Quick Facts

• Young adults with obesity showed elevated levels of NfL, a protein released when brain neurons are damaged
• Up to 90% of Americans don’t get enough choline, a nutrient essential for brain and liver health
• The same biomarker patterns appear in older adults with mild cognitive impairment and Alzheimer’s disease

Arizona State University researchers found brain damage markers in adults in their 20s and 30s with obesity. The study suggests Alzheimer’s-like changes begin decades before symptoms appear.

The research team analyzed blood samples from 30 young adults. Half had obesity, half maintained healthy weight. Those with obesity showed significantly higher levels of neurofilament light chain (NfL), a protein released when neurons are damaged.

NfL serves as an early warning sign of neurodegeneration. The protein appears at high levels in people with mild cognitive impairment and Alzheimer’s disease.

The study found the same pattern in young adults with obesity as in older adults with cognitive decline. Lower choline levels paired with higher NfL markers.

“This research adds to the growing evidence that choline is a valuable marker of metabolic and brain dysfunction,” said Professor Ramon Velazquez, who led the study.

Participants with obesity had substantially lower choline levels. These reductions correlated with inflammation, insulin resistance, elevated liver enzymes and NfL markers.

Choline deficiency affects most Americans. Up to 90% fall short of recommended intake. Only 6% of women and 11% of men meet daily requirements according to national survey data.

The nutrient supports liver health, reduces inflammation and helps produce acetylcholine, a brain neurotransmitter. Adults need 425 milligrams daily for women and 550 milligrams for men.

Women in the study had lower choline levels than men. This finding matters because women experience higher rates of cognitive aging and Alzheimer’s disease.

Choline comes from eggs, fish, poultry, beans and cruciferous vegetables like broccoli and Brussels sprouts. The liver produces small amounts, but diet provides the primary source.

About one in three American adults has metabolic syndrome. Research shows people with metabolic syndrome face 24% higher risk of developing early-onset dementia.

The researchers noted GLP-1 drugs may worsen choline deficiency. These appetite-suppressing medications could lead people to consume even less choline.

“Most people don’t realize they aren’t getting enough choline,” said Wendy Winslow, first co-author of the study.

The findings appeared in the journal Aging and Disease. The research team included scientists from ASU-Banner Neurodegenerative Disease Research Center, Banner Sun Health Research Institute and Mayo Clinic Arizona.

The study shows metabolic stress and brain health connect earlier than previously understood. Getting adequate choline and supporting metabolic health may help build stronger foundations for long-term cognitive function.

Read more: Alzheimer’s-Like Changes Seen In Young Adults — This Metabolic Marker Drives It