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Okada LM, Marques ES, Levy RB, Gonçalves VSS, Peres MFT, Azeredo CM. Association between ultra-processed dietary pattern and bullying: the role of deviant behaviors. Front Nutr 2024; 11:1352258. [PMID: 39027661 PMCID: PMC11254820 DOI: 10.3389/fnut.2024.1352258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/21/2024] [Indexed: 07/20/2024] Open
Abstract
Background Ultra-processed foods have been associated with several negative outcomes, but it is not clear whether they are related to bullying perpetration. Moreover, no previous study has investigated the potential role of deviant behaviors as a mediator of this association. Our objective was to evaluate the association between ultra-processed dietary pattern and bullying, and the mediating effect of deviant behaviors in this association, among school adolescents. Methods We used data from a representative sample of 9th grade Brazilian adolescents (N = 2,212) from the São Paulo Project for the social development of children and adolescents (SP-PROSO). Exploratory factor analysis was used to obtain the dietary patterns, through questions of frequency of consumption in the last week of several foods. The ultra-processed dietary pattern was considered as exposure. The outcomes were the types of bullying (any type, social exclusion, psychological/verbal aggression, physical aggression, property destruction, and sexual harassment). Deviant behaviors (mediator) were assessed through a score. Mediation analyses were carried out using logistic regression based on the KHB method. Results After adjusting for covariates, the mediating effect of deviant behaviors was found in the association between ultra-processed dietary pattern and all the types of bullying perpetration, especially for psychological/verbal aggression (39.4%). A small mediating effect of deviant behaviors in the association of ultra-processed dietary pattern with physical aggression (17.7%) and property destruction (18.5%) was observed, but this effect explained only a small portion of the total effect of such association (significant direct effect). Conclusion The ultra-processed dietary pattern was associated with bullying, and the association was mediated through deviant behaviors. Policies and actions for improving the adolescent's diet and managing the adoption of deviant and bullying behaviors by this public are required.
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Affiliation(s)
- Letícia Martins Okada
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Emanuele Souza Marques
- Instituto de Medicina Social Hesio Cordeiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Renata Bertazzi Levy
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Catarina Machado Azeredo
- Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, Brazil
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2
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Poulter M, Coe S, Graham CAM, Leach B, Tammam J. A systematic review of the effect of dietary and nutritional interventions on the behaviours and mental health of prisoners. Br J Nutr 2024:1-14. [PMID: 38682285 DOI: 10.1017/s0007114524000849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Prisoners experience a higher burden of poor health, aggressive behaviours and worsening mental health than the general population. This systematic review aimed to identify research that used nutrition-based interventions in prisons, focusing on outcomes of mental health and behaviours. The systematic review was registered with Prospective Register of Systematic Reviews on 26 January 2022: CRD42022293370. Inclusion criteria comprised of current prisoners with no limit on time, location, age, sex or ethnicity. Only quantitative research in the English language was included. PubMed/Medline, Web of Science, EMBASE, PsycINFO and CINAHL were searched, retrieving 933 results, with 11 included for qualitative synthesis. Studies were checked for quality using the revised tool to assess risk of bias in randomised trials or risk of bias in non-randomised studies of interventions tool. Of the included studies, seven used nutritional supplements, three included diet changes, and one used education. Of the seven supplement-based studies, six included rule violations as an outcome, and only three demonstrated significant improvements. One study included mental health as an outcome; however, results did not reach significance. Of the three diet change studies, two investigated cognitive function as an outcome, with both reaching significance. Anxiety was included in one diet change study, which found a significant improvement through consuming oily fish. One study using diet education did not find a significant improvement in overall mental resilience. Overall, results are mixed, with the included studies presenting several limitations and heterogeneity. Future research should aim to consider increased homogeneity in research design, allowing for a higher quality of evidence to assess the role nutrition can play in improving the health of prisoners.
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Affiliation(s)
- Matthew Poulter
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
| | - Shelly Coe
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
| | - Catherine Anna-Marie Graham
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
- Cereneo Foundation, Center for Interdisciplinary Research (CEFIR), 6354Vitznau, Switzerland
- Lake Lucerne Institute AG, Rubistrasse 9, 6354Vitznau, Switzerland
| | - Bethan Leach
- Practice Plus Group, Hawker House 5-6 Napier Court, Napier Rd, Reading, BerkshireRG1 8BW, UK
| | - Jonathan Tammam
- Centre for Nutrition and Health, Faculty of Health & Life Sciences, Oxford Brookes University, OX3 0BP, Oxford, UK
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3
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Schoenthaler SJ, Prescott SL, Logan AC. Homicide or Happiness: Did Folate Fortification and Public Health Campaigns Influence Homicide Rates and the Great American Crime Decline? Nutrients 2024; 16:1075. [PMID: 38613108 PMCID: PMC11013728 DOI: 10.3390/nu16071075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
The last several years have witnessed a remarkable growth in research directed at nutrition and behavior, with increased interest in the field of nutritional criminology. It is becoming clear that dietary patterns and specific nutrients play an important role in cognition and behavior, including those related to aggression, violence, and antisocial activity. Included in this expanding knowledge base is the recognition that folate, through multiple pathways, including enzymatic reactions and gut microbiome ecology, plays a critical role in central nervous system functioning. These mechanistic advances allow for a retrospective analysis of a topic that remains unexplained-the sudden and unpredicted drop in homicide and other violent crime rates in the United States and other nations in the 1990s. Here, we revisit this marked reduction in homicide rates through the lens of the coincident public health campaign (and subsequent mandatory fortification) to increase folic acid intake. Based on objectively measured blood folate levels through the National Health and Nutrition Examination Surveys, there is little doubt that tissue folate witnessed a dramatic rise at the national level from 1988 through 2000. Drawing from accumulated and emerging research on the neurobehavioral aspects of folate, it is our contention that this relatively sudden and massive increase in tissue folate levels may have contributed to reductions in violent crime in the United States.
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Affiliation(s)
- Stephen J. Schoenthaler
- Department of Criminal Justice, College of the Arts, Humanities & Social Sciences, California State University, Turlock, CA 95202, USA;
| | - Susan L. Prescott
- Nova Institute for Health, Baltimore, MD 21231, USA
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia
- Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
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Byrne MK, Cook R, Murta JCD, Bressington D, Meyer BJ. Dietary Intakes of Long-Chain Polyunsaturated Fatty Acids and Impulsivity: Comparing Non-Restricted, Vegetarian, and Vegan Diets. Nutrients 2024; 16:875. [PMID: 38542786 PMCID: PMC10975088 DOI: 10.3390/nu16060875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/08/2024] [Accepted: 03/15/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND Research suggests a link between deficiencies in omega-3 long-chain polyunsaturated fatty acids (LCPUFAs) and impulsivity among psychiatric populations. However, this association is less evident in non-clinical populations. As omega-3 LCPUFAs are predominantly sourced through fish consumption, non-fish dieters may be more vulnerable to higher impulsivity. METHODS This cross-sectional observational study explored the association between lower intakes of omega-3 LCPUFA food sources and higher self-reported measures of impulsivity among healthy adults consuming non-restricted, vegetarian, and vegan diets. RESULTS The results from the validated Food Frequency Questionnaire showed significantly lower estimated omega-3 LCPUFA intakes among vegans and vegetarians when compared with people consuming non-restricted diets. Furthermore, although all groups scored within the normal range of impulsivity measures, vegans scored comparatively higher. Vegans also scored significantly higher in impulsivity control relating to attention than those consuming non-restricted diets. CONCLUSIONS The significantly lower omega-3 LCPUFA dietary intakes in the vegan diets were associated with higher scores in the second-order attentional aspect of self-reported impulsiveness.
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Affiliation(s)
- Mitchell K. Byrne
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
| | - Rebecca Cook
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
| | - Janina C. D. Murta
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
| | - Daniel Bressington
- Faculty of Health, Charles Darwin University, Ellengowan Drive, Darwin, NT 0810, Australia; (M.K.B.); (R.C.); (J.C.D.M.); (D.B.)
- Faculty of Nursing, Chiang Mai University, 110/406 Inthawaroros Road, Sri Phum District, Chiang Mai 50200, Thailand
| | - Barbara J. Meyer
- School of Medical, Indigenous and Health Sciences, Lipid Research Centre, Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute, Wollongong, NSW 2522, Australia
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5
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Prescott SL, Logan AC, D’Adamo CR, Holton KF, Lowry CA, Marks J, Moodie R, Poland B. Nutritional Criminology: Why the Emerging Research on Ultra-Processed Food Matters to Health and Justice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:120. [PMID: 38397611 PMCID: PMC10888116 DOI: 10.3390/ijerph21020120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
There is mounting concern over the potential harms associated with ultra-processed foods, including poor mental health and antisocial behavior. Cutting-edge research provides an enhanced understanding of biophysiological mechanisms, including microbiome pathways, and invites a historical reexamination of earlier work that investigated the relationship between nutrition and criminal behavior. Here, in this perspective article, we explore how this emergent research casts new light and greater significance on previous key observations. Despite expanding interest in the field dubbed 'nutritional psychiatry', there has been relatively little attention paid to its relevancy within criminology and the criminal justice system. Since public health practitioners, allied mental health professionals, and policymakers play key roles throughout criminal justice systems, a holistic perspective on both historical and emergent research is critical. While there are many questions to be resolved, the available evidence suggests that nutrition might be an underappreciated factor in prevention and treatment along the criminal justice spectrum. The intersection of nutrition and biopsychosocial health requires transdisciplinary discussions of power structures, industry influence, and marketing issues associated with widespread food and social inequalities. Some of these discussions are already occurring under the banner of 'food crime'. Given the vast societal implications, it is our contention that the subject of nutrition in the multidisciplinary field of criminology-referred to here as nutritional criminology-deserves increased scrutiny. Through combining historical findings and cutting-edge research, we aim to increase awareness of this topic among the broad readership of the journal, with the hopes of generating new hypotheses and collaborations.
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Affiliation(s)
- Susan L. Prescott
- School of Medicine, University of Western Australia, Perth, WA 6009, Australia;
- Nova Institute for Health, Baltimore, MD 21231, USA;
- Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
- The ORIGINS Project, Telethon Kids Institute, Perth, WA 6009, Australia
| | - Alan C. Logan
- Nova Institute for Health, Baltimore, MD 21231, USA;
| | - Christopher R. D’Adamo
- Nova Institute for Health, Baltimore, MD 21231, USA;
- Department of Family and Community Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Kathleen F. Holton
- Departments of Health Studies and Neuroscience, Center for Neuroscience and Behavior, American University, Washington, DC 20016, USA;
| | - Christopher A. Lowry
- Department of Psychology and Neuroscience, Center for Neuroscience and Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA;
| | - John Marks
- Department of Criminal Justice, Louisiana State University of Alexandria, Alexandria, LA 71302, USA;
| | - Rob Moodie
- School of Population and Global Health (MSPGH), University of Melbourne, Melbourne, VIC 3052, Australia;
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5R 0A3, Canada;
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Verde L, Pagano AM, de Leo M, Vetrani C, Ambretti A, Lucania L, Babudieri S, De Chiara A, Colao A, Corsi M, Muscogiuri G, Barrea L. Diet-Related Risk Factors for Chronic Noncommunicable Diseases in Italian Prisoners: B.A.C.I. (Benessere All'interno delle Carceri Italiane, Well-Being Inside the Italian Prisons) Project by the Italian Society of Penitentiary Medicine and Public Health (S.I.M.S.Pe. Società Italiana di Medicina e Sanità Penitenziaria). Curr Nutr Rep 2023; 12:709-720. [PMID: 37948008 PMCID: PMC10766735 DOI: 10.1007/s13668-023-00502-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE OF REVIEW The review aims to present an overview of inmate health, focusing on lifestyle-related diseases, physical activity levels, and nutritional status. It also presents the B.A.C.I. (Benessere All'interno delle Carceri Italiane, well-being inside the Italian prisons) project, which aims to offers an innovative path of prevention, diagnosis, and treatment of noncommunicable diseases (NCDs) related to unhealthy lifestyles in prisons in the Campania region, Italy. RECENT FINDINGS The global prison population has risen by 24% since the year 2000, with over 10.77 million people detained worldwide in 2021. In Italy alone, there are currently over 57,000 inmates. Inmates face a higher risk of NCDs such as cardiovascular disease due to unhealthy lifestyles characterized by poor diets and lack of physical activity. Additionally, sleep disorders, particularly insomnia, are prevalent among inmates, further contributing to health disparities. While physical activity has shown positive effects on inmate well-being, there is limited research on nutritional status and interventions in prison populations. Providing quality healthcare to inmates is an international policy norm, but the standards vary globally and are often inadequate. The economic burden of NCDs is rising, and this is exacerbated in prisons, making it challenging for individuals to reintegrate into society after release.
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Affiliation(s)
- Ludovica Verde
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Antonio Maria Pagano
- President S.I.M.S.Pe. Società Italiana Di Medicina E Sanità Penitenziaria (Italian Society of Penitentiary Medicine and Healthcare), Viale Bruno Buozzi 109, 00197, Rome, Italy
- Dipartimento Delle Attività Territoriali, ASL Salerno, U.O. Tutela Salute Adulti E Minori, Area Penale, 84124, Salerno, Italy
| | - Monica de Leo
- Dipartimento Delle Attività Territoriali, ASL Salerno, U.O. Tutela Salute Adulti E Minori, Area Penale, 84124, Salerno, Italy
| | - Claudia Vetrani
- Dipartimento Di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale Isola F2, Via Porzio, 80143, Naples, Italy
| | - Antinea Ambretti
- Dipartimento Di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale Isola F2, Via Porzio, 80143, Naples, Italy
| | - Luciano Lucania
- Specialista Ambulatoriale in Chirurgia, Responsabile, Giuseppe Panzera, Street Carcere Nuovo, 15 Istituto Penitenziario Di Reggio Calabria, 89100, Reggio Calabria, Italy
- Director S.I.M.S.Pe. Società Italiana di Medicina e Sanità Penitenziaria (Italian Society of Penitentiary Medicine and Healthcare). Viale Bruno Buozzi 109, 00197, Rome, Italy
| | - Sergio Babudieri
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100, Sassari, Italy
- Scientific Director S.I.M.S.Pe. Società Italiana di Medicina e Sanità Penitenziaria (Italian Society of Penitentiary Medicine and Healthcare). Viale Bruno Buozzi 109, 00197, Rome, Italy
| | - Anna De Chiara
- Dipartimento Delle Attività Territoriali, ASL Salerno, U.O. Tutela Salute Adulti E Minori, Area Penale, 84124, Salerno, Italy
| | - Annamaria Colao
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, 80131, Naples, Italy
| | - Michele Corsi
- Dipartimento Di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale Isola F2, Via Porzio, 80143, Naples, Italy
| | - Giovanna Muscogiuri
- Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Cattedra Unesco "Educazione Alla Salute E Allo Sviluppo Sostenibile", University Federico II, 80131, Naples, Italy.
| | - Luigi Barrea
- Dipartimento Di Scienze Umanistiche, Università Telematica Pegaso, Centro Direzionale Isola F2, Via Porzio, 80143, Naples, Italy
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Choy O. Nutritional factors associated with aggression. Front Psychiatry 2023; 14:1176061. [PMID: 37415691 PMCID: PMC10320003 DOI: 10.3389/fpsyt.2023.1176061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/16/2023] [Indexed: 07/08/2023] Open
Abstract
Although the vast majority of patients in forensic psychiatry are treated using pharmacological agents, clinical and ethical concerns about their use have led to the consideration of alternative strategies to reduce aggression that is common in forensic psychiatric settings. One non-invasive and benign biologically-based treatment approach involves nutrition. This article provides a mini-review of the recent evidence on four salient nutritional factors associated with aggressive behavior, namely omega-3 fatty acids, vitamin D, magnesium, and zinc. The current evidence base indicates that lower omega-3 levels are associated with increased aggression. Although research on vitamin D and zinc in relation to aggressive behavior is more limited, there is initial evidence that they are negatively associated with aggression in healthy participants and in psychiatric samples. The relationship between magnesium and aggression varies depending on how magnesium is assessed. Findings from experimental trials reveal that nutritional intervention in the form of omega-3 supplementation has the potential to serve as an effective mode of treatment, with effects that can last beyond the intervention period. There is also support for the utility of nutrition to improve our understanding of how social processes are linked to aggression. In light of the nascent, but promising findings on the role of nutritional factors on aggressive behavior, directions for future research are discussed.
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Saxena K, Kurian S, Kumar R, Arnold LE, Simkin DR. Mood Disorders in Youth: Complementary and Integrative Medicine. Child Adolesc Psychiatr Clin N Am 2023; 32:367-394. [PMID: 37147043 DOI: 10.1016/j.chc.2022.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Omega-3 polyunsaturated fatty acids, probiotics, vitamin C, vitamin D, folic acid and L-methyl folate, broad-spectrum micronutrients, N-acetylcysteine, physical activity, herbs, bright light therapy, melatonin, saffron, meditation, school-based interventions, and transcranial photobiomodulation are reviewed, with a focus on their use for treating mood disorders in children and adolescents. For each treatment, all published randomized controlled trials are summarized.
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Affiliation(s)
- Kirti Saxena
- Department of Child and Adolescent Psychiatry, Texas Children's Hospital, 8080 North Stadium Drive, Houston, TX 77054, USA; Department of Psychiatry, Baylor College of Medicine, 1 Moursund Street, Houston, TX 77030, USA.
| | - Sherin Kurian
- Department of Child and Adolescent Psychiatry, Texas Children's Hospital, 8080 North Stadium Drive, Houston, TX 77054, USA; Department of Psychiatry, Baylor College of Medicine, 1 Moursund Street, Houston, TX 77030, USA
| | - Reena Kumar
- Andrew Weil Center for Integrative Medicine, University of Arizona, 655 N Alvernon Way, Suite 120, Tuscon, AZ 85711, USA
| | - L Eugene Arnold
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, 395E McCampbell Hall, 1581 Dodd Drive, Columbus, OH 43210, USA
| | - Deborah R Simkin
- Department of Psychiatry, Emory University School of Medicine, 8955 Highway 98 West, Suite 204, Miramar Beach, FL 32550, USA
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Tcherni-Buzzeo M. Dietary interventions, the gut microbiome, and aggressive behavior: Review of research evidence and potential next steps. Aggress Behav 2023; 49:15-32. [PMID: 35997420 DOI: 10.1002/ab.22050] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 07/15/2022] [Accepted: 08/02/2022] [Indexed: 12/14/2022]
Abstract
Research in biosocial criminology and other related disciplines has established links between nutrition and aggressive behavior. In addition to observational studies, randomized trials of nutritional supplements like vitamins, omega-3 fatty acids, and folic acid provide evidence of the dietary impact on aggression. However, the exact mechanism of the diet-aggression link is not well understood. The current article proposes that the gut microbiome plays an important role in the process, with the microbiota-gut-brain axis serving as such a mediating mechanism between diet and behavior. Based on animal and human studies, this review synthesizes a wide array of research across several academic fields: from the effects of dietary interventions on aggression, to the results of microbiota transplantation on socioemotional and behavioral outcomes, to the connections between early adversity, stress, microbiome, and aggression. Possibilities for integrating the microbiotic perspective with the more traditional, sociologically oriented theories in criminology are discussed, using social disorganization and self-control theories as examples. To extend the existing lines of research further, the article considers harnessing the experimental potential of noninvasive and low-cost dietary interventions to help establish the causal impact of the gut microbiome on aggressive behavior, while adhering to the high ethical standards and modern research requirements. Implications of this research for criminal justice policy and practice are essential: not only can it help determine whether the improved gut microbiome functioning moderates aggressive and violent behavior but also provide ways to prevent and reduce such behavior, alone or in combination with other crime prevention programs.
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10
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Gast DAA, Didden R, Westera JJ, van de Rest O, van Hemert AM, Giltay EJ. Dietary supplements for aggressive behaviour in people with intellectual disabilities: A randomised controlled crossover trial. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 36:122-131. [PMID: 36224110 PMCID: PMC10092216 DOI: 10.1111/jar.13041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Aggressive incidents are common in people with intellectual disabilities. Therefore, we aimed to assess whether supplementation of multivitamins, minerals, and omega-3 fatty acids (FA) reduces aggressive incidents. METHODS We conducted a randomised, triple blind, placebo controlled, single crossover intervention trial. People with intellectual disabilities or borderline intellectual functioning, between 12 and 40 years of age, and showing aggressive behaviour were included. Participants received either a daily dose of dietary supplements, or placebo. Primary outcome was the number of aggressive incidents, measured using the Modified Overt Aggression Scale (MOAS). RESULTS there were 113 participants (placebo, n = 56), of whom 24 (placebo, n = 10) participated in the crossover phase of the trial. All 137 trajectories were included in the analyses. There was no significant difference in mean number of aggressive incidents per day between those assigned to supplements and those who received placebo (rate ratio = 0.93: 95% Confidence Interval [CI] = 0.59-1.45). CONCLUSION In this pragmatic trial, we did not find significant differences in the outcomes between the supplement and placebo arms. The COVID-19 pandemic started midway through our trial, this may have affected the results.
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Affiliation(s)
- David A A Gast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.,Gemiva-SVG Group, Gouda, The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
| | | | - Ondine van de Rest
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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11
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de Bles NJ, Gast DAA, van der Slot AJC, Didden R, van Hemert AM, Rius-Ottenheim N, Giltay EJ. Lessons learned from two clinical trials on nutritional supplements to reduce aggressive behaviour. J Eval Clin Pract 2022; 28:607-614. [PMID: 35040231 PMCID: PMC9543803 DOI: 10.1111/jep.13653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/14/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Setting up and conducting a randomised controlled trial (RCT) has many challenges-particularly trials that include vulnerable individuals with behavioural problems or who reside in facilities that focus on care as opposed to research. These populations are underrepresented in RCTs. APPROACH In our paper, we describe the challenges and practical lessons learned from two RCTs in two care settings involving long-stay psychiatric inpatients and people with intellectual disabilities. We describe five main difficulties and how these were overcome: (1) multisite setting, (2) inclusion of vulnerable participants, (3) nutritional supplements and placebos, (4) assessment of behavioural outcomes, and (5) collecting bio samples. CONCLUSIONS By sharing these practical experiences, we hope to inform other researchers how to optimally design their trials, while avoiding and minimising the difficulties that we encountered, and to facilitate the implementation of a trial. Both trials were registered in the Clinical Trials Register (RCT A: NCT02498106; RCT B: NCT03212092).
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Affiliation(s)
- Nienke J de Bles
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - David A A Gast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.,Gemiva-SVG Group, Gouda, The Netherlands
| | - Abe J C van der Slot
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Robert Didden
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Trajectum, Zwolle, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Johnstone JM, Hatsu I, Tost G, Srikanth P, Eiterman LP, Bruton AM, Ast HK, Robinette LM, Stern MM, Millington EG, Gracious BL, Hughes AJ, Leung BMY, Arnold LE. Micronutrients for Attention-Deficit/Hyperactivity Disorder in Youths: A Placebo-Controlled Randomized Clinical Trial. J Am Acad Child Adolesc Psychiatry 2022; 61:647-661. [PMID: 34303786 PMCID: PMC8782920 DOI: 10.1016/j.jaac.2021.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/11/2021] [Accepted: 07/15/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To evaluate whether micronutrients (vitamins/minerals) benefit attention-deficit/hyperactivity disorder (ADHD) and irritability in a North American pediatric sample. METHOD A 3-site, 8-week, placebo-controlled, randomized clinical trial of micronutrients was conducted in nonmedicated children aged 6 to 12 years with ADHD and at least 1 impairing irritability symptom by parent report on the Child and Adolescent Symptom Inventory-5 (CASI-5). A priori-defined primary outcomes were Clinical Global Impression-Improvement (CGI-I) (CGI-I of 1 or 2 = treatment responder) and parent-rated CASI-5 composite score of ADHD, oppositional defiant, disruptive mood dysregulation, and peer conflict symptoms, including impairment scores. RESULTS Of 135 randomized (mean age 9.8 years), 126 youths (93%) comprised the modified intention-to-treat population. Blinding was maintained. For the CGI-I, 54% of the micronutrient and 18% of the placebo group were responders (risk ratio = 2.97, 97.5% CI = 1.50, 5.90, p < .001). CASI-5 composite scores improved significantly for both groups (p < .01), with a mean change of -0.31 (95% CI = -0.39, -0.23) in the micronutrient group and a mean change of -0.28 (95% CI = -0.38, -0.19) in the placebo group. However, the between-group difference was not significant (mean change = -0.02; 97.5% CI = -0.16, 0.12, effect size = 0.07, p = .70). The micronutrient group grew 6 mm more than the placebo group (p = .002). No serious adverse events or clinically significant changes from baseline in blood and urine tests occurred. CONCLUSION Micronutrients showed global benefit over placebo by blinded clinician rating, but not by parent-report CASI-5 composite rating in a population with ADHD and irritability. Micronutrients showed greater height growth. Micronutrients were well tolerated, and the majority of participants adhered to the number of capsules prescribed. This randomized controlled trial replicates safety and efficacy reported for ADHD in 2 smaller trials of a similar formula containing all vitamins and known essential minerals in amounts between the Recommended Dietary Allowance and Upper Tolerable Intake Level. CLINICAL TRIAL REGISTRATION INFORMATION Micronutrients for ADHD in Youth (MADDY) Study; https://clinicaltrials.gov; NCT03252522.
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Affiliation(s)
- Jeanette M Johnstone
- Oregon Health & Science University, Portland; National University of Natural Medicine, Helfgott Research Institute, Portland, Oregon.
| | | | | | - Priya Srikanth
- OHSU-Portland State University School of Public Health, Oregon
| | | | | | | | | | | | | | - Barbara L Gracious
- The Ohio State University, Columbus; Orange Park Medical Center, Florida, and the Edward Via College of Osteopathic Medicine, Spartanburg, South Carolina
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de Bles NJ, Rius-Ottenheim N, Geleijnse JM, van de Rest O, Bogers JPAM, Schat A, Nijman HLI, van den Berg D, Joos L, van Strater A, de Ridder T, Stolker JJ, van den Hout WB, van Hemert AM, Giltay EJ. Effects of multivitamin, mineral and n-3 polyunsaturated fatty acid supplementation on aggression among long-stay psychiatric in-patients: randomised clinical trial. BJPsych Open 2022; 8:e42. [PMID: 35109953 PMCID: PMC8867900 DOI: 10.1192/bjo.2022.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Aggression and violent incidents are a major concern in psychiatric in-patient care. Nutritional supplementation has been found to reduce aggressive incidents and rule violations in forensic populations and children with behavioural problems. AIMS To assess whether multivitamin, mineral and n-3 polyunsaturated fatty acid supplementation would reduce the number of aggressive incidents among long-stay psychiatric in-patients. METHOD The trial was a pragmatic, multicentre, randomised, double-blind placebo-controlled study. Data were collected from 25 July 2016 to 29 October 2019, at eight local sites for mental healthcare in The Netherlands and Belgium. Participants were randomised (1:1) to receive 6-month treatment with either three supplements containing multivitamins, minerals and n-3 polyunsaturated fatty acid, or placebo. The primary outcome was the number of aggressive incidents, determined by the Staff Observation Aggression Scale - Revised (SOAS-R). Secondary outcomes were patient quality of life, affective symptoms and adverse events. RESULTS In total, 176 participants were randomised (supplements, n = 87; placebo, n = 89). Participants were on average 49.3 years old (s.d. 14.5) and 64.2% were male. Most patients had a psychotic disorder (60.8%). The primary outcome of SOAS-R incidents was similar in supplement (1.03 incidents per month, 95% CI 0.74-1.37) and placebo groups (0.90 incidents per month, 95% CI 0.65-1.19), with a rate ratio of 1.08 (95% CI 0.67-1.74, P = 0.75). Differential effects were not found in sensitivity analyses on the SOAS-R or on secondary outcomes. CONCLUSIONS Six months of nutritional supplementation did not reduce aggressive incidents among long-stay psychiatric in-patients.
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Affiliation(s)
- Nienke J de Bles
- Department of Psychiatry, Leiden University Medical Center, The Netherlands
| | | | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University & Research, The Netherlands
| | - Ondine van de Rest
- Division of Human Nutrition and Health, Wageningen University & Research, The Netherlands
| | - Jan P A M Bogers
- Intensive Care Clinics, Mental Health Organization Rivierduinen, The Netherlands
| | - Anke Schat
- Department of Psychology, University of the Arts London, UK
| | - Henk L I Nijman
- Behavioural Science Institute, Radboud University, The Netherlands; and Forensic Psychiatric Institute, Fivoor, The Netherlands
| | - David van den Berg
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Netherlands; and Department of Clinical Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, The Netherlands
| | - Lucas Joos
- Sector psychosezorg, PZ Bethaniënhuis, Belgium
| | | | | | | | - Wilbert B van den Hout
- Department of Biomedical Data Sciences, Leiden University Medical Center, The Netherlands
| | | | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, The Netherlands
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Meyer BJ, Byrne MK, Cortie CH, Parletta N, Jones A, Eckermann S, Butler T, Greenberg D, Batterham M, Fernandez F, Schofield PW, Winberg PC, Bowles K, Dally J, Martin AM, Grant L. The effect of omega-3 long chain polyunsaturated fatty acids on aggressive behaviour in adult male prisoners: a structured study protocol for a multi-centre, double-blind, randomised placebo-controlled trial and translation into policy and practice. Trials 2021; 22:318. [PMID: 33934704 PMCID: PMC8088826 DOI: 10.1186/s13063-021-05252-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/07/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Interventions to better manage aggressive behaviour and reduce recidivism are a primary concern for corrective services. Nutritional interventions to correct prisoner behaviour have been largely overlooked in the literature. Emerging evidence suggests that dietary intake influences aggressive behaviours and that nutritional supplementation with omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) could attenuate both the severity and frequency of aggressive behaviour. METHODS Adult male prisoners who have a history of aggressive behaviour (n = 600) will be recruited from at least 6 Correctional Centres and randomised to receive either n-3 LCPUFA or placebo supplementation for a 16-week duration. Treatment will be with either 1 g/day of n-3 LCPUFA (694 mg DHA and 397 mg EPA) or placebo capsules, which are a corn/soy oil blend and are identical in size and colour. The primary outcome measure is the Inmate Behavioural Observation Scale (IBOS): an objective measure of aggressive behaviour. Secondary outcome measures include questionnaires (including aggression, attention deficit disorder, impulsivity, depression/anxiety/stress scales), engagement in programmes, recidivism and quality of life. Baseline and post-intervention assessments include the IBOS, questionnaires and blood to measure the levels of n-3 LCPUFA. DISCUSSION To conclusively test the potential that increasing n-3 LCPUFA intakes can improve rates of prisoner aggression and associated mental health and violence-related social system management costs, we propose an adequately powered multi-centre, double-blind, randomised controlled trial, examining the effects of n-3 LCPUFA supplementation on aggressive behaviour in adult male prisoners. If successful, this study will inform prisoner policy with respect to nutrition and by inference contribute to a broader community approach to preventative mental health practices. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry (ANZCTR) ACTRN12618001665224 . Registered on 10 October 2018.
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Affiliation(s)
- Barbara J Meyer
- School of Medicine, Lipid Research Centre, Molecular Horizons, University of Wollongong and Illawarra Health & Medical Research Institute (IHMRI), Northfields Ave, Wollongong, NSW, 2522, Australia.
| | - Mitchell K Byrne
- School of Psychology, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Colin H Cortie
- School of Medicine, Lipid Research Centre, Molecular Horizons, University of Wollongong and Illawarra Health & Medical Research Institute (IHMRI), Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Natalie Parletta
- Centre for Population Health Research, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia
| | - Alison Jones
- DVC (Health and Communities), University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Simon Eckermann
- Australian Health Services Research Institute, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Tony Butler
- Kirby Institute, University of New South Wales, Sydney, NSW, 2052, Australia
| | - David Greenberg
- School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
- Justice Health & Forensic Mental Health Network, Anzac Pde., Matraville, NSW, 2035, Australia
| | - Marijka Batterham
- School of Mathematics & Applied Statistics, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Francesca Fernandez
- School of Health and Behavioural Science, Australian Catholic University, Banyo, QLD, 4014, Australia
| | - Peter W Schofield
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, 2300, Australia
| | - Pia C Winberg
- Venus Shell Systems, PO Box 2149, Bomaderry, NSW, 2541, Australia
| | - Kate Bowles
- School of the Arts, English and Media, University of Wollongong, Northfields Ave, Wollongong, NSW, 2522, Australia
| | - Jean Dally
- Corrective Services NSW, 20 Lee St, Haymarket, NSW, 2000, Australia
| | | | - Luke Grant
- Corrective Services NSW, 20 Lee St, Haymarket, NSW, 2000, Australia
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15
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Qureshi FM, Kunaratnam N, Kolla NJ, Konkolÿ Thege B. Nutritional supplementation in the treatment of violent and aggressive behavior: A systematic review. Aggress Behav 2021; 47:296-309. [PMID: 33580517 DOI: 10.1002/ab.21953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/14/2022]
Abstract
Aggression in correctional and psychiatric settings is relatively common and has a negative effect on physical and mental health both among inmates/clients and staff, as well as organizational-level functioning. The aim of the present study was to critically review the evidence on the effectiveness of nutritional supplements in reducing aggression and violence to contribute to a better understanding of options available for managing aggressive behaviors in adults. The EMBASE, MEDLINE, PsycINFO, Cochrane Library, and PubMed databases were searched for effectiveness studies published in English anytime up until March 2020. Study quality was assessed using the Mixed Methods Appraisal Tool. Altogether, 14 studies met inclusion criteria; 2 investigated micronutrients, 10 examined macronutrients, while further 2 examined a combination of micro and macronutrients. Out of the 14 studies, 5 reported a beneficial effect of nutritional supplementation (omega-3 fatty acids, vitamins/minerals, S-adenosyl-l-methionine, or tryptophan). Five studies did not report a significant beneficial effect of nutritional supplementation (omega-3 fatty acids, folic acid, tryptophan, broad range supplement containing vitamins and fatty acids, and fatty acids in augmentation with valproic acid), while four studies reported mixed effects (on l-tryptophan, broad-range micronutrient formula, folic acid, and omega-3 fatty acids). The results overall indicated that research in this area is in its infancy: very few studies examined the same composition of nutritional supplementation and when they did so the results were contradictory. The methodological shortcoming of existing studies and directions for future research are discussed to facilitate high-quality research in this evolving area of nutritional psychiatry.
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Affiliation(s)
- Fahad M. Qureshi
- Faculty of Medicine University of Toronto Toronto Ontario Canada
| | - Nirsan Kunaratnam
- SickKids Research Institute The Hospital for Sick Children Toronto Ontario Canada
| | - Nathan J. Kolla
- Waypoint Research Institute Waypoint Centre for Mental Health Care Penetanguishene Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
| | - Barna Konkolÿ Thege
- Waypoint Research Institute Waypoint Centre for Mental Health Care Penetanguishene Ontario Canada
- Department of Psychiatry University of Toronto Toronto Ontario Canada
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16
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Infection threat shapes our social instincts. Behav Ecol Sociobiol 2021; 75:47. [PMID: 33583997 PMCID: PMC7873116 DOI: 10.1007/s00265-021-02975-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 02/07/2023]
Abstract
We social animals must balance the need to avoid infections with the need to interact with conspecifics. To that end we have evolved, alongside our physiological immune system, a suite of behaviors devised to deal with potentially contagious individuals. Focusing mostly on humans, the current review describes the design and biological innards of this behavioral immune system, laying out how infection threat shapes sociality and sociality shapes infection threat. The paper shows how the danger of contagion is detected and posted to the brain; how it affects individuals’ mate choice and sex life; why it strengthens ties within groups but severs those between them, leading to hostility toward anyone who looks, smells, or behaves unusually; and how it permeates the foundation of our moral and political views. This system was already in place when agriculture and animal domestication set off a massive increase in our population density, personal connections, and interaction with other species, amplifying enormously the spread of disease. Alas, pandemics such as COVID-19 not only are a disaster for public health, but, by rousing millions of behavioral immune systems, could prove a threat to harmonious cohabitation too.
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Raine A, Fung ALC, Gao Y, Lee TMC. Omega-3 supplementation, child antisocial behavior, and psychopathic personality: a randomized, double-blind, placebo-controlled, stratified, parallel group trial. Eur Child Adolesc Psychiatry 2021; 30:303-312. [PMID: 32222821 DOI: 10.1007/s00787-020-01513-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 03/10/2020] [Indexed: 11/27/2022]
Abstract
While some RCTs have observed efficacy for omega-3 supplementation in reducing antisocial behavior, the role of psychopathic personality and gender in moderating treatment outcome has not been examined. This study examines whether omega-3 supplementation reduces antisocial behavior, and whether any treatment effects are a function of gender and psychopathy. Three hundred and twenty-four schoolchildren with a mean age of 11.9 years were randomized into 3 groups: omega-3 (N = 108), placebo (N = 110), and no-treatment controls (N = 106). Parent and child reports of child antisocial and aggressive behavior and psychopathic-like personality were collected at 0 months (baseline), 6 months (end of treatment), and 12 months (6 months post-treatment). A group × time × gender interaction (p = .016) indicated that only females in the omega-3 group showed a significant reduction in antisocial behavior 6 months post-treatment compared to baseline (d = .35), whereas the females in the two control groups showed no change over time. A group x time x psychopathy interaction (p < .006) was also observed, with psychopathic personality levels moderating treatment outcome. Children in the omega-3 group with high (but not low) psychopathic-like personality showed significant improvements in child-reported antisocial behavior at the end of treatment (d = .19) Results suggest that omega-3 supplementation may be helpful in reducing childhood antisocial and aggressive behavior in females, and those with psychopathic-like personalities.
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Affiliation(s)
- Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, McNeil Building, Room 483, 3718 Locust Walk, Philadelphia, PA, 19104-6286, USA.
| | - Annis Lai Chu Fung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Yu Gao
- Department of Psychology, Brooklyn College and the Graduate Center of the City University of New York, Brooklyn, NY, USA
| | - Tatia M C Lee
- Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong, China
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18
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Don't slap the fish: The relationship between dietary omega-3 intake and physical aggression is mediated by motor inhibition in response to distressed faces. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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19
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Johnstone JM, Hughes A, Goldenberg JZ, Romijn AR, Rucklidge JJ. Multinutrients for the Treatment of Psychiatric Symptoms in Clinical Samples: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2020; 12:E3394. [PMID: 33158241 PMCID: PMC7694278 DOI: 10.3390/nu12113394] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022] Open
Abstract
This systematic review and meta-analysis focused on randomized controlled trials (RCT) of multinutrients consisting of at least four vitamins and/or minerals as interventions for participants with psychiatric symptoms. A systematic search identified 16 RCTs that fit the inclusion criteria (n = 1719 participants) in six psychiatric categories: depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, and autism. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to rate the evidence base. Significant clinical benefit was assessed using minimal clinically important differences (MIDs). Due to heterogeneity in participants, multinutrient formulas, outcome measures, and absence of complete data, only the Attention-Deficit/Hyperactivity Disorder (ADHD) category was eligible for meta-analyses. In ADHD populations, statistically and clinically significant improvements were found in global functioning, Mean Difference (MD) -3.3, p = 0.001, MID -3.26; Standardized Mean Difference (SMD) -0.49 p = 0.001 MD -0.5), clinician ratings of global improvement (MD -0.58, p = 0.001, MID -0.5) and ADHD improvement (MD -0.54, p = 0.002, MID -0.5), and clinician (but not observer) measures of ADHD inattentive symptoms (MD -1.53, p = 0.05, MID -0.5). Narrative synthesis also revealed a pattern of benefit for global measures of improvement, for example: in autism, and in participants with behavioral deficits in dementia. Post-natural disaster anxiety and the number of violent incidents in prison populations also improved. Broad-spectrum formulas (vitamins + minerals) demonstrated more robust effects than formulas with fewer ingredients. This review highlights the need for robust methodology-RCTs that report full data, including means and standard deviations for all outcomes-in order to further elucidate the effects of multinutrients for psychiatric symptoms.
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Affiliation(s)
- Jeanette M. Johnstone
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA;
- Child and Adolescent Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA
| | - Andrew Hughes
- Adult Psychiatry, Oregon Health & Science University, Portland, OR 97239, USA;
| | - Joshua Z. Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA;
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney 2007, Australia
| | - Amy R. Romijn
- Department of Psychology, Swansea University, Swansea SA2 8PP, UK;
| | - Julia J. Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, 8140 Christchurch, New Zealand
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The Effect of Dietary Supplementation on Aggressive Behaviour in Australian Adult Male Prisoners: A Feasibility and Pilot Study for a Randomised, Double Blind Placebo Controlled Trial. Nutrients 2020; 12:nu12092617. [PMID: 32867282 PMCID: PMC7551402 DOI: 10.3390/nu12092617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/13/2022] Open
Abstract
This study aimed to assess the feasibility of conducting a nutrition trial in adult male prisoners. Adult male prisoners were recruited for a 16-week randomised control trial comparing the effect of ingestion of omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) and multivitamin supplements versus placebo on aggressive behaviour. The baseline and post-intervention assessments from the participant blood samples were the erythrocyte n-3 LCPUFA levels as well as measures of aggressive behaviour determined through institutional records of misconduct (IRM), the Inmate Behaviour Observation Scale (IBOS), and questionnaires. A total of 136 adult male prisoners consented to the study with a retention rate of 60%, and 93% of blood samples were successfully collected. The IRM and IBOS scores were collected for 100% of participants, whilst 82–97% of participants completed the questionnaires. From the baseline data, the Odds Ratio shows that prisoners are 4.3 times more likely to have an IBOS >2 if they are below the 6% cut off on the omega-3 index. Both groups improved across all outcome measures and, at the current sample size, no significant differences were seen between them. A power calculation suggests a total sample size of 600 participants is required to detect the effects of this dietary supplementation, and that this supplementation study is feasible in a Correctional Centre. Important criteria for the exclusion and consideration of logistics and compliance are presented.
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21
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Wu WC, Lin CI, Li YF, Chang LY, Chiang TL. The mediating effect of dietary patterns on the association between mother's education level and the physical aggression of five-year-old children: a population-based cohort study. BMC Pediatr 2020; 20:221. [PMID: 32414349 PMCID: PMC7227108 DOI: 10.1186/s12887-020-02126-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relatively few studies have investigated the effects of diet on behavior problems among preschoolers, particularly, physical aggression. In addition, children raised by poorly educated mothers usually have a higher probability of developing negative outcomes. Additionally, highly educated mothers have a higher probability of providing more healthy foods for their children. Thus, mothers providing healthy foods might mitigate children's behavior problems. The study aims to examine whether preschoolers' dietary pattern, as a manipulable factor, mediates the association between maternal education level and physical aggression. METHODS Data came from the Taiwan Birth Cohort Study (TBCS), a nationally representative population-based cohort study, which included 18,513 five-year-old Taiwanese children. Mothers and primary caregivers reported the information on preschoolers' physical aggression and food consumption at age 5 and maternal education level at age 6 months. Two dietary patterns, namely a healthy diet and a high-fat-sugar-salt (HFSS) diet, were retrieved by exploratory factor analysis. Mediation hypotheses were tested by a series of multiple regression models conducted using the PROCESS macro of SAS 9.4. All models were adjusted for children's sex, parental marital status, household income, mental distress at age 5 and children's physical aggression at age 3. RESULTS Maternal education positively linked to healthy dietary patterns (B = 0.014, p = 0.002) which was negatively associated with preschoolers' physical aggression (B = -0.096, p = 0.013), and it is negatively related to the HFSS dietary pattern (B = -0.042, p = 0.002) which was directly positively associated with preschoolers' physical aggression (B = 0.123, p = 0.008). The association between maternal education and preschoolers' physical aggression was partially mediated by preschoolers' healthy (B = -0.001, p < .001) and HFSS (B = -0.005, p = <.001) dietary patterns, respectively. The R-square of the mediation model is 0.178. CONCLUSIONS Preschoolers' dietary patterns directly associate with their physical aggression. In addition, mothers with poor education may provide less healthy foods and more unhealthy foods to their children, which may increase the level of physical aggression. The results imply partial mediating effects of dietary patterns between maternal education and physical aggression. It is suggested that a parent-based nutritional education program focusing on healthy meal preparation for poor educated mothers might be beneficial for preschoolers' healthy development.
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Affiliation(s)
- Wen-Chi Wu
- Department of Health Promotion and Health Education, National Taiwan Normal University, 17 Xuzhou Road, Taipei, 100, Taiwan
| | - Ching-I Lin
- Department of Nutrition and Health Sciences, Kainan University, No. 1, Kainan Road, Luzhu District, Taoyuan City, 338, Taiwan.
| | - Yi-Fan Li
- Division of Clinical Chinese Medicine, National Research Institute of Chinese Medicine, Ministry of Health and Welfare, 11221 Room, No. 155-1, Section 2, Linong St, Beitou District, Taipei City, 112, Taiwan
| | - Ling-Yin Chang
- Institute of Health Behaviors and Community Sciences, School of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei, 100, Taiwan
| | - Tung-Liang Chiang
- Institute of Health Policy and Management, School of Public Health, National Taiwan University, 17 Xuzhou Road, Taipei, 100, Taiwan
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Qiao Y, Liu CP, Han HQ, Liu FJ, Shao Y, Xie B. No Impact of Omega-3 Fatty Acid Supplementation on Symptoms or Hostility Among Patients With Schizophrenia. Front Psychiatry 2020; 11:312. [PMID: 32372988 PMCID: PMC7186329 DOI: 10.3389/fpsyt.2020.00312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study was aimed to explore the impact of fish oil (Omega-3 fatty acids) on hostility and psychopathology among patients with acute violent schizophrenia. METHOD Sixty seven acute hospitalized patients demonstrating violent behavior in the context of a schizophrenic illness, treated with antipsychotics, were randomly assigned to a supplement with either fish oil (N=32) or placebo (N=35) in a double-blind, placebo-controlled trial. Assessments were conducted at the baseline, week 4 and week 8. RESULTS The symptoms and hostility decreased after treatment for 4 and 8 weeks in both groups, with no group differences. CONCLUSIONS The current study did not find improvements in symptoms or hostility from the Omega-3 fatty acid supplementation in patients with schizophrenia. The implication is that Omega-3 fatty acids do not reduce psychopathology and hostility in acute patients with schizophrenia.
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Affiliation(s)
- Yi Qiao
- *Correspondence: Yi Qiao, ; Yang Shao, ; Bin Xie,
| | | | | | | | - Yang Shao
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Xie
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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23
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Conan GM. Frequently overlooked realistic moral bioenhancement interventions. JOURNAL OF MEDICAL ETHICS 2020; 46:43-47. [PMID: 31462452 DOI: 10.1136/medethics-2019-105534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/21/2019] [Accepted: 08/07/2019] [Indexed: 06/10/2023]
Abstract
Many supporters of 'moral bioenhancement' (MBE), the use of biomedical interventions for moral improvement, have been criticised for having unrealistic proposals. The interventions they suggest have often been called infeasible and their implementation plans vague or unethical. I dispute these criticisms by showing that various interventions to implement MBE are practically and ethically feasible enough to warrant serious consideration. Such interventions include transcranial direct current stimulation over the medial and dorsolateral prefrontal cortex, as well as supplementation with lithium and omega-3. Considering their efficacy and feasibility, it is strange that these interventions have rarely been proposed or discussed as MBE. I review evidence that each of those interventions can reduce antisocial behaviour, reduce racial bias, increase executive function or increase prosocial traits like fairness and altruism. I then specify and defend realistic, ethically permissible ways to implement these interventions, especially for violent offenders and public servants-the former as rehabilitation and the latter to meet the high standards of their occupations. These interventions could be given to violent offenders in exchange for a reduced sentence or compulsorily in some cases. Potential intervention methods for non-prisoners include increasing the USDA-recommended dose of omega-3, encouraging food companies to supplement their products with omega-3 or trace lithium, requiring MBE for employment as a police officer or political leader, and insurance companies providing discounts for undergoing MBE. In some reasonably limited form, using these interventions may be a good first step to implement the project of MBE.
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The current status of the magnocellular theory of developmental dyslexia. Neuropsychologia 2019; 130:66-77. [DOI: 10.1016/j.neuropsychologia.2018.03.022] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/15/2017] [Accepted: 03/19/2018] [Indexed: 01/28/2023]
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Raine A, Ang RP, Choy O, Hibbeln JR, Ho RMH, Lim CG, Lim-Ashworth NSJ, Ling S, Liu JCJ, Ooi YP, Tan YR, Fung DSS. Omega-3 (ω-3) and social skills interventions for reactive aggression and childhood externalizing behavior problems: a randomized, stratified, double-blind, placebo-controlled, factorial trial. Psychol Med 2019; 49:335-344. [PMID: 29743128 DOI: 10.1017/s0033291718000983] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND While studies suggest that nutritional supplementation may reduce aggressive behavior in children, few have examined their effects on specific forms of aggression. This study tests the primary hypothesis that omega-3 (ω-3), both alone and in conjunction with social skills training, will have particular post-treatment efficacy for reducing childhood reactive aggression relative to baseline. METHODS In this randomized, double-blind, stratified, placebo-controlled, factorial trial, a clinical sample of 282 children with externalizing behavior aged 7-16 years was randomized into ω-3 only, social skills only, ω-3 + social skills, and placebo control groups. Treatment duration was 6 months. The primary outcome measure was reactive aggression collected at 0, 3, 6, 9, and 12 months, with antisocial behavior as a secondary outcome. RESULTS Children in the ω-3-only group showed a short-term reduction (at 3 and 6 months) in self-report reactive aggression, and also a short-term reduction in overall antisocial behavior. Sensitivity analyses and a robustness check replicated significant interaction effects. Effect sizes (d) were small, ranging from 0.17 to 0.31. CONCLUSIONS Findings provide some initial support for the efficacy of ω-3 in reducing reactive aggression over and above standard care (medication and parent training), but yield only preliminary and limited support for the efficacy of ω-3 in reducing overall externalizing behavior in children. Future studies could test further whether ω-3 shows promise in reducing more reactive, impulsive forms of aggression.
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Affiliation(s)
- Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology,University of Pennsylvania,PA,USA
| | - Rebecca P Ang
- National Institute of Education,Nanyang Technological University,Singapore
| | - Olivia Choy
- Psychology Programme,School of Social Sciences,Nanyang Technological University,Singapore
| | - Joseph R Hibbeln
- Section on Nutritional Neuroscience,National Institute on Alcohol Abuse and Alcoholism,Rockville,MD,USA
| | - Ringo M-H Ho
- Psychology Programme,School of Social Sciences,Nanyang Technological University,Singapore
| | - Choon Guan Lim
- Department of Child and Adolescent Psychiatry,Institute of Mental Health,Singapore
| | | | - Shichun Ling
- Department of Criminology,University of Pennsylvania,Philadelphia,PA,USA
| | - Jean C J Liu
- Division of Social Sciences,Yale-NUS College,Singapore
| | - Yoon Phaik Ooi
- Department of Child and Adolescent Psychiatry,Institute of Mental Health,Singapore
| | - Yi Ren Tan
- Department of Child and Adolescent Psychiatry,Institute of Mental Health,Singapore
| | - Daniel S S Fung
- Department of Child and Adolescent Psychiatry,Institute of Mental Health,Singapore
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Wangmo T, Handtke V, Bretschneider W, Elger BS. Improving the Health of Older Prisoners: Nutrition and Exercise in Correctional Institutions. JOURNAL OF CORRECTIONAL HEALTH CARE 2018; 24:352-364. [DOI: 10.1177/1078345818793121] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Violet Handtke
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | | | - Bernice S. Elger
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
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Mocking RJT, Assies J, Ruhé HG, Schene AH. Focus on fatty acids in the neurometabolic pathophysiology of psychiatric disorders. J Inherit Metab Dis 2018. [PMID: 29524021 DOI: 10.1007/s10545-018-0158-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Continuous research into the pathophysiology of psychiatric disorders, such as major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and schizophrenia, suggests an important role for metabolism. This narrative review will provide an up-to-date summary of how metabolism is thought to be involved in the pathophysiology of these psychiatric disorders. We will focus on (I) the important role of fatty acids in these metabolic alterations, (II) whether fatty acid alterations represent epiphenomena or risk factors, and (III) similarities and dissociations in fatty acid alterations between different psychiatric disorders. (Historical) epidemiological evidence links fatty acid intake to psychiatric disorder prevalence, corroborated by altered fatty acid concentrations measured in psychiatric patients. These fatty acid alterations are connected with other concomitant pathophysiological mechanisms, including biological stress (hypothalamic-pituitary-adrenal (HPA)-axis and oxidative stress), inflammation, and brain network structure and function. Metabolomics and lipidomics studies are underway to more deeply investigate this complex network of associated neurometabolic alterations. Supplementation of fatty acids as disease-modifying nutraceuticals has clinical potential, particularly add-on eicosapentaenoic acid (EPA) in depressed patients with markers of increased inflammation. However, by interpreting the observed fatty acid alterations as partly (mal)adaptive phenomena, we attempt to nuance translational expectations and provide new clinical applications for these novel neurometabolic insights, e.g., to predict treatment response or depression recurrence. In conclusion, placing fatty acids in context can contribute to further understanding and optimized treatment of psychiatric disorders, in order to diminish their overwhelming burden of disease.
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Affiliation(s)
- R J T Mocking
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands.
| | - J Assies
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
| | - H G Ruhé
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
- Warneford Hospital, Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A H Schene
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, the Netherlands
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Portnoy J, Raine A, Liu J, Hibbeln JR. Reductions of intimate partner violence resulting from supplementing children with omega-3 fatty acids: A randomized, double-blind, placebo-controlled, stratified, parallel-group trial. Aggress Behav 2018; 44:491-500. [PMID: 29781086 DOI: 10.1002/ab.21769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 04/13/2018] [Accepted: 04/15/2018] [Indexed: 12/14/2022]
Abstract
Omega-3 supplementation has been found to reduce externalizing behavior in children. Reciprocal models of parent-child behavior suggest that improving child behavior could lead to improvements in parent behavior, however no study has examined whether omega-3 supplementation in children could reduce intimate partner violence or child maltreatment by their adult caregivers. In this randomized, double-blind, placebo-controlled, stratified, parallel group trial, a community sample of children were randomized to receive either a fruit drink containing 1 gm of omega-3 fats (Smartfish Recharge; Omega-3 group, n = 100) or the same fruit drink without omega-3's (Placebo group, n = 100). Child participants, adult caregivers, and research staff were blinded to group assignment. Adult caregivers reported inter-partner and child-directed physical assault and psychological aggression at baseline, 6 months (end of treatment) and 12 months (6 months post-treatment) using the Conflicts Tactics Scale. Caregivers of children in the omega-3 group reported long-term reductions in psychological aggression in a group × time interaction. Improvements in adult psychological aggression were correlated with improvements in child externalizing behavior scores. No differences were reported for child maltreatment. This study is the first to show that omega-3 supplementation in children can reduce inter-partner psychological aggression among adult caregivers not receiving supplements. Findings suggest that improving child behavior through omega-3 supplementation could have long-term benefits to the family system as a whole.
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Affiliation(s)
- Jill Portnoy
- School of Criminology and Justice Studies, University of Massachusetts Lowell, Lowell, Massachusetts
| | - Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph R Hibbeln
- Section on Nutritional Neuroscience, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland
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Bègue L, Zaalberg A, Shankland R, Duke A, Jacquet J, Kaliman P, Pennel L, Chanove M, Arvers P, Bushman BJ. Omega-3 supplements reduce self-reported physical aggression in healthy adults. Psychiatry Res 2018; 261:307-311. [PMID: 29331711 DOI: 10.1016/j.psychres.2017.12.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/12/2017] [Accepted: 12/14/2017] [Indexed: 12/13/2022]
Abstract
There is emerging evidence that Omega-3 polyunsaturated fatty acids (PUFA) supplements can decrease aggression. However, experimental studies with adults from non-specific populations are scarce. We hypothesized that Omega-3 supplements would decrease self-reported aggression among non-clinical participants. In a double-blind randomized trial, two groups of participants (N = 194) aged 18-45 from the general population followed a 6-weeks treatment with 638mg docosahexaenoic acid (DHA) and 772mg eicosapentaenoic acid (EPA) per day or the equivalent quantity of copra oil (placebo). Self-reported aggressiveness was measured at baseline and after the 6-week treatment period. Findings showed that Omega-3 supplements significantly decreased self-reported aggressiveness at the end of the 6-week period (d = 0.31). In conclusion, this experiment indicates that Omega-3 administration has beneficial effects in reducing aggression among the general population.
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Affiliation(s)
- Laurent Bègue
- LIP/PC2S, University Grenoble Alpes, Grenoble, France..
| | - Ap Zaalberg
- Ministry of Security and Justice, Crime, Law Enforcement and Sanctions Research Division (CRS), The Hague, The Netherlands
| | | | - Aaron Duke
- LIP/PC2S, University Grenoble Alpes, Grenoble, France
| | - Julie Jacquet
- LIP/PC2S, University Grenoble Alpes, Grenoble, France
| | - Perla Kaliman
- Center for Mind and Brain, University of California, Davis, United States
| | - Lucie Pennel
- University Hospital, University Grenoble Alpes, Grenoble, France
| | - Marc Chanove
- MSH Alpes, CNRS/University Grenoble Alpes, Grenoble, France
| | | | - Brad J Bushman
- School of Communication and Department of Psychology, The Ohio State University, Columbus, Ohio, United States
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James Onaolapo O, Yetunde Onaolapo A. Nutrition in autism spectrum disorders: A review of evidences for an emerging central role in aetiology, expression, and management. AIMS MEDICAL SCIENCE 2018. [DOI: 10.3934/medsci.2018.2.122] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Hambly JL, Francis K, Khan S, Gibbons KS, Walsh WJ, Lambert B, Testa C, Haywood A. Micronutrient Therapy for Violent and Aggressive Male Youth: An Open-Label Trial. J Child Adolesc Psychopharmacol 2017; 27:823-832. [PMID: 28481642 DOI: 10.1089/cap.2016.0199] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Pharmacotherapy for problematic aggressive and violent behavior disorders in male children and adolescents is associated with significant adverse events. Treatments with more acceptable risk-benefit ratios are critically needed. Micronutrient intervention will be investigated as an alternative to bridge the therapeutic gap in the management of these behaviors. METHODS Males aged 4-14 who displayed ongoing violent and aggressive behaviors received micronutrient intervention containing alpha-tocopherol (vitamin E), ascorbic acid (vitamin C), biotin, chromium, pyridoxal-5-phosphate (P5P), pyridoxine (vitamins B6), selenium, and zinc, in a 16-week open-label trial. Plasma zinc, plasma copper, copper/zinc ratio, and urinary hydroxyhemopyrroline-2-one (HPL) tests were conducted at baseline and endpoint. Participants were examined for changes in aggressive and violent behaviors measured using the Children's Aggression Scale (CAS) and the Modified Overt Aggression Scale (MOAS), improvements in family functioning measured using the Family Functioning Style Scale, improvements in health-related quality of life (HRQoL) measured using the Pediatric Quality of Life Inventory (PedsQL) at baseline, 8 weeks, endpoint, and at 4-6-month follow-up. RESULTS Thirty-two male children and adolescents met inclusion criteria. Thirty-one (mean 8.35 ± standard deviation 2.93 years) completed the study, with one participant lost to follow-up. Micronutrient therapy significantly improved parent-reported aggressive and violent behaviors measured using the CAS for all domains except the use of weapons (p < 0.001 to p = 0.02) with medium to large effect size (Cohen's d = 0.72-1.43) and the MOAS (p < 0.001) with large effect size (Cohen's d = 1.26). Parent-reported HRQoL (p < 0.001; Cohen's d = -1.69) and family functioning (p = 0.03; Cohen's d = -0.41) also significantly improved. CONCLUSION Micronutrient therapy appeared well tolerated, with a favorable side effect profile. It appeared effective in the reduction of parent-reported aggressive and violent behaviors, and showed improvement in family functioning and HRQoL in male youth after 16 weeks. Further research in the form of a double-blinded, randomized controlled trial is required to verify these initial positive observations.
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Affiliation(s)
- Jessica L Hambly
- 1 School of Pharmacy, Menzies Health Institute Queensland, Griffith University , Southport, Australia
| | - Kelly Francis
- 2 Happiness in Health , West Burleigh, Queensland, Australia
| | - Sohil Khan
- 1 School of Pharmacy, Menzies Health Institute Queensland, Griffith University , Southport, Australia .,3 Mater Research Institute-The University of Queensland , Brisbane, Queensland, Australia
| | - Kristen S Gibbons
- 3 Mater Research Institute-The University of Queensland , Brisbane, Queensland, Australia
| | | | - Brett Lambert
- 5 Applied Analytical Laboratories , Meadowbrook, Queensland, Australia
| | - Chris Testa
- 6 Chris Testa's Tugun Compounding Pharmacy , Tugun, Queensland, Australia
| | - Alison Haywood
- 1 School of Pharmacy, Menzies Health Institute Queensland, Griffith University , Southport, Australia .,3 Mater Research Institute-The University of Queensland , Brisbane, Queensland, Australia
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Kaplan BJ, Isaranuwatchai W, Hoch JS. Hospitalization cost of conventional psychiatric care compared to broad-spectrum micronutrient treatment: literature review and case study of adult psychosis. Int J Ment Health Syst 2017; 11:14. [PMID: 28163777 PMCID: PMC5282873 DOI: 10.1186/s13033-017-0122-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/22/2017] [Indexed: 11/25/2022] Open
Abstract
Background Healthcare costs are skyrocketing, with mental health treatment amongst the most expensive, especially when hospitalization is involved. According to the Mental Health Commission of Canada, one in five Canadians is living with a mental disorder in any given year, at an annual cost of $50 billion. In light of this societal burden, alternative approaches are being evaluated, such as brief psychotherapy by phone, peer support, and, as part of the emerging field of nutritional mental health, treatment with micronutrients (minerals and vitamins). Effectiveness of micronutrients has been demonstrated for many types of psychiatric symptoms, in about 45 studies of formulas that are either multinutrient (e.g., several B vitamins) or broad-spectrum (usually over 20 minerals and vitamins). Although this literature demonstrates therapeutic benefits, the potential economic impact of micronutrient treatment has been evaluated in only one case study of childhood psychosis. Methods The current case study was initiated to evaluate mental health-related hospitalization costs from 1997 to 2003 for a female adult diagnosed with various mood and psychotic symptoms. She was treated for the first 5 years with conventional methods and then subsequently with a broad-spectrum micronutrient formula. Results The patient’s annual mental health hospitalization costs during conventional treatment averaged $59,864 across 5 years (1997–2001), with a peak annual cost of about $140,000. Since transitioning to broad-spectrum micronutrients, she has incurred no provincial hospitalization costs for mental health care, though her self-funded costs are currently $720/year for the micronutrients. Conclusion Further exploration of the treatment of mental health problems with broad-spectrum micronutrient formulas has the potential to make two significant contributions: improved mental health, and decreased costs for governments.
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Affiliation(s)
- Bonnie J Kaplan
- Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Wanrudee Isaranuwatchai
- Centre for Excellence in Economic Analysis Research, St. Michael's Hospital and Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Jeffrey S Hoch
- Centre for Excellence in Economic Analysis Research, St. Michael's Hospital and Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,Department of Public Health Sciences, University of California, Davis, USA
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Meyer BJ, Byrne M, Parletta N, Gow R, Hibbeln JR. Fish Oil and Impulsive Aggressive Behavior. J Child Adolesc Psychopharmacol 2016. [PMID: 26217883 PMCID: PMC6445213 DOI: 10.1089/cap.2015.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Barbara J. Meyer
- School of Medicine, University of Wollongong, New South Wales, Australia
| | - Mitchell Byrne
- School of Psychology, University of Wollongong, New South Wales, Australia
| | - Natalie Parletta
- School of Population Health, Sansom Institute for Health Research, University of South Australia, South Australia, Australia
| | - Rachel Gow
- Section of Nutritional Neurosciences, Laboratory of Membrane Biology and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
| | - Joseph R. Hibbeln
- Section of Nutritional Neurosciences, Laboratory of Membrane Biology and Biophysics, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
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Gajos JM, Beaver KM. The effect of omega-3 fatty acids on aggression: A meta-analysis. Neurosci Biobehav Rev 2016; 69:147-58. [DOI: 10.1016/j.neubiorev.2016.07.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/09/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
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Raine A, Cheney RA, Ho R, Portnoy J, Liu J, Soyfer L, Hibbeln J, Richmond TS. Nutritional supplementation to reduce child aggression: a randomized, stratified, single-blind, factorial trial. J Child Psychol Psychiatry 2016; 57:1038-46. [PMID: 27166583 DOI: 10.1111/jcpp.12565] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND While some studies suggest that nutritional supplementation may reduce aggressive behavior in children, they have not examined whether its efficacy may be enhanced in conjunction with other treatment approaches. This study tests the hypothesis that a nutritional supplementation of omega-3, multivitamins, and minerals over 3 months, combined with cognitive behavior therapy, will reduce childhood aggression. METHODS In this randomized, single-blind, stratified, factorial trial, a high-risk community sample of 290 children aged 11-12 years were randomized into Nutrition only, cognitive behavioral therapy (CBT) only, Nutrition + CBT, and Control groups. The primary outcome measures of child- and parent-reported aggressive and antisocial behavior were collected at 0 months (baseline), 3 months (end of treatment), 6 months (3 months posttreatment), and 12 months (9 months posttreatment). The trial ('Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)' was registered at ClinicalTrials.gov at https://clinicaltrials.gov/ct2/show/NCT00842439 RESULTS: For child self-reports, children in the Nutrition only group showed reduced externalizing behavior compared to Controls at 3 months. At 6 months, the Nutrition + CBT group scored lower on externalizing behavior compared to both CBT only and Control groups. Findings were more in evidence for an Aggressive-Reactive form of antisocial behavior than for a Callous-Proactive form. Effect sizes were in the small-to-medium range (d = -.33 to -.37). Group differences were not sustained 9 months posttreatment, and no other effects were significant. CONCLUSIONS Findings provide some limited support for the efficacy of omega-3, vitamin, and mineral supplementation in reducing aggressive behavior in children, and represent the first evaluation of nutritional supplements in conjunction with CBT.
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Affiliation(s)
- Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, Philadelphia, PA, USA
| | - Rose A Cheney
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ringo Ho
- Division of Psychology, Nanyang Technological University, Singapore City, Singapore
| | - Jill Portnoy
- Department of Criminology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jianghong Liu
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Liana Soyfer
- Department of Criminology, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph Hibbeln
- Section on Nutritional Neuroscience, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
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Zaalberg A, Wielders J, Bulten E, van der Staak C, Wouters A, Nijman H. Relationships of diet-related blood parameters and blood lead levels with psychopathology and aggression in forensic psychiatric inpatients. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2016; 26:196-211. [PMID: 25827608 DOI: 10.1002/cbm.1954] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 10/28/2014] [Accepted: 01/20/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Earlier studies have suggested associations between diet-related blood parameters and both aggression and psychopathological symptoms, but little is known about this in forensic psychiatric inpatients. AIM This article aims to explore the levels of diet-related blood parameters and their relationship to aggressive behaviour and/or psychopathology among Dutch forensic psychiatric inpatients. METHODS Minerals, vitamins, lead and fatty acid levels were measured in blood samples from 51 inpatients, well enough to consent and participate in the study, from a possible total of 99. Levels of aggression and psychopathology were assessed using questionnaires, observation instruments and clinical data. Associations between blood parameters and behavioural measures were calculated. RESULTS Low average levels of vitamin D3 and omega (ω)-3 fatty acids were found, with nearly two-thirds of the patients having below recommended levels of D3 , while vitamin B6 levels were high. Magnesium, iron, zinc, copper and lead were overall within reference values, but copper/zinc ratios were high. Several significant associations between levels of fatty acid measures and both aggression and psychopathology were observed. CONCLUSION In our sample of forensic psychiatric inpatients, fatty acids - but not mineral or vitamin levels - were associated with aggression and psychopathology. A potentially causal link between fatty acids and aggression could be tested in a randomised, placebo-controlled trial of fish oil supplements. General health of such patients might be improved by better vitamin D status (increased sun exposure and/or supplement use) and better ω-3 fatty acid status (oily fish or fish oil consumption), but discouraging unnecessary self-prescription of B vitamins where necessary. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ap Zaalberg
- Research and Documentation Centre (WODC), Ministry of Security and Justice, PO Box 20301, 2500 EH, The Hague, The Netherlands
| | - Jos Wielders
- Meander Medical Centre, Amersfoort, The Netherlands
| | - Erik Bulten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Forensic Psychiatric Centre "Pompekliniek", Nijmegen, The Netherlands
| | - Cees van der Staak
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Anouk Wouters
- Division of Ortho- and Forensic Psychiatry, "Altrecht" Mental Health Institute, Den Dolder, The Netherlands
| | - Henk Nijman
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Division of Ortho- and Forensic Psychiatry, "Altrecht" Mental Health Institute, Den Dolder, The Netherlands
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Vaughn MG, Salas-Wright CP, Naeger S, Huang J, Piquero AR. Childhood Reports of Food Neglect and Impulse Control Problems and Violence in Adulthood. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:389. [PMID: 27043598 PMCID: PMC4847051 DOI: 10.3390/ijerph13040389] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/24/2016] [Accepted: 03/28/2016] [Indexed: 11/24/2022]
Abstract
Food insecurity and hunger during childhood are associated with an array of developmental problems in multiple domains, including impulse control problems and violence. Unfortunately, extant research is based primarily on small convenience samples and an epidemiological assessment of the hunger-violence link is lacking. The current study employed data from Wave 1 (2001-2002) and Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC is a nationally representative sample of non-institutionalized U.S. residents aged 18 years and older. Participants who experienced frequent hunger during childhood had significantly greater impulsivity, worse self-control, and greater involvement in several forms of interpersonal violence. These effects were stronger among whites, Hispanics, and males. The findings support general theoretical models implicating impulse control problems as a key correlate of crime and violence and add another facet to the importance of ameliorating food neglect in the United States.
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Affiliation(s)
- Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, USA.
| | | | - Sandra Naeger
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, USA.
| | - Jin Huang
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO 63103, USA.
| | - Alex R Piquero
- Program in Criminology, School of Economic, Political and Policy Sciences, University of Texas at Dallas, Dallas, TX 75080, USA.
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Rucklidge JJ, Mulder RT. Could nutrition help behaviours associated with personality disorders? A narrative review. Personal Ment Health 2016; 10:3-11. [PMID: 26643554 DOI: 10.1002/pmh.1325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/10/2015] [Indexed: 12/11/2022]
Abstract
Personality disorders are common, and the core problems of interpersonal dysfunction and social disturbance are difficult to treat. One area gaining international attention is the impact that diet and nutrients can have on psychiatric/psychological symptoms. There are no empirical studies studying the specific relationship between nutrition and personality disorders. A systematic search revealed longitudinal studies following malnourished children, either during pregnancy or in early life that reported malnourishment is a risk factor that can express as maladaptive behaviours later in life. Other studies show associations between nutrient intake and personality styles. A small body of literature reveals a potential benefit of consuming nutrients therapeutically in order to address behaviours often associated with personality disorders. If we consider the broad patterns of behaviour that typify personality disorders, such as cognition, affectivity, interpersonal functioning and impulse control, there is a research rationale for studying the role that nutrition could play in protecting against the development of these problems as well as possibly modifying them. Whether it is too late to intervene with nutrition once the pathological behaviours are entrenched is unknown. Given the dearth of good evidence-based treatments currently available for people with personality disorders, it is an area worth investing in.
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Roger T Mulder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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The effect of omega-3 polyunsaturated fatty acid supplementation on emotional dysregulation, oppositional behaviour and conduct problems in ADHD: A systematic review and meta-analysis. J Affect Disord 2016; 190:474-482. [PMID: 26551407 DOI: 10.1016/j.jad.2015.09.053] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 09/26/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND A number of randomised controlled trials report a beneficial effect of omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation on emotional lability (EL) and related domains (e.g. oppositional behaviour, conduct problems). Given that n-3 PUFA supplementation shows a significant effect on reducing symptoms of attention-deficit/hyperactivity disorder (ADHD) and that EL and related behaviours commonly co-occurs with ADHD, it is important that there is a more conclusive picture as to the effect of n-3 PUFA on these co-occurring clinical domains. METHODS Databases (Ovid Medline, Embase, Psychinfo) were searched for trials assessing the effects of n-3 PUFA on EL, oppositional behaviour, aggression and conduct problems. We included trials in children who had ADHD or a related neurodevelopmental disorder. RESULTS Of the 1775 identified studies, 10 were included in the meta-analysis. In the primary analyses n-3 PUFA supplementation did not show improvements in measures of EL, oppositional behaviour, conduct problems or aggression. However subgroup analyses of higher quality studies and those meeting strict inclusion criteria found a significant reduction in EL and oppositional behaviour. LIMITATIONS A number of treatment effects may have failed to reach statistical significance due to small sample sizes and within and between study heterogeneity in terms of design and study participants. CONCLUSIONS These results exclude the possibility of moderate to large effects. They provide suggestive evidence of small effects of n-3 PUFA on reducing EL and oppositional behaviour in subgroups of children with ADHD.
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Jackson DB, Beaver KM. The Influence of Nutritional Factors on Verbal Deficits and Psychopathic Personality Traits: Evidence of the Moderating Role of the MAOA Genotype. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:15739-55. [PMID: 26690459 PMCID: PMC4690953 DOI: 10.3390/ijerph121215017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 11/25/2022]
Abstract
The current study explores whether: (a) nutritional factors among adolescent males predict their risk of exhibiting verbal deficits and psychopathic traits during adulthood and (b) the link between nutritional factors and these outcomes is conditioned by the MAOA genotype. The study analyzes data from the U.S. National Longitudinal Study of Adolescent Health (Add Health), a nationally representative, genetically informative sample. We find evidence that meal deprivation increases the likelihood of both verbal deficits and psychopathic personality traits, whereas poor quality nutrition increases the risk of verbal deficits. We detect the presence of a number of gene-environment interactions between measures of food quality and MAOA genotype, but no evidence of GxE in the case of meal deprivation. Limitations are noted and avenues for future research are discussed.
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Affiliation(s)
- Dylan B Jackson
- Department of Criminal Justice, College of Public Policy, 501 W. Cesar E. Chavez Blvd, University of Texas at San Antonio, San Antonio, TX 78207, USA.
| | - Kevin M Beaver
- College of Criminology and Criminal Justice, 145 Convocation Way, Florida State University, Tallahassee, Florida, FL 32306-1273, USA.
- King Abdulaziz University, Jeddah, Saudi Arabia, TX 78207, USA.
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Matsudaira T, Gow RV, Kelly J, Murphy C, Potts L, Sumich A, Ghebremeskel K, Crawford MA, Taylor E. Biochemical and Psychological Effects of Omega-3/6 Supplements in Male Adolescents with Attention-Deficit/Hyperactivity Disorder: A Randomized, Placebo-Controlled, Clinical Trial. J Child Adolesc Psychopharmacol 2015; 25:775-82. [PMID: 26682998 PMCID: PMC4691649 DOI: 10.1089/cap.2015.0052] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND An abnormality in long chain-polyunsaturated fatty acid (LC-PUFA) levels has been implicated in attention-deficit/hyperactivity disorder (ADHD). Studies evaluating LC-PUFA supplementation for therapeutic efficacy in ADHD have shown mixed and, therefore, inconclusive results. METHODS Seventy-six male adolescents (age 12-16 years, mean = 13.7) with ADHD were assessed for the effects of 12 weeks omega-3 and omega-6 supplements on biochemical and psychological outcomes in a randomized, placebo-controlled, clinical trial. The primary outcome measure was change in the Conners' Teacher Rating Scales (CTRS) following 12 weeks of supplementation of LC-PUFA or placebo. At baseline, the placebo and treatment groups had comparable levels of LC-PUFA as measured by red blood cell phosphatidylcholine. In the treatment group, supplementation enhanced eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and total omega-3 fatty acid levels. RESULTS No superiority of LC-PUFAs to placebo was observed on the primary outcome. Further, there were no reliable treatment effects on aggression, impulsivity, depression, and anxiety. CONCLUSIONS Future studies should use larger sample sizes and longer supplementation period to detect small-modest effects for clinical recommendations in ADHD.
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Affiliation(s)
- Toshiko Matsudaira
- Department of Adolescent and Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Rachel V. Gow
- Section of Nutritional Neuroscience, National Institutes of Health, Bethesda, Maryland
| | - Joanna Kelly
- King's Clinical Trials Unit, Department of Biostatistics, Institute of Psychiatry, London, United Kingdom
| | - Caroline Murphy
- King's Clinical Trials Unit, Department of Biostatistics, Institute of Psychiatry, London, United Kingdom
| | - Laura Potts
- King's Clinical Trials Unit, Department of Biostatistics, Institute of Psychiatry, London, United Kingdom
| | - Alexander Sumich
- Division of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Kebreab Ghebremeskel
- Lipidomics and Nutrition Research Centre, London Metropolitan University, London, United Kingdom
| | - Michael A. Crawford
- Reproductive Physiology, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Eric Taylor
- Department of Adolescent and Child Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
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A randomised double-blind placebo-controlled trial investigating the behavioural effects of vitamin, mineral and n-3 fatty acid supplementation in typically developing adolescent schoolchildren. Br J Nutr 2015; 115:361-73. [PMID: 26573368 DOI: 10.1017/s0007114515004390] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Nutrient deficiencies have been implicated in anti-social behaviour in schoolchildren; hence, correcting them may improve sociability. We therefore tested the effects of vitamin, mineral and n-3 supplementation on behaviour in a 12-week double-blind randomised placebo-controlled trial in typically developing UK adolescents aged 13-16 years (n 196). Changes in erythrocyte n-3 and 6 fatty acids and some mineral and vitamin levels were measured and compared with behavioural changes, using Conners' teacher ratings and school disciplinary records. At baseline, the children's PUFA (n-3 and n-6), vitamin and mineral levels were low, but they improved significantly in the group treated with n-3, vitamins and minerals (P=0·0005). On the Conners disruptive behaviour scale, the group given the active supplements improved, whereas the placebo group worsened (F=5·555, d=0·35; P=0·02). The general level of disciplinary infringements was low, thus making it difficult to obtain improvements. However, throughout the school term school disciplinary infringements increased significantly (by 25 %; Bayes factor=115) in both the treated and untreated groups. However, when the subjects were split into high and low baseline infringements, the low subset increased their offences, whereas the high-misbehaviour subset appeared to improve after treatment. But it was not possible to determine whether this was merely a statistical artifact. Thus, when assessed using the validated and standardised Conners teacher tests (but less clearly when using school discipline records in a school where misbehaviour was infrequent), supplementary nutrition might have a protective effect against worsening behaviour.
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Shniderman AB, Solberg LB. Cosmetic Psychopharmacology for Prisoners: Reducing Crime and Recidivism Through Cognitive Intervention. NEUROETHICS-NETH 2015. [DOI: 10.1007/s12152-015-9242-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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How do counsellors and psychotherapists understand diet and nutrition as part of the therapy process? A heuristic study. COUNSELLING & PSYCHOTHERAPY RESEARCH 2015. [DOI: 10.1002/capr.12041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Raine A, Portnoy J, Liu J, Mahoomed T, Hibbeln J. Reduction in behavior problems with omega-3 supplementation in children aged 8-16 years: a randomized, double-blind, placebo-controlled, stratified, parallel-group trial. J Child Psychol Psychiatry 2015; 56:509-20. [PMID: 25146492 PMCID: PMC4336833 DOI: 10.1111/jcpp.12314] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND While limited evidence suggests that omega-3 supplementation may reduce antisocial behavior in children, studies have not reported on posttreatment follow-up and most treatment periods have been of short duration. This study tests the hypothesis that omega-3 supplementation over 6 months will reduce behavior problems in children both at the end of treatment and at 6 months post treatment. METHODS In this randomized, double-blind, placebo-controlled, stratified, parallel-group trial, a community sample of 8-16 year old children were randomized into a treatment group (N = 100) and a placebo-control group (N = 100). The supplementation consisted of a fruit drink containing 1 g/day of omega-3 or a placebo consisting of the same fruit drink without omega-3. Participants, caregivers, and research assistants were blinded to group assignment. The primary outcome measures of externalizing and internalizing behavior problems were reported by both caregivers and their children in a laboratory setting at 0 months (baseline), 6 months (end of treatment) and 12 months (6 months post treatment), together with the secondary outcome measures of parental antisocial behavior. Data were analyzed on an intention-to-treat basis including all participants. TRIAL REGISTRATION ClinicalTrials.gov: http://clinicaltrials.gov/ct2/show/NCT02016079?term=mauritius&rank=2 RESULTS: Significant group × time interactions were observed with the treatment group showing long-term improvements in child behavior problems. The average posttreatment effect size was d = -.59. Effects were documented for parent reports, but with the exception of proactive and reactive aggression, child-report data were nonsignificant. Parents whose children took omega-3 showed significant posttreatment reductions in their own antisocial and aggressive behavior. This improvement in caregiver behavior partly mediated the improvements observed in child behavior. CONCLUSIONS Findings provide initial evidence that omega-3 supplementation can produce sustained reductions in externalizing and internalizing behavior problems. Results are the first to report improvements in caregiver behavior, and to establish this improvement as a part-mechanism for the efficacy of omega-3.
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Affiliation(s)
- Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania
| | - Jill Portnoy
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania
| | | | | | - Joseph Hibbeln
- Section on Nutritional Neuroscience, National Institute on Alcohol Abuse and Alcoholism
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Meyer BJ, Byrne MK, Collier C, Parletta N, Crawford D, Winberg PC, Webster D, Chapman K, Thomas G, Dally J, Batterham M, Farquhar I, Martin AM, Grant L. Baseline omega-3 index correlates with aggressive and attention deficit disorder behaviours in adult prisoners. PLoS One 2015; 10:e0120220. [PMID: 25793501 PMCID: PMC4368577 DOI: 10.1371/journal.pone.0120220] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is emerging evidence that the supplementation of omega-3 contributes to a decrease in aggressive behaviour in prison populations. A challenge of such research is achieving statistical power against effect sizes which may be affected by the baseline omega-3 index. There are no published data on the blood omega-3 index with studies of this kind to assess the variability of the blood omega-3 index in conjunction with aggression and attention deficit assessments. OBJECTIVE To determine if the variance of the omega-3 index is correlated with aggressive and attention deficit behaviour in a prison population. DESIGN 136 adult male prisoners were recruited from South Coast Correctional Centre (SCCC), NSW Australia. A 7 point categorisation was used to quantify levels of aggressive behaviour (4 weeks) from individual SCCC case notes, whereby higher scores correspond to increasingly aggressive behaviour. Study participants completed the Aggression Questionnaire (AQ) and the Brown's Attention Deficit Disorder Scales (BADDS), provided a blood sample for erythrocyte fatty acid analysis using gas chromatography and the omega-3 index was calculated. RESULTS The baseline omega-3 index ranged from 2.3% to 10.3%, indicating that some participants already had substantial omega-3 intake, however a median of 4.7% indicated a lower overall omega-3 intake than the general Australian population. Assessment of aggressive and attention deficit behaviour shows that there were negative correlations between baseline omega-3 index and baseline aggression categorisation scores (r = -0.21, P = 0.016); total AQ score (r = -0.234, P = 0.011); Anger (r = -0.222 p = 0.016); Hostility AQ (r = -0.239, P = 0.009); indirect aggression (r = -0.188 p = 0.042); total BADDS (r = -0.263, p = 0.005); Activation (r = -0.224, p = 0.016); Attention (r = -0.192, p = 0.043); Effort (r = -0.253, p = 0.007); Affect (r = -0.330, p = 0.000) and Memory (r = -0.240, p = 0.010). CONCLUSIONS There is a high variability in omega-3 status of a NSW prison population, and inmates with lower omega-3 index were more aggressive and had higher ADD scores.
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Affiliation(s)
- Barbara J. Meyer
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Heath and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- * E-mail:
| | - Mitchell K. Byrne
- Illawarra Heath and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Carole Collier
- South Coast Correctional Centre, Nowra, New South Wales, Australia
| | - Natalie Parletta
- School of Population Health, Sansom Institute for Health Research, Adelaide, University of South Australia, Adelaide, Australia
| | - Donna Crawford
- South Coast Correctional Centre, Nowra, New South Wales, Australia
| | - Pia C. Winberg
- Venus Shell Systems and Shoalhaven Marine & Freshwater Centre, University of Wollongong, Wollongong, New South Wales, Australia
| | - David Webster
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Karen Chapman
- South Coast Correctional Centre, Nowra, New South Wales, Australia
| | - Gayle Thomas
- South Coast Correctional Centre, Nowra, New South Wales, Australia
| | - Jean Dally
- South Coast Correctional Centre, Nowra, New South Wales, Australia
| | - Marijka Batterham
- Statistical Consulting Service, University of Wollongong, Wollongong, New South Wales 2522, Australia
| | - Ian Farquhar
- South Coast Correctional Centre, Nowra, New South Wales, Australia
| | | | - Luke Grant
- Corrective Services New South Wales, Sydney, Australia
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48
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Lipids and Health. Lipids 2014. [DOI: 10.1201/b17656-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Rucklidge JJ, Kaplan BJ. Broad-spectrum micronutrient treatment for attention-deficit/hyperactivity disorder: rationale and evidence to date. CNS Drugs 2014; 28:775-85. [PMID: 25056569 DOI: 10.1007/s40263-014-0190-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric illness, which often co-occurs with other common psychiatric problems. Although empirical evidence supports the short-term efficacy of pharmacological and behavioural treatments, families often search for alternative treatment methods because of concerns about side effects and safety, cost and access, as well as fears about long-term exposure to psychotropic medications. This review presents the published evidence on use of broad-spectrum micronutrients to treat ADHD symptoms. This approach makes physiological sense in that nutrients are required for many critical biochemical reactions to occur, ranging from manufacturing neurotransmitters, to providing the mitochondria with essential nutrients for energy production, to assisting the gut to heal from inflammation. Multi-nutrient treatment approaches are an intriguing yet under-researched area; all but one of the trials conducted in the last decade have shown benefit for the treatment of ADHD symptoms, and the one negative trial likely used doses too low to effect change. However, the methodologies have varied widely from case-controlled studies to open-label trials to one randomized controlled trial. Sample sizes have typically been modest, although the effect sizes have tended to be medium to large. What is required now is replication, as well as investigation into the optimal ingredient range and optimal doses of nutrients. We discuss the proven and potential benefits of the broad-spectrum nutrient approach, considering the heterogeneous nature of ADHD.
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Affiliation(s)
- Julia J Rucklidge
- Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, New Zealand,
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50
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Gow RV, Hibbeln JR. Omega-3 fatty acid and nutrient deficits in adverse neurodevelopment and childhood behaviors. Child Adolesc Psychiatr Clin N Am 2014; 23:555-90. [PMID: 24975625 PMCID: PMC4175558 DOI: 10.1016/j.chc.2014.02.002] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Nutritional insufficiencies of omega-3 highly unsaturated fatty acids (HUFAs) may have adverse effects on brain development and neurodevelopmental outcomes. A recent meta-analysis reported a small to modest effect size for the efficacy of omega-3 in youth. Several controlled trials of omega-3 HUFAs combined with micronutrients show sizable reductions in aggressive, antisocial, and violent behavior in youth and young adult prisoners. Studies of HUFAs in youth, however, remain lacking. As the evidence base for omega-3 HUFAs as potential psychiatric treatment develops, dietary adjustments to increase omega-3 and reduce omega-6 HUFA consumption are sensible recommendations based on general health considerations.
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Affiliation(s)
- Rachel V Gow
- Section of Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, 31 Center Drive, Building 31, Room 1B54, Rockville, MD 20892, USA
| | - Joseph R Hibbeln
- Section of Nutritional Neurosciences, Laboratory of Membrane Biochemistry and Biophysics, National Institute of Alcohol Abuse and Alcoholism, National Institutes of Health, 5625 Fishers Lane, Room 3N-01, Rockville, MD 20892, USA.
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