The link between violence and what we eat.

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Omega-3, junk food and the link between violence and what we eatCourtesy - JoAnn Guest. Research with British and US offenders suggests nutritionaldeficiencies may play a key role in aggressive behaviourFelicity LawrenceTuesday October 17, 2006The Guardianhttp://lifeandhealth.guardian.co.uk/health/story/0,,1924356,00.htmlThat Dwight Demar is able to sit in front of us, sober, calm, andemployed, is "a miracle", he declares in the cadences of a prayer-meeting sinner. He has been rocking his 6ft 2in bulk to and frowhile delivering a confessional account of his past into the middledistance.He wants us to know what has saved him after 20 years on thestreets: "My dome is working. They gave me some kind of pill and Ichanged. Me, myself and I, I

changed."Demar has been in and out of prison so many times he has lost countof his convictions. "Being drunk, being disorderly, trespass,assault and battery; you name it, I did it. How many times I been injail? I don't know, I was locked up so much it was my second home."Demar has been taking part in a clinical trial at the USgovernment's National Institutes for Health, near Washington. Thestudy is investigating the effects of omega-3 fatty acid supplementson the brain, and the pills that have effected Demar's "miracle" aredoses of fish oil.The results emerging from this study are at the cutting edge of thedebate on crime and punishment. In Britain we lock up more peoplethan ever before. Nearly 80,000 people are now in our prisons, whichreached their capacity this week.But the new research calls into question the very basis of criminaljustice and the notion of culpability. It suggests that

individualsmay not always be responsible for their aggression. Taken togetherwith a study in a high-security prison for young offenders in theUK, it shows that violent behaviour may be attributable at least inpart to nutritional deficiencies.The UK prison trial at Aylesbury jail showed that when young menthere were fed multivitamins, minerals and essential fatty acids,the number of violent offences they committed in the prison fell by37%. Although no one is suggesting that poor diet alone can accountfor complex social problems, the former chief inspector of prisonsLord Ramsbotham says that he is now "absolutely convinced that thereis a direct link between diet and antisocial behaviour, both thatbad diet causes bad behaviour and that good diet prevents it."The Dutch government is currently conducting a large trial to see ifnutritional supplements have the same effect on its prisonpopulation. And this week,

new claims were made that fish oil hadimproved behaviour and reduced aggression among children with someof the most severe behavioural difficulties in the UK.DeficiencyFor the clinician in charge of the US study, Joseph Hibbeln, theresults of his trial are not a miracle, but simply what you mightpredict if you understand the biochemistry of the brain and thebiophysics of the brain cell membrane. His hypothesis is that modernindustrialised diets may be changing the very architecture andfunctioning of the brain.We are suffering, he believes, from widespread diseases ofdeficiency. Just as vitamin C deficiency causes scurvy, deficiencyin the essential fats the brain needs and the nutrients needed tometabolise those fats is causing of a host of mental problems fromdepression to aggression. Not all experts agree, but if he is right,the consequences are as serious as they could be. The pandemic ofviolence

in western societies may be related to what we eat or failto eat. Junk food may not only be making us sick, but mad and badtoo.In Demar's case the aggression has blighted many lives. He hasattacked his wife. "Once she put my TV out the door, I snapped offand smacked her." His last spell in prison was for a particularlyviolent assault. "I tried to kill a person. Then I knew somethingneed be done because I was half a hundred and I was either going tokill somebody or get killed."Demar's brain has blanked out much of that last attack. He canremember that a man propositioned him for sex, but the details ofhis own response are hazy.When he came out of jail after that, he bought a can of beer andseemed headed for more of the same until a case worker who had seenadverts for Hibbeln's trial persuaded him to take part.The researchers at the National Institute on Alcohol Abuse andAlcoholism, which is part

of NIH, had placed adverts for aggressivealcoholics in the Washington Post in 2001. Some 80 volunteers cameforward and have since been enrolled in the double blind study. Theyhave ranged from homeless people to a teacher to a former secretservice agent. Following a period of three weeks' detoxification ona locked ward, half were randomly assigned to 2 grams per day of theomega-3 fatty acids EPA and DHA for three months, and half toplacebos of fish-flavoured corn oil.An earlier pilot study on 30 patients with violent records foundthat those given omega-3 supplements had their anger reduced by one-third, measured by standard scales of hostility and irritability,regardless of whether they were relapsing and drinking again. Thebigger trial is nearly complete now and Dell Wright, the nurseadministering the pills, has seen startling changes in those on thefish oil rather than the placebo. "When Demar came in there

wasalways an undercurrent of aggression in his behaviour. Once he wason the supplements he took on the ability not to be impulsive. Hekept saying, 'This is not like me'."Demar has been out of trouble and sober for a year now. He has agirlfriend, his own door key, and was made employee of the month athis company recently. Others on the trial also have long historiesof violence but with omega-3 fatty acids have been able for thefirst time to control their anger and aggression. J, for example,arrived drinking a gallon of rum a day and had 28 scars on his handfrom punching other people. Now he is calm and his cravings havegone. W was a 19st barrel of a man with convictions for assault andbattery. He improved dramatically on the fish oil and later tolddoctors that for the first time since the age of five he had managedto go three months without punching anyone in the head.Threat to societyHibbeln is a

psychiatrist and physician, but as an employee of theUS government at the NIH he wears the uniform of a commander, withhis decorations for service pinned to his chest. As we queued to getpast the post-9/11 security checks at the NIH federal base, heexplained something of his view of the new threat to society.Over the last century most western countries have undergone adramatic shift in the composition of their diets in which the omega-3 fatty acids that are essential to the brain have been flooded outby competing omega-6 fatty acids, mainly from industrial oils suchas soya, corn, and sunflower. In the US, for example, soya oilaccounted for only 0.02% of all calories available in 1909, but by2000 it accounted for 20%. Americans have gone from eating afraction of an ounce of soya oil a year to downing 25lbs (11.3kg)per person per year in that period. In the UK, omega-6 fats fromoils such as soya, corn, and sunflower

accounted for 1% of energysupply in the early 1960s, but by 2000 they were nearly 5%. Theseomega-6 fatty acids come mainly from industrial frying fortakeaways, ready meals and snack foods such as crisps, chips,biscuits, ice-creams and from margarine. Alcohol, meanwhile,depletes omega-3s from the brain.To test the hypothesis, Hibbeln and his colleagues have mapped thegrowth in consumption of omega-6 fatty acids from seed oils in 38countries since the 1960s against the rise in murder rates over thesame period. In all cases there is an unnerving match. As omega-6goes up, so do homicides in a linear progression. Industrialsocieties where omega-3 consumption has remained high and omega-6low because people eat fish, such as Japan, have low rates of murderand depression.Of course, all these graphs prove is that there is a strikingcorrelation between violence and omega 6-fatty acids in the diet.They don't

prove that high omega-6 and low omega-3 fat consumptionactually causes violence. Moreover, many other things have changedin the last century and been blamed for rising violence - exposureto violence in the media, the breakdown of the family unit andincreased consumption of sugar, to take a few examples. But some ofthe trends you might expect to be linked to increased violence -such as availability of firearms and alcohol, or urbanisation - donot in fact reliably predict a rise in murder across countries,according to Hibbeln.There has been a backlash recently against the hype surroundingomega-3 in the UK from scientists arguing that the evidence remainssketchy. Part of the backlash stems from the eagerness of somesupplement companies to suggest that fish oils work might wonderseven on children who have no behavioural problems.Alan Johnson, the education secretary, appeared to be jumping on thebandwagon

recently when he floated the idea of giving fish oils toall school children. The idea was quickly knocked down when the foodstandards agency published a review of the evidence on the effect ofnutrition on learning among schoolchildren and concluded there wasnot enough to conclude much, partly because very few scientifictrials have been done.Professor John Stein, of the department of physiology at OxfordUniversity, where much of the UK research on omega-3 fatty aciddeficiencies has been based, agrees: "There is only slender evidencethat children with no particular problem would benefit from fishoil. And I would always say [for the general population] it's betterto get omega-3 fatty acids by eating fish, which carries all thevitamins and minerals needed to metabolise them."However, he believes that the evidence from the UK prison study andfrom Hibbeln's research in the US on the link between

nutritionaldeficiency and crime is " strong", although the mechanisms involvedare still not fully understood.Hibbeln, Stein and others have been investigating what themechanisms of a causal relationship between diet and aggressionmight be. This is where the biochemistry and biophysics comes in.Essential fatty acids are called essential because humans cannotmake them but must obtain them from the diet. The brain is a fattyorgan - it's 60% fat by dry weight, and the essential fatty acidsare what make part of its structure, making up 20% of the nervecells' membranes. The synapses, or junctions where nerve cellsconnect with other nerve cells, contain even higher concentrationsof essential fatty acids - being made of about 60% of the omega-3fatty acid DHA.Communication between the nerve cells depends on neurotransmitters,such as serotonin and dopamine, docking with receptors in the nervecell

membrane.Omega-3 DHA is very long and highly flexible. When it isincorporated into the nerve cell membrane it helps make the membraneitself elastic and fluid so that signals pass through itefficiently. But if the wrong fatty acids are incorporated into themembrane, the neurotransmitters can't dock properly. We know frommany other studies what happens when the neurotransmitter systemsdon't work efficiently. Low serotonin levels are known to predict anincreased risk of suicide, depression and violent and impulsivebehaviour. And dopamine is what controls the reward processes in thebrain.Laboratory tests at NIH have shown that the composition of tissueand in particular of the nerve cell membrane of people in the US isdifferent from that of the Japanese, who eat a diet rich in omega-3fatty acids from fish. Americans have cell membranes higher in theless flexible omega-6 fatty acids, which appear to have

displacedthe elastic omega-3 fatty acids found in Japanese nerve cells.Hibbeln's theory is that because the omega-6 fatty acids competewith the omega-3 fatty acids for the same metabolic pathways, whenomega-6 dominates in the diet, we can't convert the omega-3s to DHAand EPA, the longer chain versions we need for the brain. What seemsto happen then is that the brain picks up a more rigid omega-6 fattyacid DPA instead of DHA to build the cell membranes - and they don'tfunction so well.Other experts blame the trans fats produced by partial hydrogenationof industrial oils for processed foods. Trans fats have been shownto interfere with the synthesis of essentials fats in foetuses andinfants. Minerals such as zinc and the B vitamins are needed tometabolise essential fats, so deficiencies in these may be playingan important part too.There is also evidence that deficiencies in DHA/EPA at times whenthe

brain is developing rapidly - in the womb, in the first 5 yearsof life and at puberty - can affect its architecture permanently.Animal studies have shown that those deprived of omega-3 fatty acidsover two generations have offspring who cannot release dopamine andserotonin so effectively."The extension of all this is that if children are left with lowdopamine as a result of early deficits in their own or theirmother's diets, they cannot experience reward in the same way andthey cannot learn from reward and punishment. If their serotoninlevels are low, they cannot inhibit their impulses or regulate theiremotional responses," Hibbeln points out.Mental healthHere too you have one possible factor in cycles of deprivation(again, no one is suggesting diet is the only factor) and whycriminal behaviour is apparently higher among lower socio-economicgroups where nutrition is likely to be poorer.These

effects of the industrialisation of the diet on the brain werealso predicted in the 1970s by a leading fats expert in the UK,Professor Michael Crawford, now at London's Metropolitan University.He established that DHA was structural to the brain and foresaw thatdeficiencies would lead to a surge in mental health and behaviouralproblems - a prediction borne out by the UK's mental health figures.It was two decades later before the first study of the effect ofdiet on behaviour took place in a UK prison. Bernard Gesch, now asenior researcher at Stein's Oxford laboratory, first becameinvolved with nutrition and its relationship to crime as a directorof the charity Natural Justice in northwest England. He wassupervising persistent offenders in the community and was struck bytheir diets. He later set out to test the idea that poor diet mightcause antisocial behaviour and crime in the maximum securityAylesbury

prison.His study, a placebo-controlled double blind randomised trial, took231 volunteer prisoners and assigned half to a regime ofmultivitamin, mineral and essential fatty acid supplements and halfto placebos. The supplement aimed to bring the prisoners' intakes ofnutrients up to the level recommended by government. It was notspecifically a fatty acid trial, and Gesch points out that nutritionis not pharmacology but involves complex interactions of manynutrients.Prison trialAylesbury was at the time a prison for young male offenders, aged 17to 21, convicted of the most serious crimes. Trevor Hussey was thendeputy governor and remembers it being a tough environment. "It wasa turbulent young population. They had problems with their anger.They were all crammed into a small place and even though it was wellrun you got a higher than normal number of assaults on staff andother prisoners."Although

the governor was keen on looking at the relationshipbetween diet and crime, Hussey remembers being sceptical himself atthe beginning of the study. The catering manager was good, and eventhough prisoners on the whole preferred white bread, meat andconfectionery to their fruit and veg, the staff tried to encourageprisoners to eat healthily, so he didn't expect to see much of aresult.But quite quickly staff noticed a significant drop in the number ofreported incidents of bad behaviour. "We'd just introduced a policyof 'earned privileges' so we thought it must be that rather than afew vitamins, but we used to joke 'maybe it's Bernard's pills'."But when the trial finished it became clear that the drop inincidents of bad behaviour applied only to those on the supplementsand not to those on the placebo.The results, published in 2002, showed that those receiving theextra nutrients committed 37% fewer serious

offences involvingviolence, and 26% fewer offences overall. Those on the placebosshowed no change in their behaviour. Once the trial had finished thenumber of offences went up by the same amount. The office theresearchers had used to administer nutrients was restored to arestraint room after they had left."The supplements improved the functioning of those prisoners. It wasclearly something significant that can't be explained away. I wasdisappointed the results were not latched on to. We put a lot ofeffort into improving prisoners' chances of not coming back in, andyou measure success in small doses."Gesch believes we should be rethinking the whole notion ofculpability. The overall rate of violent crime in the UK has risensince the 1950s, with huge rises since the 1970s. "Such largechanges are hard to explain in terms of genetics or simply changesof reporting or recording crime. One plausible candidate to

explainsome of the rapid rise in crime could be changes in the brain'senvironment. What would the future have held for those 231 young menif they had grown up with better nourishment?" Gesch says.He said he was currently unable to comment on any plans for futureresearch in prisons, but studies with young offenders in thecommunity are being planned.For Hibbeln, the changes in our diet in the past century are "a verylarge uncontrolled experiment that may have contributed to thesocietal burden of aggression, depression and cardiovascular death".To ask whether we have enough evidence to change diets is to put thequestion the wrong way round. Whoever said it was safe to changethem so radically in the first place?Young offender's dietOne young offender had been sentenced by the British courts on 13occasions for stealing trucks in the early hours of the morning.Bernard Gesch recorded the boy's

daily diet as follows:Breakfast: nothing (asleep)Mid morning: nothing (asleep)Lunchtime: 4 or 5 cups of coffee with milk and 2½ heaped teaspoonsof sugarMid afternoon: 3 or 4 cups of coffee with milk and 2½ heaped sugarsTea: chips, egg, ketchup, 2 slices of white bread, 5 cups of tea orcoffee with milk and sugarEvening: 5 cups of tea or coffee with milk and sugar, 20 cigarettes,£2 worth of sweets, cakes and if money available 3 or 4 pints ofbeer. "I am, and have been for years a confirmed anti-vaccinationist. I have not the least doubt in my mind that vaccination is a filthy process that is harmful in the end" - Mahatma Gandhi (Koren Publications Inc.)

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