Anxiety disorders affect millions of people, and new research is exploring whether nutrition may play a supporting role in brain chemistry related to stress and emotional regulation. A recent analysis suggests that people with certain anxiety disorders may have lower levels of choline in specific brain regions, but experts caution against oversimplifying the findings.
What the Research Found
Researchers at UC Davis Health analyzed data from 25 previously published brain-imaging studies, comparing 370 individuals with anxiety disorders to 342 individuals without anxiety. Using a non-invasive MRI technique called magnetic resonance spectroscopy, they measured brain metabolites rather than blood nutrient levels.
Across the combined studies, individuals with generalized anxiety disorder, panic disorder, and social anxiety disorder showed an average of about 8% lower choline levels in brain regions involved in thinking, emotional regulation, and stress response.¹
Although an 8% difference may seem small, researchers noted that even modest changes in brain chemistry can be meaningful, particularly in regions that help regulate emotional balance.
What Is Choline and Why It Matters
Choline is an essential nutrient, meaning the body produces only small amounts and must obtain the rest from food. It plays an important role in:
- Cell membrane structure
- Neurotransmitter production (especially acetylcholine)
- Memory and cognitive function
- Nervous system development and maintenance
Choline is found in foods such as eggs, beef, poultry, fish, soybeans, and dairy products.²
National surveys show that most Americans do not meet recommended choline intake levels, including children and older adults.³
Cause or Consequence?
Importantly, the study does not prove that low choline causes anxiety. The researchers themselves emphasized this point.
One hypothesis is that chronic stress and heightened threat responses in anxiety disorders may increase the brain’s metabolic demand for choline, gradually lowering its levels. In this view, low choline may be a marker of metabolic strain, not the root cause of anxiety.¹
Psychiatrists and nutrition experts interviewed in response to the findings agree that anxiety is multifactorial, involving genetics, life experiences, neurobiology, and environmental stressors—not a single nutrient deficiency.⁴⁻⁶
Should People Take Choline Supplements?
At this stage, experts say no.
While choline is essential, high-dose supplementation can cause side effects, including gastrointestinal distress, low blood pressure, and fishy body odor.⁷ Researchers stressed that it is too early to recommend choline supplements as a treatment for anxiety.
Instead, clinicians suggest reviewing overall diet quality and ensuring adequate intake of brain-supporting nutrients as part of general health guidance, especially for individuals under chronic stress.
Nutrition Is One Piece of a Larger Puzzle
Other nutrients—such as vitamin D, omega-3 fatty acids, magnesium, and B vitamins—have also been linked to mood and anxiety regulation in previous studies.⁸ Nutrition may help support resilience and metabolic balance, but it is not a substitute for evidence-based anxiety treatments, including therapy and, when appropriate, medication.
A balanced diet that includes whole foods like eggs, fish, dairy, vegetables, and healthy fats may support overall brain health, regardless of anxiety status.
Bottom Line
This research highlights a consistent association between anxiety disorders and lower choline levels in key brain regions—but it does not show that choline deficiency causes anxiety or that supplementation is a cure.
The findings open the door for future research into how stress, metabolism, and nutrition interact in the brain, while reinforcing an important principle: mental health is complex, and no single nutrient explains it all.
References
- Maddock RJ, Smucny J, et al. Reduced brain choline in anxiety disorders: A meta-analysis using magnetic resonance spectroscopy. Biological Psychiatry. 2025.
- Zeisel SH, da Costa KA. Choline: an essential nutrient for public health. Nutrition Reviews. 2009;67(11):615–623.
- Wallace TC, Fulgoni VL. Usual choline intakes are below recommendations for most Americans. Journal of the American College of Nutrition. 2016;35(8):709–717.
- Stein MB, Sareen J. Clinical practice: generalized anxiety disorder. New England Journal of Medicine. 2015;373:2059–2068.
- Kocher N. Clinical commentary on metabolic stress and anxiety. Psychiatric Practice Review. 2025.
- Manaker L. Nutrition and mental health: separating correlation from causation. Journal of Nutrition & Dietetics. 2024.
- Institute of Medicine. Dietary Reference Intakes for Choline. National Academies Press, 1998.
- Sarris J, et al. Nutritional medicine as mainstream in psychiatry. The Lancet Psychiatry. 2015;2(3):271–274.