Association of dietary choline intake with cognitive decline and related outcomes: a systematic review and dose-response meta-analysis of observational studies.
Shiqing Feng, Kang An, Yingying Wang et al.
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In 30 seconds
This systematic review and dose-response meta-analysis examined observational evidence on dietary choline intake and cognitive decline or related outcomes. Eleven articles were included; nine independent cohorts, comprising 218 378 participants, contributed to the primary analysis. Higher choline intake was associated with lower odds of adverse cognitive outcomes (pooled OR = 0.76, 95% CI: 0.63-0.92). Associations were also reported for cognitive impairment/decline and Alzheimer's disease, but not dementia. Dose-response analyses found nonlinear associations, with the lowest risks at approximately 350-400 mg day -1.
Key findings
- Higher dietary choline intake was associated with lower odds of adverse cognitive outcomes (pooled OR = 0.76, 95% CI: 0.63-0.92).
- The association was also inverse for cognitive impairment/decline (pooled OR = 0.67, 95% CI: 0.47-0.95) and Alzheimer's disease (pooled OR = 0.74, 95% CI: 0.55-0.99).
- The association with dementia was not statistically significant.
- Dose-response analyses showed nonlinear associations, with the lowest risks at approximately 350-400 mg day -1 of dietary choline.
Why it matters
The findings suggest that dietary choline intake may be relevant to cognitive health in aging populations, while indicating that associations differ by outcome and may not be linear across intake levels. The results add pooled evidence to an epidemiological literature described as inconsistent, but do not establish that choline intake prevents cognitive decline.
What to keep in mind
The evidence comes from observational studies, so the reported associations do not establish causation.