People with anxiety disorders have lower levels of choline in their brains.
Researchers from the UC Davis School of Medicine found that people with anxiety had 8% lower levels of the essential nutrient in their brains compared with those who do not have anxiety.
“We found a consistent pattern of reduced levels of soluble choline compounds in the cerebral cortex of people with anxiety disorders,” Richard Maddock, senior author of the study, a psychiatrist and research professor in the Department of Psychiatry and Behvioral Sciences at UC Davis told Thervive.
“I was interested in investigating brain levels of choline, or more precisely, soluble choline moieties. This is what can be measured with an MRI scanner. In two earlier studies of patients with panic disorder, I noticed low brain levels of soluble choline moieties. Later, I noted a similar pattern of low brain levels of soluble choline in patients with hyperthyroidism. Anxiety disorders and hyperthyroidism have in common a state of heightened metabolic arousal, which could be the reason for the low soluble choline levels. I wanted to learn if this abnormality was a general feature across all three of the major anxiety disorders—panic disorder, generalized anxiety disorder, and social anxiety disorder. This turned out to be the case, and it is another step toward understanding the biological underpinnings of anxiety disorders.”
The research is the first of its kind to demonstrate a chemical pattern in the brain in anxiety disorders. The study was published in the journal Molecular Psychiatry, and examined data from 25 studies. They looked at the levels of neurometabolites in the brain, these are chemicals produced during brain metabolism. The studies included 370 people who had anxiety disorders and 342 who didn’t.
They found reduced levels of choline in the brains of those with anxiety, particularly in the area of the brain known as the prefrontal cortex. This is the part of the brain that helps with thinking, behavior and emotion.
Choline is an essential nutrient and is important for cell membranes as well as brain functions including muscle control, mood regulation and memory. Whilst the body makes a small amount of choline, the bulk of it comes from food intake.
Given this, the findings of the study suggest that factoring nutrition into anxiety management, perhaps through choline supplementation, could help change the brain chemistry of people with anxiety and improve patient outcomes.
“Among the metabolites that can be easily measured in the brain, choline is the only one that is an essential nutrient. That is, it must be obtained by dietary intake. The most important take-home message from this study is for nutrition scientists and psychiatrists to find out if increasing choline intake has beneficial effects in people with anxiety disorders,” Maddock said.
Past research demonstrates that most people in the US, including children, don’t get enough choline in their diet.
Foods rich in choline include soybeans, milk, fish, beef, chicken, eggs (and in particular the yolk) and beef liver.
Maddock says diet is something people with anxiety could consider.
“They should look carefully at their diet to make sure it is providing an adequate amount of choline… For their overall health–and possibly for problems with anxiety—they should ensure their diet contains adequate amounts of choline,” he said.
“It is not yet known if increasing dietary intake of choline compounds will have a beneficial effect for people with anxiety disorders. Consuming the recommended dietary intake of choline is entirely harmless, so it is a good idea to be sure they are getting that. However, there is not yet enough evidence to make this a scientifically-based medical recommendation.”
But it is not yet known if choline supplements will help people with anxiety. This is something Maddock plans to explore in future research.
“The next step will be to carry out a randomized, controlled trial of appropriate choline supplementation in people with anxiety disorders to see if it has a beneficial effect,” he said.
“There are many different kinds of choline supplements. The best evidence suggests that some kinds enter the brain more readily than others. It will be important for future studies to clarify which forms are most efficient in raising brain levels. Some recent studies suggest that choline bound to omega-3 fatty acids in fish oils (such as salmon oil) is the best for raising brain levels. A better understanding of what foods or supplements can best raise brain choline levels will be an important step forward.”