New research from UC Davis Health shows that people with anxiety disorders tend to have lower levels of a brain chemical called choline.
This discovery could help explain some of the brain changes that occur in people with anxiety and might lead to new ways to support mental health through diet.
The study was published in the journal Molecular Psychiatry and looked at 25 previous studies. It compared brain chemical levels in 370 people with anxiety disorders to 342 people without anxiety.
Researchers found that choline levels were about 8% lower in people with anxiety. This was most noticeable in the prefrontal cortex, the part of the brain that helps us make decisions and manage emotions.
Dr. Jason Smucny, one of the study authors, said this is the first time a meta-analysis has shown a clear chemical pattern in the brain in people with anxiety. He explained that the results suggest nutritional approaches, such as getting enough choline through food, might help balance brain chemistry and support treatment for anxiety.
Choline is a vital nutrient that helps build cell membranes and supports brain functions like mood, memory, and muscle control. Our bodies make a small amount of choline, but most of it must come from food. Good sources of choline include egg yolks, beef liver, chicken, fish, soybeans, and milk.
Anxiety disorders are very common. In fact, about 30% of adults in the U.S. are affected. These disorders include generalized anxiety disorder, panic disorder, social anxiety, and phobias. They can be severe and often go untreated.
Dr. Richard Maddock, a psychiatrist and research professor at UC Davis, has spent many years studying anxiety and how brain chemistry affects it. He explained that anxiety disorders often involve changes in how the brain processes stress and danger.
In people with anxiety, the amygdala, which helps judge whether situations are safe, and the prefrontal cortex, which helps with decision-making, don’t work the same way as they do in people without anxiety.
Chemicals in the brain, like norepinephrine—which helps control the body’s fight-or-flight response—are often higher in people with anxiety. Normally, the brain helps us tell the difference between daily stress and real danger, but in anxiety disorders, small problems can feel overwhelming.
To measure choline and other brain chemicals, the researchers used a special brain scan method called proton magnetic resonance spectroscopy (1H-MRS). This technique uses an MRI machine to look at brain chemistry rather than just brain images. It allowed them to see that people with anxiety consistently had lower choline levels.
Dr. Maddock said that although an 8% drop might not sound like much, it’s actually quite significant when it comes to brain chemistry. He thinks that the brain’s increased stress levels in anxiety may use up more choline, which could explain why levels are lower in these patients.
Still, the researchers don’t yet know whether adding more choline to the diet can reduce anxiety. More studies are needed before making that recommendation. Dr. Maddock warned against taking large amounts of choline supplements, which may not be safe or helpful without medical advice.
Instead, he recommends eating a balanced diet that includes foods rich in choline. He noted that most people in the U.S.—including children—do not get enough choline through food. Fatty fish like salmon, which also contain omega-3 fatty acids, may be especially good sources for the brain.
This research helps us understand how brain chemistry may play a role in anxiety. It also shows that nutrients like choline are important for mental health, not just physical health.
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