A Summary of the article “The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort”
The article by Poly et al. published in The American Journal of Clinical Nutrition in December 2011, investigated the link between dietary choline intake, cognitive function, and specific brain morphology features in a large population of non-demented individuals.
Background and Objective
The study was grounded in the understanding that choline is essential as the precursor to the neurotransmitter acetylcholine, which is crucial for cholinergic neural networks associated with memory. The loss of cholinergic neurons is frequently linked to impaired cognitive function, memory loss, and Alzheimer disease (AD). Furthermore, generalized brain atrophy and increased white-matter hyperintensity (WMH) are strongly associated with cognitive impairment and AD. The study aimed to determine if dietary choline intake related to cognitive function and brain morphology, specifically WMH volume (WMHV), in a community-based cohort.
Study Design and Measurements
The research included 1391 participants (mean age 60.9 years) from the Framingham Offspring population who were free of dementia, clinical stroke, or other major neurological conditions. Dietary choline intake was measured using the Harvard Food-Frequency Questionnaire (FFQ) at two time points: Exam 5 (remote intake, 1991–1995) and Exam 7 (concurrent intake, 1998–2001). Participants underwent neuropsychological evaluations and brain MRI scans during Exam 7. Cognitive performance was categorized into four factors: verbal memory (VM), visual memory (VsM), verbal learning, and executive function (EF). Brain morphology was primarily measured by WMHV, which was often log-transformed for analysis due to its skewed distribution.
Key Findings on Cognitive Function
The study found a significant association between higher concurrent choline intake (Exam 7) and better cognitive performance on memory factors. In multivariable-adjusted models, performance was better with higher concurrent choline intake for both the VM factor (average change = 0.60; P < 0.01) and the VsM factor (average change = 0.66; P < 0.01). Further analysis confirmed a significant positive relation between higher choline intake and both immediate and delayed recall in VM and VsM. Remote choline intake (Exam 5) did not show a significant association with any of the neuropsychological factors.
Key Findings on Brain Morphology
A primary finding regarding brain morphology concerned remote choline intake. Higher remote choline intake (Exam 5) was inversely related to log-transformed WMHV. This means individuals with a higher choline intake years earlier had less WMHV (average change per unit change in choline = -0.05; P = 0.02). A significant inverse association was also observed between remote higher choline intake and the presence of large WMHV (OR: 0.56; P = 0.01). In contrast, concurrent choline intake (Exam 7) was not significantly related to WMHV. No significant association was found between choline intake and total cranial brain volume (TCBV) at either exam.
Conclusion and Implications
The study concluded that in this population of nondemented individuals, better memory performance was related to higher concurrent choline intake, while higher remote choline intake was significantly associated with a lower volume of WMH. These results suggest that higher dietary choline intake in midlife may be neuroprotective, preserving the neurological pathways associated with memory and promoting improved cognitive function over time. This highlights the potential of dietary, and therefore modifiable, factors in preventing adverse brain changes that lead to cognitive decline.
References
Poly, C., Massaro, J. M., Seshadri, S., Wolf, P. A., Cho, E., Krall, E., Jacques, P. F., & Au, R. (2011). The relation of dietary choline to cognitive performance and white-matter hyperintensity in the Framingham Offspring Cohort. The American Journal of Clinical Nutrition, 94(6), 1584–1591. https://doi.org/10.3945/ajcn.110.008938
This post is based on Open Access research and is for informational purposes only.
