Fewer than one in ten American adults consume enough choline each day, and new brain research suggests the shortfall is not harmless.
An analysis of national survey data found that only about 8 percent of adults and 8.5 percent of pregnant women meet the recommended intake, well below the 550 mg daily target for men and 425 mg for women set by health authorities.
A meta-analysis published November 10, 2025 in Molecular Psychiatry by UC Davis researchers pulled 25 brain-imaging studies together and compared 370 people with anxiety disorders to 342 without.
Choline levels in the brain were about 8 percent lower in the anxiety group, with the clearest signal in the prefrontal cortex.
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"An 8% lower amount doesn't sound like that much, but in the brain it's significant," senior author Richard Maddock, a psychiatrist and research professor at the UC Davis Department of Psychiatry and Behavioral Sciences, told the university.
Why the brain and liver rely on it
The body uses choline to build acetylcholine, a neurotransmitter that, according to the Harvard T.H. Chan School of Public Health, "helps muscles to contract, activates pain responses, and plays a role in brain functions of memory and thinking."
Harvard also notes that people with Alzheimer's disease have lower levels of the enzyme that converts choline into acetylcholine, a mechanism researchers are still probing for potential preventive value.
Most of the choline you eat goes to your liver, where it is turned into phosphatidylcholine and helps ferry fats out of the organ. When intake runs low, fat can accumulate, raising the risk of nonalcoholic fatty liver disease.
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A separate line of work points to costs that show up long before old age.
In a study of 30 young adults published November 27, 2025 in Aging and Disease, Arizona State University researchers found that young people with obesity had elevated inflammation, liver enzyme abnormalities, higher neurofilament light chain (a marker of neuron damage) and substantially lower blood choline than healthy-weight peers. The pattern echoed changes usually seen in older adults with cognitive impairment.
What the anxiety study can and cannot tell us
The UC Davis paper is a meta-analysis of observational brain scans, not a trial of choline as a treatment. It shows a consistent association, not that low choline causes anxiety or that supplementing will fix it.
"We don't know yet if increasing choline in the diet will help reduce anxiety. More research will be needed," Maddock cautioned.
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Where choline actually shows up on your plate
Choline is concentrated in a short list of animal foods, with a few plant options at lower levels. Figures below are drawn from the peer-reviewed assessment of U.S. intake that analyzed the National Health and Nutrition Examination Survey.
Chicken liver, 3 oz: about 247 mg
Salmon, 3 oz: about 187 mg
One large egg: about 125 mg, almost all in the yolk
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Beef steak (grass-fed), 3 oz: about 55 mg
Soybeans, dairy and cruciferous vegetables round out the smaller contributors
Egg eaters clear the bar much more often. In the same national analysis, adults who ate eggs averaged 525 mg of choline a day, while non-egg-eaters averaged 294 mg. Only 2.4 percent of adult non-egg-eaters met the recommended intake, versus 57 percent of egg eaters.
Supplements exist, but food comes first
Choline is sold as a supplement in forms such as choline bitartrate and phosphatidylcholine, and clinical guidance from Harvard's Nutrition Source is measured. Observational data hint at cognitive benefits, but "clinical trials have not found that choline supplementation significantly improves these cognitive measures."
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For most people, closing the gap is a food question, not a pill question. An egg at breakfast, salmon at dinner or the occasional serving of liver moves the daily total quickly. Anyone weighing supplements, especially during pregnancy or alongside prescription medication, should talk it through with a doctor first.