Anxiety disorders affect millions of people worldwide and are among the most common mental health conditions. While counselling, medication, exercise, stress management, and good sleep habits remain important components of treatment, researchers are increasingly exploring how nutrition may influence mental wellbeing.
One nutrient that has recently come under the spotlight is choline.
A 2025 review published in Molecular Psychiatry analysed brain imaging studies involving people with anxiety disorders and found consistently lower levels of choline-containing compounds in several brain regions compared to healthy controls. These findings were observed across multiple anxiety disorders, suggesting that altered choline metabolism may be a common feature of anxiety-related conditions.
While this doesn’t mean that low choline causes anxiety, it does raise an interesting question: could consuming enough choline-rich foods help support brain health and play a role in anxiety management?
What is Choline?
Choline is an essential nutrient that plays a vital role in brain function, nervous system health, and overall wellbeing. Although the body can produce small amounts, most of our choline needs must come from the foods we eat.
Choline is involved in:
- Producing acetylcholine, a neurotransmitter involved in memory, learning, mood, and muscle function
- Maintaining healthy cell membranes
- Supporting liver function
- Assisting methylation pathways involved in brain and nervous system health
- Supporting cognitive function and communication between brain cells
Despite its importance, many people don’t consume enough choline on a regular basis, particularly those who avoid eggs or animal-based foods.
What Did the Research Find?
The recent Molecular Psychiatry review examined 25 studies investigating choline levels in the brains of people with anxiety disorders.
Researchers found that participants with anxiety disorders had significantly lower levels of total choline-containing compounds in several cortical brain regions, with concentrations averaging approximately 8% lower than those of healthy controls.
The authors suggest these findings may be linked to changes in neuroplasticity—the brain’s ability to learn, adapt, and respond to experiences. Since anxiety disorders often involve altered learning patterns, increased threat perception, and changes in brain circuitry, choline may play an important role in these processes.
The researchers also highlighted previous evidence showing that choline deficiency can negatively affect learning and memory, while adequate choline intake appears important for optimal cognitive function.
Importantly, the study does not suggest that choline supplements should be used as a treatment for anxiety. Instead, it highlights a promising area for future research and suggests that choline deserves greater attention in discussions around mental health and nutrition.
Why Food Should Come Before Supplements
When a nutrient starts making headlines, it’s easy to assume that supplements are the answer.
However, nutrition rarely works in isolation.
Many choline-rich foods provide a package of nutrients that work together to support brain health, including:
- Omega-3 fatty acids
- Vitamin B12
- Folate
- Iron
- Zinc
- Selenium
- Protein
These nutrients play important roles in neurotransmitter production, brain cell communication, energy production, and nervous system function.
A supplement may provide choline alone, but wholefoods offer a much broader range of benefits that are difficult to replicate in a capsule.
For most people, prioritising food sources of choline is likely to be the most beneficial and sustainable approach.
The Best Wholefood Sources of Choline
Eggs
Eggs are one of the richest sources of choline available. In fact, a large proportion of the choline in eggs is found in the yolk, making whole eggs the best choice.
In addition to choline, eggs provide protein, selenium, iodine, vitamin B12, and other nutrients important for brain health.
Salmon
Salmon is another excellent source of choline and provides omega-3 fatty acids, which have been extensively studied for their role in supporting cognitive function and mental wellbeing.
Together, choline and omega-3 fats make salmon one of the most nutrient-dense foods for brain health.
Lean Beef
Lean beef provides choline alongside iron, zinc, vitamin B12, and high-quality protein.
These nutrients support energy production, oxygen transport, and cognitive performance.
Soy Foods
For vegetarians and vegans, soy foods are among the best plant-based sources of choline.
Examples include:
- Tofu
- Tempeh
- Edamame
- Soybeans
These foods also provide plant protein and beneficial compounds called isoflavones.
Legumes
Chickpeas, lentils, kidney beans, and other legumes contain moderate amounts of choline while providing fibre that supports gut health.
As research continues to uncover the connection between gut health and mental wellbeing, legumes are a valuable addition to any diet.
Cruciferous Vegetables
Broccoli, cauliflower, Brussels sprouts, and cabbage contribute smaller amounts of choline but can still make a meaningful contribution when consumed regularly.
They also provide antioxidants and phytochemicals that support overall health.
Three Choline-Rich Recipes to Support Brain Health
Mediterranean Egg and Chickpea Breakfast Bowl
A satisfying breakfast that combines two excellent sources of choline.
Ingredients
- 4 eggs
- 1 cup chickpeas, drained and rinsed
- 1 cup baby spinach
- 1 cucumber, diced
- 1 tomato, diced
- 2 tablespoons feta cheese
- 1 tablespoon extra virgin olive oil
- Juice of half a lemon
Method
- Cook eggs to your preference.
- Heat olive oil in a pan and lightly sauté the spinach and chickpeas.
- Divide between two bowls.
- Add cucumber, tomato, and feta.
- Top with eggs and finish with lemon juice.
Miso Salmon with Sesame Broccoli
A simple weeknight meal rich in both choline and omega-3 fats.
Ingredients
- 4 salmon fillets
- 1 tablespoon white miso paste
- 1 tablespoon reduced-salt soy sauce
- 1 teaspoon honey
- 2 heads broccoli, chopped
- 1 tablespoon sesame seeds
- Cooked brown rice to serve
Method
- Preheat oven to 200°C.
- Mix miso, soy sauce, and honey together.
- Brush over salmon fillets.
- Bake for 12–15 minutes or until cooked through.
- Steam broccoli until tender.
- Sprinkle broccoli with sesame seeds and serve with salmon and brown rice.
Tempeh and Vegetable Stir-Fry
A plant-based meal packed with choline and fibre.
Ingredients
- 250g tempeh, sliced
- 2 cups broccoli florets
- 1 red capsicum, sliced
- 1 carrot, julienned
- 2 tablespoons tamari
- 1 tablespoon sesame oil
- 1 clove garlic, minced
- Brown rice to serve
Method
- Heat sesame oil in a large pan.
- Cook tempeh until lightly golden.
- Add vegetables and stir-fry until tender-crisp.
- Add garlic and tamari.
- Serve over brown rice.
Could Choline Deficiency Cause Anxiety?
At this stage, we don’t have enough evidence to say that low dietary choline directly causes anxiety disorders.
What we do know is that people with anxiety disorders appear to have lower levels of choline-containing compounds in certain regions of the brain.
Whether these lower levels contribute to anxiety symptoms, result from anxiety itself, or reflect another underlying process remains unclear.
Mental health is influenced by many factors, including:
- Genetics
- Sleep quality
- Physical activity
- Chronic stress
- Social connection
- Life experiences
- Overall dietary patterns
No single nutrient is likely to provide a complete solution.
However, ensuring adequate choline intake through food is a practical step that may help support overall brain health.
Take Home Message
The connection between nutrition and mental health is complex, and no single nutrient is likely to be a magic solution for anxiety. However, emerging research suggests that choline may be an important piece of the puzzle.
A recent review found that people living with anxiety disorders had lower levels of choline-containing compounds in key areas of the brain, highlighting a potential connection between choline metabolism and anxiety. While more research is needed to determine whether increasing choline intake can directly improve anxiety symptoms, ensuring adequate intake remains an important part of supporting overall brain health.
The good news is that choline is found in a variety of nutritious wholefoods, including eggs, salmon, legumes, tofu, tempeh, lean meats, and cruciferous vegetables. These foods provide far more than just choline—they also contain a range of nutrients that work together to support cognitive function, nervous system health, and overall wellbeing.
Rather than focusing on supplements, a food-first approach that includes a variety of choline-rich foods is likely to offer the greatest benefit. As researchers continue to explore the fascinating link between nutrition and mental health, choline is certainly a nutrient worth keeping on your radar.
Looking for Personalised Nutrition Support?
Nutrition is just one piece of the mental health puzzle, but it can play an important role in supporting brain health, energy levels, gut health, and overall wellbeing. If you’re experiencing anxiety or looking to optimise your health through nutrition, working with an Accredited Practising Dietitian can help you develop a practical and sustainable approach tailored to your individual needs.
At Feed Your Future Dietetics, we provide evidence-based nutrition advice that looks beyond individual nutrients and focuses on your whole health. Whether you’re seeking support for mental wellbeing, digestive health, chronic disease management, neurodivergence, or general healthy eating, we’re here to help.
Ready to nourish your body and mind?
Contact Feed Your Future Dietetics at ashleigh@feedyourfuturedietetics.com.au to book an appointment and receive personalised nutrition support tailored to your goals.
Reference:
- Maddock, R.J., Smucny, J. Transdiagnostic reduction in cortical choline-containing compounds in anxiety disorders: a 1H-magnetic resonance spectroscopy meta-analysis. Mol Psychiatry 30, 6020–6032 (2025). https://doi.org/10.1038/s41380-025-03206-7
