By Karen Kier, Pharmacist
On behalf of the ONU HealthWise team

In the 1800s, the phrase “food for thought” was used to support the theory of digesting certain foods by the stomach to stimulate the brain to think. Some examples include the famous apple a day to keep the doctor away and the use of chicken soup for a cold. Then, there is the controversial egg for health.

For generations, the humble egg has been breakfast, comfort food and the subject of arguments about cholesterol. But there is another reason the egg deserves some attention: they are one of the richest and most common sources of choline, a nutrient for our brains.

Choline is not always a household name when it comes to nutritional supplements. It does not have the notoriety of vitamin D, omega-3 fatty acids or vitamin C despite it being involved in important jobs within the body. Our brains use choline to help make acetylcholine, a chemical messenger involved in memory, attention and muscle control. Choline helps build and maintain cell membranes and plays an important role while a baby's brain is developing.

The intriguing question is whether getting enough choline might help protect our thinking and memory as we grow older. Early evidence suggests some benefit from infants to aging adults. 

Some of the most interesting research has involved pregnancy. In one randomized controlled trial, pregnant women in their third trimester were assigned to consume either 480 milligrams or 930 milligrams of choline each day. When their babies were tested repeatedly during the first year of life, the infants whose mothers received the higher amount of choline showed faster information-processing speeds.

Researchers followed children from another randomized trial even longer. At age 7, children whose mothers had consumed 930 milligrams of choline daily during the final trimester performed better on a test of sustained attention than children whose mothers had received 480 milligrams.

A 2025 systematic review of the research found the evidence to be interesting, but not consistent enough to say that more prenatal choline reliably produces better neurodevelopmental outcomes in the babies. 

More recent studies have focused on 450mg of choline prior to pregnancy and then taking the supplement through all 3 trimesters of pregnancy. The administration of choline has been shown to reduce the risk of neural tube defects early in pregnancy and supports early brain development in the infant.

Is there benefit in choline supplementation in adults?

In controlled experiments involving healthy young adults, researchers gave participants relatively large doses of choline and then tested different types of memory. They found no significant improvement in working memory or declarative memory.

Does choline have a role in older adults?

Researchers have studied choline-containing compounds, including choline alfoscerate (alpha-GPC), in people with cognitive impairment and Alzheimer's disease. One multicenter randomized-controlled trial involving 261 people with mild-to-moderate Alzheimer's dementia reported improvements in cognitive and clinical measures among participants receiving choline alfoscerate compared with placebo. A later systematic review and meta-analysis examining choline alfoscerate studies reported improvements in several cognitive and functional outcomes.

A 2024 study published in Medicine (Baltimore) found an additional improvement in Alzheimer’s dementia patients when alpha-GPC was added to donepezil, which is a traditional prescription drug for Alzheimer’s.

Choline alfoscerate is a specific compound studied in clinical trials and can be found in nonprescription supplements. It is not the same thing as eating an egg for breakfast or taking an ordinary choline supplement. Choline alfoscerate is a specialized choline formulation that enhances absorption of the nutrient and crosses into the brain. A 2025 study published in Frontiers in Neurology found choline alfoscerate to be superior in patients with cognitive decline compared to choline supplements. These studies do not establish that increasing dietary choline prevents Alzheimer's disease.

It is important not to discount the benefits of choline as a nutrient in food. 

The National Institutes of Health lists an adequate daily intake of choline at 550 milligrams for adult men and 425 milligrams for adult women. Requirements are higher during pregnancy and breastfeeding. Good sources besides eggs include meat, fish, dairy products, soybeans and some beans and vegetables.

As with so many things in nutrition, more is not always better.

The adult tolerable upper intake level for choline is 3,500 milligrams a day. Very high intakes can cause adverse effects such as sweating, gastrointestinal distress, low blood pressure and a fishy body odor.

The brain is an astonishingly complicated organ. It is built and maintained through thousands of interactions among genes, nutrition, sleep, exercise, social connections, blood vessel health and other factors. Choline is one small piece of the puzzle—a nutrient our brains need and can be overlooked.

Choline is a nutrient that needs some food for thought!