The One Nutrient Anxious Brains Keep Running Low On

8%
lower choline found in the brains of people with anxiety disorders vs. those without
91%
of Americans fall below the recommended daily intake for choline
31%
of U.S. adults will experience an anxiety disorder at some point in their lives

If you’ve ever wished your anxious brain came with a user manual, science may have just handed you a small but meaningful page. A new meta-analysis out of UC Davis Health found that people with anxiety disorders, including social anxiety, generalized anxiety disorder, and panic disorder — have significantly lower levels of a nutrient called choline in their brains compared to people without those conditions.

The finding isn’t alarming so much as it’s actionable: it points to something that everyday food choices can genuinely address.

Dr. Richard Maddock, a professor of psychiatry and behavioral sciences at UC Davis and the study’s senior author, spent years using MRI scanners to measure the concentration of key molecules in living brains. He kept noticing a pattern. Anxious patients tended to run low on choline.

That observation eventually led to a formal meta-analysis of 25 studies involving 712 participants. The 8% choline gap held up. For context, the brain is remarkably precise about its chemistry, which makes that margin unusually significant.

Dr. Maddock described the choline gap as one of the largest abnormalities he’s observed in the brains of people with anxiety disorders, noting that the brain typically maintains very tight control over its chemistry — making even an 8% shift unusually significant.

— paraphrased from UC Davis Health

Choline might be the most important nutrient most people have never heard of. It was only officially recognized as essential in 1998, and researchers have described it as “underconsumed and underappreciated” ever since. Unlike vitamin D or magnesium, it rarely makes headlines. Yet your brain, liver, cell membranes, and nervous system all depend on it every single day.

What Choline Actually Does In Your Brain

Choline is a water-soluble compound that sits somewhere between a vitamin and a mineral in how the body handles it. Your liver makes a small amount, but nowhere near enough. The rest must come from food. Think of it as a structural nutrient: it’s a core ingredient in the membranes surrounding every cell in your body. The brain, with its enormously complex network of branching neurons constantly communicating with each other, has a higher demand for healthy cell membranes than almost any other tissue.

Choline is also the raw material your body uses to produce acetylcholine. It’s a neurotransmitter that plays a central role in memory, learning, muscle control, and mood regulation. When choline runs low, acetylcholine production can suffer, and that has real consequences for how you feel, focus, and regulate your emotions from day to day.

The Possible Feedback Loop In Anxiety

Anxiety triggers chronic, elevated stress response

Heightened neural activity may deplete choline faster

Lower choline limits acetylcholine production

Reduced capacity to regulate emotional responses

Anxiety becomes harder to manage over time

Does Low Choline Cause Anxiety — Or Does Anxiety Drain It?

This is the genuinely fascinating and still-open question in the research. It could be that people prone to anxiety are born with a slightly less efficient choline metabolism. Or it could be that the chronic hyperactivated stress response that defines anxiety disorders burns through choline faster, depleting the brain’s reserves over time. Researchers suspect the answer is probably some combination of both — a feedback loop that’s easier to interrupt once you know it exists.

What makes the connection especially interesting is its implication for therapy. Anxiety is most effectively treated with cognitive behavioral therapy, which is fundamentally a learning process: you’re training yourself to recognize thought patterns and respond differently. Acetylcholine is directly involved in the brain’s learning and memory systems. If low choline is impairing that machinery, it could help explain why some people move through therapy faster than others — and why addressing nutrition alongside treatment may matter more than we’ve appreciated.

The Therapy Connection

CBT works by teaching the brain new emotional responses — it’s active learning. Choline supports the acetylcholine system that makes that learning possible. Researchers suggest that adequate choline intake may help the brain be more receptive to the rewiring that therapy requires, which could make treatment more effective for some people.

Why Almost None Of Us Are Getting Enough

Here’s the part that deserves more attention than it typically gets: data from the National Health and Nutrition Examination Survey found that only about 6% of women and 11% of men in the U.S. meet the adequate daily intake for choline. Oregon State University’s Linus Pauling Institute, reviewing national micronutrient data, found that roughly 91% of Americans fall short of the recommended level. That’s not a fringe deficiency — it’s practically universal.

The recommended adequate intake is 425 mg per day for women and 550 mg per day for men. Pregnant women need slightly more, at 450 mg — and fewer than 9% of pregnant women actually hit that target. The irony is striking: choline is especially critical during pregnancy for fetal brain development, yet the people who need it most are getting it least.

One major reason for the widespread gap: choline is found predominantly in animal-based foods. As plant-forward and vegan diets have grown in popularity, choline has quietly become harder to get without conscious planning. Plant sources exist, but they tend to contain lower concentrations, meaning vegetarians and vegans need to be especially intentional about including them.

The Foods To Prioritize

The good news is that eating for choline does not require a dramatic overhaul. A handful of foods, many of which you probably already enjoy, can make a meaningful difference.

See also

🥚 Eggs
One egg delivers ~125mg; almost all of it is in the yolk. Don’t skip it!
🐟 Salmon
The standout choice: rich in both choline and omega-3s, which help choline reach the brain
🥩 Beef Liver
The single most concentrated source. Not for everyone, but nutritionally exceptional
🫘 Kidney & Navy Beans
The best plant-based sources; great in soups, grain bowls, and salads
🥦 Cruciferous Vegetables
Broccoli, Brussels sprouts, bok choy, and kale all contribute meaningfully
🍗 Chicken & Turkey
Lean poultry is one of the most accessible and versatile choline sources going
🐟 Canned Tuna
An underrated, budget-friendly option. Easy to add to salads, wraps, or pasta
🍄 Shiitake Mushrooms
One of the better plant-based sources; a smart addition to stir-fries and broths

Why Salmon Is The Smart Standout

There’s an important detail that elevates salmon above everything else on this list: choline appears to enter the brain most efficiently when omega-3 fatty acids — particularly DHA — are also present in the diet. The two nutrients appear to work together, with omega-3s helping choline cross the blood-brain barrier more effectively. Foods that contain both (salmon, mackerel, sardines) give you a genuine two-for-one nutritional advantage. If your diet is lower in fatty fish, nutrition researchers suggest pairing choline-rich foods with an omega-3 supplement to help maximize absorption.

A Note on Supplements

Despite the compelling data, both nutritionists and the UC Davis researchers consistently advise against simply reaching for a choline supplement. Choline from whole food comes packaged with other nutrients that aid absorption and use, and very high supplemental doses can have side effects. The guidance from the research community is consistent: food first. Start by adding eggs to your morning routine and working more salmon, beans, and cruciferous vegetables into your week. If you’re genuinely concerned about your levels, a registered dietitian can assess your specific diet and advise accordingly.

What This Research Doesn’t Mean

It would be easy to read these findings and assume that eating more eggs will fix anxiety. That’s not what the science says, and it’s worth saying clearly. Anxiety disorders are complex conditions influenced by genetics, life experience, sleep, stress, and brain chemistry in ways no single nutrient can fully address. Choline is one piece of a larger picture.

What this research does offer is a reminder that nutrition is an underexplored variable in mental health, and that the foods we eat every day have a quieter relationship with how our brains function than most of us realize. For anyone already working with a therapist or doctor on anxiety management, paying attention to choline intake is a low-effort, science-backed addition to the toolkit. For everyone else, it’s solid motivation to eat your eggs — and not skip the yolk.

A note on this article: This piece is intended for general wellness interest and should not be read as medical advice. If anxiety is affecting your daily life, please speak with a qualified healthcare provider. Dietary changes are best made in consultation with your doctor or a registered dietitian.

Sources

  1. Smucny J, Maddock RJ. Choline concentration in anxiety disorders: A meta-analysis of proton magnetic resonance spectroscopy studies. Molecular Psychiatry. 2025. PubMed Central →
  2. National Institutes of Health, Office of Dietary Supplements. Choline — Health Professional Fact Sheet. ods.od.nih.gov →
  3. National Institutes of Health, Office of Dietary Supplements. Choline — Consumer Fact Sheet. ods.od.nih.gov →
  4. Oregon State University, Linus Pauling Institute. Choline. lpi.oregonstate.edu →
  5. Oregon State University, Linus Pauling Institute. Micronutrient Inadequacies in the US Population. lpi.oregonstate.edu →
  6. Zeisel SH, da Costa KA. Choline: An Essential Nutrient for Public Health. Nutrition Reviews. 2009. PubMed Central →
  7. National Institute of Mental Health. Any Anxiety Disorder — Statistics. nimh.nih.gov →

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