Is dietary choline intake related to dementia and Alzheimer’s disease risks? Results from the Framingham Heart Study
Open accessAbstract
BACKGROUND: The positive association of choline for cognition has been reported in both animal and human studies, yet the associations of choline with the risks of incident dementia or Alzheimer's disease (AD) in humans is unclear. OBJECTIVES: Our objective was to test the hypothesis that lower or higher dietary choline intake is associated with increased or decreased, respectively, risks of incident dementia and AD. METHODS: Data from the Framingham Heart Study Offspring Cohort exam 5 to exam 9 were used. Participants were free of dementia and stroke, with a valid self-reported 126-item Harvard FFQ at exam 5. The intakes of total choline, its contributing compounds, and betaine were estimated based on a published nutrient database. The intakes were updated at each exam to represent the cumulative average intake across the 5 exams. The associations between dietary choline intakes and incident dementia and AD were examined in mixed-effect Cox proportional hazard models, adjusting for covariates. RESULTS: A total of 3224 participants (53.8% female; mean ± SD age, 54.5 ± 9.7 y) were followed up for a mean ± SD of 16.1 ± 5.1 y (1991-2011). There were 247 incident dementia cases, of which 177 were AD. Dietary choline intake showed nonlinear relationships with incident dementia and AD. After adjusting for covariates, low choline intake (defined as ≤ 219 and ≤ 215 mg/d for dementia and AD, respectively) was significantly associated with incident dementia and incident AD. CONCLUSIONS: Low choline intake was associated with increased risks of incident dementia and AD.
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Studies have shown benefits of dietary choline intake and supplementation on cognitive performance in human individuals and in animal models.
“This finding aligns with studies showing benefits of dietary choline intake and supplementation on cognitive performance in human individuals and in animal models71–78.”
From Single-cell multiregion dissection of Alzheimer’s disease (2024) · cites this paper as [77]
Low dietary choline intake is associated with an elevated risk of dementia and AD.
“a low dietary choline intake has been associated with an elevated risk of dementia and AD.”
From Microbiota–gut–brain axis and its therapeutic applications in neurodegenerative diseases (2024) · cites this paper as [672]
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- Authors
- Yuan, J., Liu, X., Liu, C., Ang, A. F., Massaro, J., Devine, S. A., Auerbach, S. H., Blusztajn, J. K., Au, R., & Jacques, P. F.
- Affiliations
- Boston University (US)
- Tufts University (US)
- Corresponding author
- Jacques, Paul F
- ORCID
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2022-11
- Volume
- 116
- Issue
- 5
- Pages
- 1201-1207
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC9630864
- OpenAlex
- W4289524724
- Cited by
- 61
- References
- 28
- Citations by year
- 2026: 12 · 2025: 25 · 2024: 13 · 2023: 11
- FWCI
- 7.98
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (N01-HC-25195, HHSN268201500001I)
- NIH
- National Institute on Aging (AG008122, AG016495, AG033040, AG054156, AG049810, AG062109, AG057768)
- Pfizer
- USDA Agricultural Research Service (#58-1950-9-004)
- Chinese Academy of Medical Sciences (2016I2M1004)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Keywords
- dietary choline intake, Alzheimer's disease, dementia, betaine, nonlinear dose-response relationship, Framingham Offspring cohort, cognitive aging, dietary biomarkers
- MeSH terms
- Adult, Alzheimer Disease, Animals, Betaine, Choline, Eating, Female, Humans, Longitudinal Studies, Male, Middle Aged
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