Editorial

Thirty years ago it was observed that there were abnormalities in essential fatty acid metabolism in people with violent behavior (Virkkunen, 1987) and subsequent intervention studies went on to show that this metabolic abnormality may have its origins in inadequate dietary intake, which, when improved could reduce such behavior (Buydens-Branchey, 2008). It has since been demonstrated that optimizing dietary intake of a wide range of vitamins and minerals, not only essential fatty acids, results in important reductions in violent and aggressive behavior in children, adolescents and adults (Raine, 2016, Schoenthaler, 2000, Gesch, 2002, Zaalberg, 2010, Long, 2013).

Early life nutrition appears to play a key role in determining anti-social, violent and aggressive behavior, with malnutrition at 3-years of age found to be a potent predisposing factor for antisocial and aggressive behavior in children and young adults (Liu, 2004). This observation is further strengthened by the observation that nutritional enrichment at 3-years of age reduced antisocial behavior at 17 years and criminal behavior at 23 years (Raine, 2003). Collectively, this research supports the view that there is a biological and neurobiological basis for violent behavior, and that the food we eat, at least in part, plays an important role in its development and remediation (Raine, 2013).

In this issue of the Journal, Crespo-Bujosa, Gonzalez, Duconge and colleagues make a strong case for the role of inadequate nutrition in the development of aggressive behavior (Crespo-Bujosa, 2017). They propose a conceptual model by which wider environmental factors such as an individual’s social environment and the quality of soils (and thus food) collectively contribute to compromised nutrient status and interrelated alterations in neurological function that give rise to changes in behavior manifesting as aggression and violence. Their model of nutrient depletion-induced neuro-chemical disorder is as relevant today as the first observations that food could influence violent behavior.

Nutrition has been very slow to be adopted in mainstream psychiatry research and practice but the importance of nutrition in determining mental health and behavior and the therapeutic potential of nutritional treatments is gaining momentum (Sarris, 2015). The adoption of nutrition in mainstream psychiatry is of vital importance. Indeed, the essentiality of nutrition for brain development and function, and the contribution of malnutrition to poor mental health, has been proposed to be “important to the future of humanity (Crawford, 2008).” Clearly the evidence that improved nutrition could significantly reduce violent and aggressive behaviour at a societal level deserves greater appreciation in public health.

At a clinical level the translation of research linking malnutrition to psychiatric and behavioural disorders into better treatments has tremendous potential to reduce cost and improve patient outcomes. For example, a simple cost analysis comparison suggested that a patient with mood and psychotic symptoms who responded to vitamin and mineral supplementation incurred a peak annual conventional treatment cost of about $140,000 compared to $720 per year for the micronutrients, which also eliminated the patients need for hospitalization, outpatient care, and psychiatric medication (Kaplan, 2017). It appears we have a powerful and cost-effective way to reduce violent behavior, yet we are not using it: food.

 

Benjamin I. Brown
Editor

 

References:

Buydens-Branchey L, Branchey M, Hibbeln JR. (2008). Associations between increases in plasma n-3 polyunsaturated fatty acids following supplementation and decreases in anger and anxiety in substance abusers. Prog Neuropsychopharmacol Biol Psychiatry. Feb 15;32(2):568-75.

Crawford MA, Broadhurst CL, Galli C, et al. (2008) The Role of Docosahexaenoic and Arachidonic Acids as Determinants of Evolution and Hominid Brain Development. Fisheries for Global Welfare and Environment, 5th World Fisheries Congress, pp. 57–76.

Crespo-Bujosa HB, Gonzalez MJ, Duconge J, et al. (2017). Nutrient Depletion-Induced Neuro-Chemical Disorder (Brain Hunger) as the Basis of Psychopathology and Aggressive Behavior. JOM. 35 (5).

Gesch CB, Hammond SM, Hampson SE, et al. (2002). Influence ofsupplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Randomised, placebo-controlled trial. Br J Psychiatry. Jul;181:22-8.

Kaplan BJ, Isaranuwatchai W, Hoch JS. (2017). Hospitalization cost of conventional psychiatric care compared to broad-spectrum micronutrient treatment: literature review and case study of adult psychosis. Int J Ment Health Syst. Jan 31;11:14.

Liu J, Raine A, Venables PH, et al. (2004). Malnutrition at age 3 years andexternalizing behavior problems at ages 8, 11, and 17 years. Am J Psychiatry. Nov;161(11):2005-13.

Long SJ, Benton D. (2013). A double-blind trial of the effect of docosahexaenoic acid and vitamin and mineral supplementation on aggression, impulsivity, and stress. Hum Psychopharmacol. May;28(3):238-47.

Raine A, Mellingen K, Liu J, et al. (2003). Effects of environmental enrichment at ages 3-5 years on schizotypal personality and antisocial behavior at ages 17 and 23 years. Am J Psychiatry. Sep;160(9):1627-35.

Raine, A. (2013). The anatomy of violence: The biological roots of crime. New York, NY: Pantheon Books.

Raine A, Cheney RA, Ho R, et al. (2016). Nutritional supplementation to reduce child aggression: a randomized, stratified, single-blind, factorial trial. J Child Psychol Psychiatry. 2016 Sep;57(9):1038-46.

Sarris J, Logan AC, Akbaraly TN, et al; International Society for Nutritional Psychiatry Research. (2015). Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry. Mar;2(3):271-4.

Schoenthaler SJ, Bier ID. (2000). The effect of vitamin-mineral supplementation on juvenile delinquency among American schoolchildren: a randomized, double-blindplacebo-controlled trial. J Altern Complement Med. Feb;6(1):7-17.

Virkkunen ME, Horrobin DF, Jenkins DK, et al. (1987). Plasma phospholipid essential fatty acids and prostaglandins in alcoholic, habitually violent, and impulsive offenders. Biol Psychiatry. Sep;22(9):1087-96.

Zaalberg A, Nijman H, Bulten E, et al. (2010). Effects of nutritional supplements on aggression, rule-breaking, and psychopathology among young adult prisoners. Aggress Behav. Mar-Apr;36(2):117-26.