memory function, higher choline intake is a must.


  1. Poly C, Massaro JM, Seshadri S, Wolf PA, Cho E, Krall E, Jacques PF, Au R. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort. Am J Clin Nutr 2011 Nov 9. [Epub ahead of print] PMID: 22071706 [PubMed - as supplied by publisher].

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