NMU – 178 Choline and Lecithin: Under-Appreciated Nutrients in Preserving Memory and Brain Health
Lifestyle Medicine Update no 178 (October 22, 2020)
with Dr. James Meschino
Topic: Choline and Lecithin: Under-Appreciated Nutrients in Preserving Memory and Brain Health
Main Sources: Journal Nutrients (2019) and the American Journal of Clinical Nutrition (2011)
The chemical in our brain that allows us to have memory is called acetylcholine, and for brain cells to make acetylcholine they need a constant daily supply of the nutrient choline. Many people are not familiar with the nutrient choline, but it is a constituent found in many foods. Yet most people do not ingest the daily amount of choline each day from their diet that is recommended by health authorities, as I will discuss in a moment. Research has been showing for some time that sub-optimal intake of choline over our lifetime is strongly linked to the development of dementia and Alzheimer’s disease problems as we get older. A great illustration of this comes from the famous Framingham Heart Study, which followed a sub-group of their participants, totaling almost 1400 participants, where they performed dietary analysis, neuropsychological testing, and MRI studies of the brain. The average age of participants was roughly 61 years of age. The results clearly showed that individuals who routinely ingested the highest amount of choline showed better memory on test scores and their brain MRI results showed significantly fewer biological changes linked to dementia and Alzheimer’s disease. On MRI the appearance of what is called white matter hyperintensity (WMH) correlates strongly with cognitive impairment and brain atrophy(shrinkage). Individuals with higher choline intake showed significantly less of these MRI indicators of brain atrophy and degeneration. This is likely because higher choline ingestion not only increases the amount of the memory choline acetylcholine in the brain, hence improving memory, but choline is also required to maintain the outer skin of brain cells called the nerve cell membrane. Preserving the nerve cell membrane helps preserve brain cell integrity and brain cell function and helps prevent brain cell degeneration and brain cell death.
What is important to point out, however, is that in subjects who consumed a great deal of saturated fat from their diet, the high saturated fat intake negated or nullified the protective effect of choline on memory and healthy brain MRI findings. Thus, the health message is clear – get the choline you need each day, and at the same time limit foods that contain a lot of saturated fats (such as beef, high-fat dairy products like cheese, butter, ice cream, cream, etc., as well as coconut and palm oil, many pastries rich in butter, cream or cheese, etc.). By the way, higher choline intake in this study was also associated with lower blood homocysteine levels. We know that high homocysteine blood levels are associated with an increased risk for Alzheimer’s disease. Choline helps to lower homocysteine levels because some of the choline you ingest is converted in the liver to a homocysteine-lowering agent called betaine. Along the same line, animal studies show that choline administration blocks the dangerous build-up of amyloid plaque, which is a hallmark feature of Alzheimer’s disease and it reduces brain inflammation (also seen in Alzheimer’s disease) by suppressing the action of inflammation-promoting cells in the brain called microglia. As such, it can be stated that choline plays a key role in preserving memory and brain health via multi-faceted mechanisms.
So, how much choline do you need to preserve your memory and where can you get choline from healthy food sources? The recommended amount of daily choline for men is 550 mg per day and for women, it is 425 mg per day. Pregnant and breast-feeding women required 450 and 550 mg of choline per day, respectively. Unfortunately, studies show that men ingest, on average, only about 380 mg per day of choline (vs 550 mg recommended) and women ingest about 275 mg (vs 425 mg recommended). Day after day, week after week, month after month, and year after year this adds up to sub-optimal choline brain concentrations and an increased risk for dementia and Alzheimer’s disease, according to emerging studies.
Recommended Choline Intake:
So, where can you get choline from healthy foods?
Tofu – 150 gm or 5.7 ounces – 160 mg Choline
Chicken Breast – 75 gm or 2.5 ounces – 80 mg Choline
Fish (most fish) 3 oz – 71 mg Choline
Soybeans – ¾ cup – 60 mg Choline
Other Beans and Peas – ¾ cup – 57 mg Choline
Lentils – ¾ cup – 45 mg Choline
Nuts (peanuts, pistachios, almonds, cashews) – ¼ cup – 23 mg Choline
Non-fat or 1% Milk – 1 cup – 43 mg Choline
Cottage Cheese – 1 cup – 42 mg Choline
Non-fat or 1% Yogurt – ¾ cup – 27 mg Choline
Broccoli, Brussel sprouts, Cauliflower, Collard Greens – ½ cup – 35 mg Choline
Avocado – ½ – 14 mg Choline
Banana – 1 medium – 12 mg Choline
Potato – 1 large – 57 mg Choline
Brown Rice – 1 cup cooked – 19 mg Choline
Whole Grain Bread and Pita – 1 large piece – 17 mg Choline
Tangerines and Kiwi Fruit ½ cup of each – 7-10 mg Choline
Carrots – ½ cup – 6 mg Choline
Wheat Germ – 30 gm or roughly 1 oz – 54 mg Choline
Quinoa – ½ cup – 23 mg Choline
Foods Containing Choline:
When you examine the food charts closely you can see that it can be difficult to get 450 to 550 mg of choline each day from food alone, and thus, the daily average intake of choline across the population is much lower than these what is recommended. One convenient way to increase choline intake is to do what I do, which is to ingest two, 1200 mg capsules of lecithin each day. Each capsule of lecithin contains about 160 mg of choline. So, two capsules per day provide 320 mg of choline. Lecithin also contains other phospholipids that are important brain, liver, and kidney health as well as the overall health and integrity of most body cells.
You may want to know that 1 tablespoon of lecithin granules contains 250 mg of choline, but lecithin in this form has a very fishy odor and taste that most people, including me, find to be quite unpalatable.
So, I would suggest that be cognizant of how much choline you are getting each day from the foods you eat. If you are not getting the recommended amount then consider including foods that contain more choline and/or think about taking a lecithin supplement, as I have done.
I have included the main references for this information in the text below.
1. Poly C et al. The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham offspring cohort. Am J Clin Nutr. 2011; 94(6):1584-1591 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3252552
2. Bekdash RA. Neuroprotective effects of choline and other methyl donors. Nutrients. 2019; 11, 2995. https://www.mdpi.com/2072-6643/11/12/2995
3. Animal Studies on Choline and Alzheimer’s disease: Ramon Velazquez, Eric Ferreira, Sara Knowles, Chaya Fux, Alexis Rodin, Wendy Winslow, Salvatore Oddo. Lifelong choline supplementation ameliorates Alzheimer’s disease pathology and associated cognitive deficits by attenuating microglia activation. Aging Cell, 2019. https://onlinelibrary.wiley.com/doi/full/10.1111/acel.13037
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