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Pihlaja S, Jääskeläinen E, Heikkilä L, Hintsanen M. Associations of lipids in adolescence and adulthood with self- and other-directed compassion in adulthood. Scand J Psychol 2024. [PMID: 39013837 DOI: 10.1111/sjop.13052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/31/2024] [Accepted: 06/12/2024] [Indexed: 07/18/2024]
Abstract
Self- and other-directed compassion have been linked with better mental and physical health but research on factors contributing to their development is scarce. Previous studies indicate a possible causal relationship of lipids with personality and socioemotional functioning. As an extension to earlier research, in the present study we examine whether lipids assessed in adolescence and adulthood are associated with self-compassion and other-directed compassion in adulthood. The study utilizes data on lipids from two follow-ups in the Northern Finland Birth Cohort 1986 at ages 15-16 and 33-35. In the latter follow-up also self-compassion and other-directed compassion were assessed with the self-compassion scale - short form and the subscale for compassion in the dispositional positive emotions scale, respectively. The sample for the cross-sectional associations of lipids in adulthood with the compassion variables in adulthood includes 1,459 participants, whereas the sample for the longitudinal associations of lipids in adolescence and the compassion variables in adulthood consists of 1,509 participants. The associations were examined with hierarchical linear regression (lipids as continuous variables) and univariate general linear model (lipids as categorical variables). The results suggest that in women, high-density lipoprotein (HDL) cholesterol in adolescence is associated with high empathic concern (a component of other-directed compassion) in adulthood. The results show further that, in women, an HDL cholesterol level above 1.2 mmol/L in adulthood is associated with high other-directed compassion and empathic concern in adulthood. The present study provides tentative evidence that biological factors such as lipids might play a role in the development of empathic concern and other-directed compassion.
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Affiliation(s)
- Sofia Pihlaja
- Research Center of Psychology, Faculty of Education and Psychology, University of Oulu, Oulu, Finland
| | - Erika Jääskeläinen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Laura Heikkilä
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr, Oulu, Finland
| | - Mirka Hintsanen
- Research Center of Psychology, Faculty of Education and Psychology, University of Oulu, Oulu, Finland
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Bach-Faig A, Ferreres Giménez I, Pueyo Alamán MG. [Immunonutrition and (its impact on) health. Micronutrients and debilitating factors]. NUTR HOSP 2023; 40:3-8. [PMID: 37929894 DOI: 10.20960/nh.04945] [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] [Indexed: 11/07/2023] Open
Abstract
Introduction Introduction: the interaction between immunity and nutrition is complex and multifaceted. Micronutrients, including vitamins and minerals, are essential for immune function. In turn, immune function and lifestyle habits can affect nutritional needs and micronutrient utilization, creating an interdependence between nutrition and immunity that can be modulated by both external and internal factors. Objectives: to examine the relationship between micronutrient intake and immune function, and how debilitating factors such as aging, disease, and stress can impact this relationship. Methods: a review of scientific evidence and recommendations from major international scientific societies was conducted to identify the importance of micronutrients in immune function and how debilitating factors can alter their impact. Results: the effect of different micronutrients on immune function is described. Debilitating factors like aging, stress, and chronic diseases can compromise the immune system and make the body more susceptible to infections. However, adequate intake of micronutrients and healthy habits can help to strengthen immunity and mitigate the effects of these debilitating factors. Conclusion: immunonutrition is a critical component for maintaining a strong and healthy immune system. Sufficient intake of micronutrients and healthy lifestyle habits can help improve immunity, especially in the presence of debilitating factors.
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Affiliation(s)
- Anna Bach-Faig
- Grupo de Investigación FoodLab (2017SGR 83), Estudios de Ciencias de la Salud, Universitat Oberta de Catalunya (UOC), Spain
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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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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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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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Blampied M, Bell C, Gilbert C, Rucklidge JJ. Broad spectrum micronutrient formulas for the treatment of symptoms of depression, stress, and/or anxiety: a systematic review. Expert Rev Neurother 2021; 20:351-371. [PMID: 32178540 DOI: 10.1080/14737175.2020.1740595] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Introduction: Vitamin and mineral nutritional supplements are becoming increasingly popular as alternative treatments for anxiety and depression, as issues such as side effects from medication, failure to respond to psychotherapy and workforce limitations pose barriers for successful treatment.Areas covered: This review covered double-blind, randomized controlled trials (DBRCTs) testing formulas including at least four vitamins and/or minerals used for the treatment of symptoms of anxiety, stress, or depression in adults not currently taking medication for psychiatric difficulties.Expert opinion: The majority of the 23 trials reviewed were conducted on people without psychological difficulties, limiting the generalizability of the results in people with diagnosed mood and anxiety difficulties. Sixteen studies demonstrated positive effects for symptoms of anxiety, depression, or stress. Micronutrient supplementation in healthy nonclinical adults has limited benefits for mood and anxiety symptoms, although may convey some subtle general improvements. The evidence for adults with physical or mental ill health is more positive although limited by small samples and variability in nutrients studied. Broad-spectrum nutrient products may be more effective than a selected few. While an effect of micronutrients cannot be dismissed, the variability of the studies makes it extremely challenging to identify specific treatment benefits.
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Affiliation(s)
- Meredith Blampied
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Caroline Bell
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Claire Gilbert
- Canterbury District Health Board, Christchurch, New Zealand
| | - Julia J Rucklidge
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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van der Wurff IS, Meyer BJ, de Groot RH. Effect of Omega-3 Long Chain Polyunsaturated Fatty Acids (n-3 LCPUFA) Supplementation on Cognition in Children and Adolescents: A Systematic Literature Review with a Focus on n-3 LCPUFA Blood Values and Dose of DHA and EPA. Nutrients 2020; 12:nu12103115. [PMID: 33053843 PMCID: PMC7599612 DOI: 10.3390/nu12103115] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 02/06/2023] Open
Abstract
Omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) supplementation in the cardiovascular field is effective if a certain Omega-3 index (O3I) is achieved or the daily n-3 LCPUFA dose is high enough. Whether this applies to studies on cognition in children and adolescents is unclear. The aims of the current review were to investigate whether: (1) a certain O3I level and (2) a minimum daily n-3 LCPUFA dose are required to improve cognition in 4-25 year olds. Web of Science and PubMed were searched. Inclusion criteria: placebo controlled randomized controlled trial; participants 4-25 years; supplementation with docosahexaenoic acid (DHA) and/or eicosapentaenoic acid (EPA); assessing cognition; in English and ≥10 participants per treatment arm. Thirty-three studies were included, 21 in typically developing participants, 12 in those with a disorder. A positive effect on cognitive measures was more likely in studies with an increase in O3I to >6%. Half of the studies in typically developing children with daily supplementation dose ≥450 mg DHA + EPA showed improved cognition. For children with a disorder no cut-off value was found. In conclusion, daily supplementation of ≥450 mg DHA + EPA per day and an increase in the O3I to >6% makes it more likely to show efficacy on cognition in children and adolescents.
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Affiliation(s)
- Inge S.M. van der Wurff
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 Heerlen, The Netherlands;
| | - Barbara J. Meyer
- School of Medicine, Lipid Research Centre, Molecular Horizons, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia;
| | - Renate H.M. de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 Heerlen, The Netherlands;
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6200 Maastricht, The Netherlands
- Correspondence: ; Tel.: +31-45-576-2909
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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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Barón-Mendoza I, González-Arenas A. Relationship between the effect of polyunsaturated fatty acids (PUFAs) on brain plasticity and the improvement on cognition and behavior in individuals with autism spectrum disorder. Nutr Neurosci 2020; 25:387-410. [PMID: 32338174 DOI: 10.1080/1028415x.2020.1755793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: This work aimed to compile information about the neuronal processes in which polyunsaturated fatty acids (PUFAs) could modulate brain plasticity, in order to analyze the role of nutritional intervention with the ω-3 and ω-6 fatty acids as a therapeutic strategy for the Autism Spectrum Disorder (ASD)-related signs and symptoms.Methods: We reviewed different articles reporting the effect of PUFAS on neurite elongation, membrane expansion, cytoskeleton rearrangement and neurotransmission, considering the ASD-related abnormalities in these processes.Results: In accordance to the reviewed studies, it is clear that ASD is one of the neurological conditions associated with an impairment in neuronal plasticity; therefore, PUFAs-rich diet improvements on cognition and behavioral deficits in individuals with autism, could be involved with the regulation of neuronal processes implicated in the atypical brain plasticity related with this neurodevelopmental disorder.Discussion: The behavioral and cognitive improvement observed in individuals with ASD after PUFAs treatment might underlie, at least in part, in the ability of ω-3 and ω-6 fatty acids to induce neurite outgrowth, probably, through the dynamic regulation of the neuronal cytoskeleton along with the expansion of neuronal membranes. Furthermore, it might also be associated with an enhancement of the efficacy of synaptic transmission and the modulation of neurotransmitters release.
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Affiliation(s)
- Isabel Barón-Mendoza
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, México
| | - Aliesha González-Arenas
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, CDMX, México
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Chen X, Xu J, Tang J, Dai X, Huang H, Cao R, Hu J. Dysregulation of amino acids and lipids metabolism in schizophrenia with violence. BMC Psychiatry 2020; 20:97. [PMID: 32131778 PMCID: PMC7055102 DOI: 10.1186/s12888-020-02499-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/14/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Many studies have related biochemical characteristics to violence and have reported schizophrenia could elevated the risk of violent behaviour. However, the metabolic characteristics of schizophrenia patients with violence (V.SC) are unclear. METHODS To explore the metabolic characteristics of schizophrenia with violence and to identify potential biomarkers, untargeted metabolomics was performed by using gas chromatography time-of-flight mass spectrometry to analyse the plasma metabolites of fifty-three V.SC and twenty-four schizophrenia patients without violence (NV.SC). Multivariate and univariate analyses were performed to identify differential metabolites and biomarkers. Violence was assessed by the MacArthur Violence Assessment Study method. Psychiatric symptoms were assessed by the Positive and Negative Syndrome Scale. RESULTS Multivariate analysis was unable to distinguish V.SC from NV.SC. Glycerolipid metabolism and phenylalanine, tyrosine and tryptophan biosynthesis were the differential metabolic pathways between V.SC and NV.SC. We confirmed ten metabolites and five metabolites as metabolic biomarkers of V.SC by random forest and support vector machine analysis, respectively. The biomarker panel, including the ratio of L-asparagine to L-aspartic acid, vanillylmandelic acid and glutaric acid, yielded an area under the receiver operating characteristic curve of 0.808. CONCLUSIONS This study gives a holistic view of the metabolic phenotype of schizophrenia with violence which is characterized by the dysregulation of lipids and amino acids. These results might provide information for the aetiological understanding and management of violence in schizophrenia; however, this is a preliminary metabolomics study about schizophrenia with violence, which needs to be repeated in future studies.
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Affiliation(s)
- Xiacan Chen
- Institute of Forensic Medicine, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Jiajun Xu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Tang
- Chengdu Compulsory Medical Center, Chengdu, China
| | - Xinhua Dai
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041 China
| | - Haolan Huang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041 China
| | - Ruochen Cao
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041 China
| | - Junmei Hu
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041 China
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Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and 'At-Risk' Individuals. Nutrients 2019; 11:nu11092232. [PMID: 31527485 PMCID: PMC6770181 DOI: 10.3390/nu11092232] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/29/2019] [Accepted: 09/07/2019] [Indexed: 12/21/2022] Open
Abstract
A systematic review and meta-analysis was undertaken to examine and quantify the effects of B vitamin supplementation on mood in both healthy and 'at-risk' populations. A systematic search identified all available randomised controlled trials (RCTs) of daily supplementation with ≥3 B group vitamins with an intervention period of at least four weeks. Random effects models for a standardized mean difference were used to test for overall effect. Heterogeneity was tested using the I2 statistic. Eighteen articles (16 trials, 2015 participants) were included, of which 12 were eligible for meta-analysis. Eleven of the 18 articles reported a positive effect for B vitamins over a placebo for overall mood or a facet of mood. Of the eight studies in 'at-risk' cohorts, five found a significant benefit to mood. Regarding individual facets of mood, B vitamin supplementation benefited stress (n = 958, SMD = 0.23, 95% CI = 0.02, 0.45, p = 0.03). A benefit to depressive symptoms did not reach significance (n = 568, SMD = 0.15, 95% CI = -0.01, 0.32, p = 0.07), and there was no effect on anxiety (n = 562, SMD = 0.03, 95% CI = -0.13, 0.20, p = 0.71). The review provides evidence for the benefit of B vitamin supplementation in healthy and at-risk populations for stress, but not for depressive symptoms or anxiety. B vitamin supplementation may particularly benefit populations who are at risk due to (1) poor nutrient status or (2) poor mood status.
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Affiliation(s)
- Lauren M Young
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia.
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia.
| | - David J White
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia.
| | - Sarah Gauci
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia.
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia.
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Reimers A, Ljung H. The emerging role of omega-3 fatty acids as a therapeutic option in neuropsychiatric disorders. Ther Adv Psychopharmacol 2019; 9:2045125319858901. [PMID: 31258889 PMCID: PMC6591664 DOI: 10.1177/2045125319858901] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/31/2019] [Indexed: 12/15/2022] Open
Abstract
The prevalence of neurologic and psychiatric diseases has been increasing for decades and, given the moderate therapeutic efficacy and safety profile of existing pharmacological treatments, there is an urgent need for new therapeutic approaches. Nutrition has recently been recognized as an important factor for the prevention and treatment of neuropsychiatric disorders. The omega-3 polyunsaturated fatty acids (n-3 PUFAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play critical roles in neuronal cell function and neurotransmission as well as inflammatory and immune reactions that are involved in neuropsychiatric disease states. A large number of experimental and epidemiological studies provide a strong basis for interventional clinical trials that assessed the clinical efficacy of n-3 PUFAs in various neurological and psychiatric disorders. Most of these trials found beneficial effects of dietary supplementation with EPA and DHA, and no serious safety concerns have emerged. This review gives an introduction to recent findings on the clinical efficacy of n-3 PUFAs in various neuropsychiatric disorders and the underlying biochemical mechanisms. In addition, the reader will be enabled to identify common methodological weaknesses of clinical studies on n-3 PUFAs, and suggestions for the design of future studies are given.
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Affiliation(s)
- Arne Reimers
- Department of Clinical Chemistry and Pharmacology, Division of Laboratory Medicine, Klinikgatan 17, Lund, 22185, Sweden
| | - Hanna Ljung
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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Rodrigues DM, Manfro GG, Levitan RD, Steiner M, Meaney MJ, Silveira PP. Moderating effect of PLIN4 genetic variant on impulsivity traits in 5-year-old-children born small for gestational age. Prostaglandins Leukot Essent Fatty Acids 2018; 137:19-25. [PMID: 30293593 DOI: 10.1016/j.plefa.2018.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/17/2018] [Indexed: 01/08/2023]
Abstract
Poor fetal growth is associated with long-term behavioral, metabolic and psychiatric alterations, including impulsivity, insulin resistance, and mood disorders. However, the consumption of omega-3 polyunsaturated fatty acid (n-3 PUFA) seems to be protective for this population, improving inhibitory control and behavioral reactivity. We investigated whether the presence of the A allele of rs8887 SNP (PLIN4 gene), known to be associated with increased sensitivity to the consumption of n-3 PUFAs, interacts with fetal growth influencing inhibitory control. 152 five-year-old children were genotyped and performed the Stop Signal Task (SSRT). There was a significant interaction between birth weight and the presence of the A allele on SSRT performance, in which lower birth weight associated with poorer inhibitory control only in non-carriers. These results suggest that a higher responsiveness to n-3 PUFAS protects small for gestational age children from developing poor response inhibition, highlighting that optimizing n-3 PUFA intake may benefit this population.
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Affiliation(s)
- Danitsa Marcos Rodrigues
- Postgraduate Program in Neurosciences, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gisele Gus Manfro
- Postgraduate Program in Neurosciences, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Robert Daniel Levitan
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Meir Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University. Hamilton, ON, Canada
| | - Michael Joseph Meaney
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Sackler Program for Epigenetics & Psychobiology, McGill University, Canada
| | - Patrícia Pelufo Silveira
- Postgraduate Program in Neurosciences, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada; Sackler Program for Epigenetics & Psychobiology, McGill University, Canada.
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Astrup A, Bügel S. Overfed but undernourished: recognizing nutritional inadequacies/deficiencies in patients with overweight or obesity. Int J Obes (Lond) 2018; 43:219-232. [PMID: 29980762 DOI: 10.1038/s41366-018-0143-9] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/17/2018] [Accepted: 05/20/2018] [Indexed: 02/06/2023]
Abstract
Overweight and obesity are highly prevalent throughout the world and can adversely affect the nutritional status of individuals. Studies have shown that many people with obesity have inadequate intake of iron, calcium, magnesium, zinc, copper, folate and vitamins A and B12, likely as a result of poor diet quality. Nutritional inadequacies or deficiencies may also occur due to altered pharmacokinetics in the individual with obesity and due to interactions in those with overweight or obesity with various pharmaceuticals. However, it has been demonstrated that the adult population in the United States as a whole is deficient in certain micronutrients as a result of the availability and overconsumption of high-calorie, low-nutrient processed foods. Poor nutrition may contribute to the development of certain chronic conditions, such as type 2 diabetes, which is already more prevalent in those with obesity. Clinicians need to be aware of these gaps, particularly in those individuals with obesity who are undergoing bariatric surgery or taking pharmaceutical products long term to facilitate weight loss. Patients with overweight or obesity likely struggle to achieve a balanced diet and may benefit from consultation with a dietitian. Along with providing recommendations for healthy eating and exercise, supplementation with specific micronutrients or multivitamins should be considered for individuals at the highest risk for or with established deficiencies. Further research is needed to understand the factors underlying nutritional inadequacies in individuals with overweight or obesity, as well as the outcomes of treatment strategies employed to address them.
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Affiliation(s)
- Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
| | - Susanne Bügel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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15
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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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16
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17
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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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18
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Stringham NT, Holmes PV, Stringham JM. Supplementation with macular carotenoids reduces psychological stress, serum cortisol, and sub-optimal symptoms of physical and emotional health in young adults. Nutr Neurosci 2017; 21:286-296. [PMID: 28198205 DOI: 10.1080/1028415x.2017.1286445] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Oxidative stress and systemic inflammation are the root cause of several deleterious effects of chronic psychological stress. We hypothesize that the antioxidant and anti-inflammatory capabilities of the macular carotenoids (MCs) lutein, zeaxanthin, and meso-zeaxanthin could, via daily supplementation, provide a dietary means of benefit. METHODS A total of 59 young healthy subjects participated in a 12-month, double-blind, placebo-controlled trial to evaluate the effects of MC supplementation on blood cortisol, psychological stress ratings, behavioural measures of mood, and symptoms of sub-optimal health. Subjects were randomly assigned to one of three groups: placebo, 13 mg, or 27 mg / day total MCs. All parameters were assessed at baseline, 6 months, and 12 months. Serum MCs were determined via HPLC, serum cortisol via ELISA, and macular pigment optical density (MPOD) via customized heterochromatic flicker photometry. Behavioural data were obtained via questionnaire. RESULTS Significant baseline correlations were found between MPOD and Beck anxiety scores (r = -0.28; P = 0.032), MPOD and Brief Symptom Inventory scores (r = 0.27; P = 0.037), and serum cortisol and psychological stress scores (r = 0.46; P < 0.001). Supplementation for 6 months improved psychological stress, serum cortisol, and measures of emotional and physical health (P < 0.05 for all), versus placebo. These outcomes were either maintained or improved further at 12 months. CONCLUSIONS Supplementation with the MCs significantly reduces stress, cortisol, and symptoms of sub-optimal emotional and physical health. Determining the basis for these effects, whether systemic or a more central (i.e. brain) is a question that warrants further study.
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Affiliation(s)
- Nicole Tressa Stringham
- a Interdisciplinary Neuroscience Program, Biomedical and Health Sciences Institute , University of Georgia , Athens, GA 30602, USA.,b Department of Psychology , University of Georgia , Athens, GA 30602, USA
| | - Philip V Holmes
- a Interdisciplinary Neuroscience Program, Biomedical and Health Sciences Institute , University of Georgia , Athens, GA 30602, USA.,b Department of Psychology , University of Georgia , Athens, GA 30602, USA
| | - James M Stringham
- b Department of Psychology , University of Georgia , Athens, GA 30602, USA
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19
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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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20
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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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Hagenbeek FA, Kluft C, Hankemeier T, Bartels M, Draisma HHM, Middeldorp CM, Berger R, Noto A, Lussu M, Pool R, Fanos V, Boomsma DI. Discovery of biochemical biomarkers for aggression: A role for metabolomics in psychiatry. Am J Med Genet B Neuropsychiatr Genet 2016; 171:719-32. [PMID: 26913573 DOI: 10.1002/ajmg.b.32435] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 02/09/2016] [Indexed: 12/30/2022]
Abstract
Human aggression encompasses a wide range of behaviors and is related to many psychiatric disorders. We introduce the different classification systems of aggression and related disorders as a basis for discussing biochemical biomarkers and then present an overview of studies in humans (published between 1990 and 2015) that reported statistically significant associations of biochemical biomarkers with aggression, DSM-IV disorders involving aggression, and their subtypes. The markers are of different types, including inflammation markers, neurotransmitters, lipoproteins, and hormones from various classes. Most studies focused on only a limited portfolio of biomarkers, frequently a specific class only. When integrating the data, it is clear that compounds from several biological pathways have been found to be associated with aggressive behavior, indicating complexity and the need for a broad approach. In the second part of the paper, using examples from the aggression literature and psychiatric metabolomics studies, we argue that a better understanding of aggression would benefit from a more holistic approach such as provided by metabolomics. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Fiona A Hagenbeek
- Department of Biological Psychology, VU Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | | | - Thomas Hankemeier
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands.,The Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - Meike Bartels
- Department of Biological Psychology, VU Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Harmen H M Draisma
- Department of Biological Psychology, VU Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Christel M Middeldorp
- Department of Biological Psychology, VU Amsterdam, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, Amsterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, GGZ inGeest/VU University Medical Center, Amsterdam, The Netherlands
| | - Ruud Berger
- Division of Analytical Biosciences, Leiden Academic Center for Drug Research, Leiden University, Leiden, The Netherlands.,The Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - Antonio Noto
- Neonatal Intensive Care Unit, Department of Surgical Sciences, Puericultura Institute and Neonatal Section, University of Cagliari, Cagliari, Italy
| | - Milena Lussu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - René Pool
- Department of Biological Psychology, VU Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,BBMRINL: Infrastructure for the Application of Metabolomics Technology in Epidemiology, Leiden, The Netherlands
| | - Vassilios Fanos
- Neonatal Intensive Care Unit, Department of Surgical Sciences, Puericultura Institute and Neonatal Section, University of Cagliari, Cagliari, Italy
| | - Dorret I Boomsma
- Department of Biological Psychology, VU Amsterdam, Amsterdam, The Netherlands.,EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands.,Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
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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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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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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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25
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Subjective well-being in older adults: folate and vitamin B12 independently predict positive affect. Br J Nutr 2015; 114:1321-8. [PMID: 26346363 DOI: 10.1017/s0007114515002949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Vitamin B12, folate and homocysteine have long been implicated in mental illness, and growing evidence suggests that they may play a role in positive mental health. Elucidation of these relationships is confounded due to the dependence of homocysteine on available levels of vitamin B12 and folate. Cross-sectional and longitudinal relationships between vitamin B12, folate, homocysteine and subjective well-being were assessed in a sample of 391 older, community-living adults without clinically diagnosed depression. Levels of vitamin B12, but not folate, influenced homocysteine levels 18 months later. Vitamin B12, folate and their interaction significantly predicted levels of positive affect (PA) 18 months later, but had no impact on the levels of negative affect or life satisfaction. Cross-sectional relationships between homocysteine and PA were completely attenuated in the longitudinal analyses, suggesting that the cross-sectional relationship is driven by the dependence of homocysteine on vitamin B12 and folate. This is the first study to offer some evidence of a causal link between levels of folate and vitamin B12 on PA in a large, non-clinical population.
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Clouard C, Souza AS, Gerrits WJ, Hovenier R, Lammers A, Bolhuis JE. Maternal Fish Oil Supplementation Affects the Social Behavior, Brain Fatty Acid Profile, and Sickness Response of Piglets. J Nutr 2015; 145:2176-84. [PMID: 26180250 DOI: 10.3945/jn.115.214650] [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] [Received: 04/08/2015] [Accepted: 06/24/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Maternal dietary docosahexaenoic acid (DHA) intake is thought to affect development in the offspring. OBJECTIVE We assessed the impact of maternal dietary DHA on behavior, brain fatty acid (FA) profile, and sickness response of offspring in pigs, a pertinent model for human nutrition. METHODS Sows (n = 24) were fed a diet with DHA-rich fish oil (FO) (20 g/kg) or high-oleic acid sunflower oil (HOSF) (20 g/kg) from day 61 of gestation through lactation. At 4 wk of age, 4 piglets per litter were weaned and mixed with piglets from other litters. Behavior was observed in 4- to 8-wk-old piglets, and brain FA composition was analyzed at 4 (n = 15) and 14 (n = 12) wk. Thirteen-week-old piglets (n = 48) were subjected to a lipopolysaccharide (LPS) challenge. Body temperature, plasma cytokines, and motivation to approach a familiar human, indicative of a sickness response, were measured. RESULTS FO-fed pigs displayed more social activities (+262%, P = 0.02), played more (+61%, P = 0.03), and tended to show fewer oral manipulative behaviors directed at pen mates (-25%, P = 0.06) than did HOSF-fed pigs up to 4 wk after weaning. Brain DHA concentrations were higher in FO- than in HOSF-fed pigs up to 10 wk after supplementation (+10-50%, P < 0.001), although differences declined with age. Body temperature (P < 0.001) and tumor necrosis factor α and interferon γ concentrations (P < 0.05) increased after LPS injection, but no diet effect was found (P > 0.10). LPS-treated pigs were less likely to approach the human than saline-treated pigs in the HOSF-fed (-29%, P = 0.0003), but not in the FO-fed group (-13%, P = 0.11). CONCLUSIONS Maternal DHA beneficially affected offspring social behavior after weaning and mildly attenuated sickness behavior after an inflammatory challenge in pigs. These behavioral changes may be mediated by increased brain DHA proportions.
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Affiliation(s)
| | - Adriana S Souza
- Adaptation Physiology Group and Animal Nutrition Group, Department of Animal Sciences, Wageningen University, Wageningen, Netherlands
| | - Walter Jj Gerrits
- Animal Nutrition Group, Department of Animal Sciences, Wageningen University, Wageningen, Netherlands
| | - Robert Hovenier
- Animal Nutrition Group, Department of Animal Sciences, Wageningen University, Wageningen, Netherlands
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Kaplan BJ, Rucklidge JJ, Romijn AR, Dolph M. A randomised trial of nutrient supplements to minimise psychological stress after a natural disaster. Psychiatry Res 2015; 228:373-9. [PMID: 26154816 DOI: 10.1016/j.psychres.2015.05.080] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 04/29/2015] [Accepted: 05/24/2015] [Indexed: 10/23/2022]
Abstract
After devastating flooding in southern Alberta in June 2013, we attempted to replicate a New Zealand randomised trial that showed that micronutrient (minerals, vitamins) consumption after the earthquakes of 2010-11 resulted in improved mental health. Residents of southern Alberta were invited to participate in a study on the potential benefit of nutrient supplements following a natural disaster. Fifty-six adults aged 23-66 were randomised to receive a single nutrient (vitamin D, n=17), a few-nutrients formula (B-Complex, n=21), or a broad-spectrum mineral/vitamin formula (BSMV, n=18). Self-reported changes in depression, anxiety and stress were monitored for six weeks. Although all groups showed substantial decreases on all measures, those consuming the B-Complex and the BSMV formulas showed significantly greater improvement in stress and anxiety compared with those consuming the single nutrient, with large effect sizes (Cohen's d range 0.76-1.08). There were no group differences between those consuming the B-Complex and BSMV. The use of nutrient formulas with multiple minerals and/or vitamins to minimise stress associated with natural disasters is now supported by three studies. Further research should be carried out to evaluate the potential population benefit that might accrue if such formulas were distributed as a post-disaster public health measure.
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Affiliation(s)
- Bonnie J Kaplan
- Department of Paediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.
| | - Julia J Rucklidge
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Amy R Romijn
- Department of Psychology, University of Canterbury, Christchurch, New Zealand
| | - Michael Dolph
- Department of Paediatrics, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
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28
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Cooper RE, Tye C, Kuntsi J, Vassos E, Asherson P. Omega-3 polyunsaturated fatty acid supplementation and cognition: A systematic review and meta-analysis. J Psychopharmacol 2015; 29:753-63. [PMID: 26040902 DOI: 10.1177/0269881115587958] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are promoted as cognitive enhancers with consumption recommended in the general population and those with neurocognitive deficits such as attention deficit hyperactivity disorder (ADHD). However, evidence from randomised placebo-controlled trials is inconclusive. AIMS This study aimed to conduct a systematic review and meta-analysis examining the effect of n-3 PUFA supplementation on cognition in healthy populations and those with ADHD and related disorders (RDs). METHODS Databases were searched for randomised controlled trials (RCTs) in adults and school-aged children (who were healthy and typically developing (TD) or had ADHD or a related-neurodevelopmental disorder (ADHD+RD) which assessed the effects of n-3 PUFA on cognition. RESULTS In the 24 included studies n-3 PUFA supplementation, in the whole sample and the TD and ADHD+RD subgroup, did not show improvements in any of the cognitive performance measures. In those with low n-3 PUFA status, supplementation improved short-term memory. CONCLUSIONS There is marginal evidence that n-3 PUFA supplementation effects cognition in those who are n-3 PUFA deficient. However, there is no evidence of an effect in the general population or those with neurodevelopmental disorders. This has important implications given the widespread advertisement and consumption of n-3 PUFA; claims of cognitive benefit should be narrowed.
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Affiliation(s)
- Ruth E Cooper
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Charlotte Tye
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Jonna Kuntsi
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Evangelos Vassos
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
| | - Philip Asherson
- King's College London, MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London London, UK
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Reis RS, Bernardi JR, Steiner M, Meaney MJ, Levitan RD, Silveira PP. Poor infant inhibitory control predicts food fussiness in childhood - A possible protective role of n-3 PUFAs for vulnerable children. Prostaglandins Leukot Essent Fatty Acids 2015; 97:21-5. [PMID: 25892188 DOI: 10.1016/j.plefa.2015.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 01/09/2023]
Abstract
Intrauterine growth restriction (IUGR) children are more impulsive towards a sweet reward and have altered feeding behavior in adulthood. We hypothesized that early life inhibitory control predicts feeding behaviors later on in childhood, and the consumption of n-3 PUFAs during infancy may protect IUGR children from developing problematic feeding behaviors. 156 children had information on the Early Childhood Behavior Questionnaire (ECBQ) at 18 months, Food Frequency Questionnaire at 48 months and Children׳s Eating Behavior Questionnaire (CEBQ) at 72 months. There was a significant negative correlation between inhibitory control at 18 months and food fussiness at 72 months. A GLM model predicting food fussiness at 72 months showed significant interaction between n-3 PUFAs, inhibitory control and IUGR, with higher intakes associated with decreased risk for fussiness in IUGR children with poor inhibitory control. Deficits in early inhibitory control predict later food fussiness, and higher intakes of n-3 PUFAs in infancy may protect IUGR children from developing such behavior later.
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Affiliation(s)
- Roberta Sena Reis
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90035-903, Brazil
| | - Juliana Rombaldi Bernardi
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90035-903, Brazil
| | - Meir Steiner
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Michael J Meaney
- Department of Psychiatry and Neurology, McGill University, Douglas Mental Health University Institute, Montreal, Quèbec, Canada H4H 1R3; Singapore Institute for Clinical Sciences, 117609 Singapore
| | - Robert D Levitan
- Department of Psychiatry, University of Toronto and Centre for Addiction and Mental Health, Toronto, Ontario, Canada M5T 1R8
| | - Patrícia Pelufo Silveira
- Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul 90035-903, Brazil.
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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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Popper CW. Single-micronutrient and broad-spectrum micronutrient approaches for treating mood disorders in youth and adults. Child Adolesc Psychiatr Clin N Am 2014; 23:591-672. [PMID: 24975626 DOI: 10.1016/j.chc.2014.04.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Several different vitamins and minerals appear to be effective augmenting agents for mood-modifying drugs, but are not potent monotherapies in themselves for treating psychiatric disorders. In contrast, broad-spectrum micronutrient interventions appear in early trials to be as effective as psychiatric medications with fewer adverse effects for treating mood disorders, ADHD, aggressivity, and misconduct in youth and adults. Broad-spectrum treatments also may improve stress responses, cognition, and sense of well-being in healthy adults, but have been less well studied in youth. Current clinical data justify an extensive expansion of research on micronutrient mechanisms and treatments in psychiatry.
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Affiliation(s)
- Charles W Popper
- Child and Adolescent Psychiatry, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Boston, MA, USA.
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32
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Abstract
The 2010 Dietary Guidelines Advisory Committee was charged with the task of investigating the effects of multivitamin/mineral supplements on healthy populations and also on those with chronic disease. The evidence from which the committee prepared its conclusions was graded on 5 fundamental criteria: quality, consistency, quantity, clinical impact, and generalizability. The committee concluded that for the general healthy population, evidence was insufficient to make a multivitamin/mineral recommendation. On the other hand, the committee noted the value of some supplemental nutrients for at-risk populations such as iron, folic acid, and vitamin B-12. However, most of the studies referenced for the research used the conventional, all-encompassing, and oversimplified definition of a multivitamin/mineral as being a supplement containing 3 or more vitamins with or without minerals. In the few years since the committee released its 2010 report, several randomized clinical trials showing the benefits of daily multivitamin/mineral supplementation have been completed using supplements containing at least 10 or more vitamins and/or minerals, but there also continues to be some reports that do not find benefit from such supplements. Furthermore, several steps have been taken to advance the science behind these supplements so that consumers, physicians, and government agencies can all have more confidence in understanding the role of supplemental nutrition in the American diet. This review provides new evidence from 2010 onward addressing the committee's primary concerns about multivitamin/mineral research in regard to improving public health. It also includes several recent studies that may be of interest to future committees indicating the potential benefits of these supplements on improving the cognitive performance and mental well-being of healthy populations.
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