Tuesday, October 17, 2006

Guardian Unlimited | Special reports | Omega-3, junk food and the link between violence and what we eat

Guardian Unlimited | Special reports | Omega-3, junk food and the link between violence and what we eat

Research with British and US offenders suggests nutritional deficiencies may play a key role in aggressive bevaviour

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The Dutch government is currently conducting a large trial to see if nutritional supplements have the same effect on its prison population. And this week, new claims were made that fish oil had improved behaviour and reduced aggression among children with some of the most severe behavioural difficulties in the UK.

Deficiency

For the clinician in charge of the US study, Joseph Hibbeln, the results of his trial are not a miracle, but simply what you might predict if you understand the biochemistry of the brain and the biophysics of the brain cell membrane. His hypothesis is that modern industrialised diets may be changing the very architecture and functioning of the brain.

We are suffering, he believes, from widespread diseases of deficiency. Just as vitamin C deficiency causes scurvy, deficiency in the essential fats the brain needs and the nutrients needed to metabolise those fats is causing of a host of mental problems from depression to aggression. Not all experts agree, but if he is right, the consequences are as serious as they could be. The pandemic of violence in western societies may be related to what we eat or fail to eat. Junk food may not only be making us sick, but mad and bad too.

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The researchers at the National Institute on Alcohol Abuse and Alcoholism, which is part of NIH, had placed adverts for aggressive alcoholics in the Washington Post in 2001. Some 80 volunteers came forward and have since been enrolled in the double blind study. They have ranged from homeless people to a teacher to a former secret service agent. Following a period of three weeks' detoxification on a locked ward, half were randomly assigned to 2 grams per day of the omega-3 fatty acids EPA and DHA for three months, and half to placebos of fish-flavoured corn oil.

An earlier pilot study on 30 patients with violent records found that 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. The bigger trial is nearly complete now and Dell Wright, the nurse administering the pills, has seen startling changes in those on the fish oil rather than the placebo. "When Demar came in there was always an undercurrent of aggression in his behaviour. Once he was on the supplements he took on the ability not to be impulsive. He kept saying, 'This is not like me'."

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Over the last century most western countries have undergone a dramatic shift in the composition of their diets in which the omega-3 fatty acids that are essential to the brain have been flooded out by competing omega-6 fatty acids, mainly from industrial oils such as soya, corn, and sunflower. In the US, for example, soya oil accounted for only 0.02% of all calories available in 1909, but by 2000 it accounted for 20%. Americans have gone from eating a fraction 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 from oils such as soya, corn, and sunflower accounted for 1% of energy supply in the early 1960s, but by 2000 they were nearly 5%. These omega-6 fatty acids come mainly from industrial frying for takeaways, 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 the growth in consumption of omega-6 fatty acids from seed oils in 38 countries since the 1960s against the rise in murder rates over the same period. In all cases there is an unnerving match. As omega-6 goes up, so do homicides in a linear progression. Industrial societies where omega-3 consumption has remained high and omega-6 low because people eat fish, such as Japan, have low rates of murder and depression.

Of course, all these graphs prove is that there is a striking correlation between violence and omega 6-fatty acids in the diet. They don't prove that high omega-6 and low omega-3 fat consumption actually causes violence. Moreover, many other things have changed in the last century and been blamed for rising violence - exposure to violence in the media, the breakdown of the family unit and increased consumption of sugar, to take a few examples. But some of the trends you might expect to be linked to increased violence - such as availability of firearms and alcohol, or urbanisation - do not in fact reliably predict a rise in murder across countries, according to Hibbeln.

There has been a backlash recently against the hype surrounding omega-3 in the UK from scientists arguing that the evidence remains sketchy. Part of the backlash stems from the eagerness of some supplement companies to suggest that fish oils work might wonders even on children who have no behavioural problems.

Alan Johnson, the education secretary, appeared to be jumping on the bandwagon recently when he floated the idea of giving fish oils to all school children. The idea was quickly knocked down when the food standards agency published a review of the evidence on the effect of nutrition on learning among schoolchildren and concluded there was not enough to conclude much, partly because very few scientific trials have been done.

Professor John Stein, of the department of physiology at Oxford University, where much of the UK research on omega-3 fatty acid deficiencies has been based, agrees: "There is only slender evidence that children with no particular problem would benefit from fish oil. And I would always say [for the general population] it's better to get omega-3 fatty acids by eating fish, which carries all the vitamins and minerals needed to metabolise them."

However, he believes that the evidence from the UK prison study and from Hibbeln's research in the US on the link between nutritional deficiency and crime is " strong", although the mechanisms involved are still not fully understood.

Hibbeln, Stein and others have been investigating what the mechanisms of a causal relationship between diet and aggression might be. This is where the biochemistry and biophysics comes in.

Essential fatty acids are called essential because humans cannot make them but must obtain them from the diet. The brain is a fatty organ - it's 60% fat by dry weight, and the essential fatty acids are what make part of its structure, making up 20% of the nerve cells' membranes. The synapses, or junctions where nerve cells connect with other nerve cells, contain even higher concentrations of essential fatty acids - being made of about 60% of the omega-3 fatty acid DHA.

Communication between the nerve cells depends on neurotransmitters, such as serotonin and dopamine, docking with receptors in the nerve cell membrane.

Omega-3 DHA is very long and highly flexible. When it is incorporated into the nerve cell membrane it helps make the membrane itself elastic and fluid so that signals pass through it efficiently. But if the wrong fatty acids are incorporated into the membrane, the neurotransmitters can't dock properly. We know from many other studies what happens when the neurotransmitter systems don't work efficiently. Low serotonin levels are known to predict an increased risk of suicide, depression and violent and impulsive behaviour. And dopamine is what controls the reward processes in the brain.

Laboratory tests at NIH have shown that the composition of tissue and in particular of the nerve cell membrane of people in the US is different from that of the Japanese, who eat a diet rich in omega-3 fatty acids from fish. Americans have cell membranes higher in the less flexible omega-6 fatty acids, which appear to have displaced the elastic omega-3 fatty acids found in Japanese nerve cells.

Hibbeln's theory is that because the omega-6 fatty acids compete with the omega-3 fatty acids for the same metabolic pathways, when omega-6 dominates in the diet, we can't convert the omega-3s to DHA and EPA, the longer chain versions we need for the brain. What seems to happen then is that the brain picks up a more rigid omega-6 fatty acid DPA instead of DHA to build the cell membranes - and they don't function so well.

Other experts blame the trans fats produced by partial hydrogenation of industrial oils for processed foods. Trans fats have been shown to interfere with the synthesis of essentials fats in foetuses and infants. Minerals such as zinc and the B vitamins are needed to metabolise essential fats, so deficiencies in these may be playing an important part too.

There is also evidence that deficiencies in DHA/EPA at times when the brain is developing rapidly - in the womb, in the first 5 years of life and at puberty - can affect its architecture permanently. Animal studies have shown that those deprived of omega-3 fatty acids over two generations have offspring who cannot release dopamine and serotonin so effectively.

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