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The Effect of Randomized Vitamin-Mineral Supplementation on Violent and Non-violent Antisocial Behavior Among Incarcerated Juveniles

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Abstract

In a randomized controlled double-blind trial, the effects of vitamin-mineral supplementation on violence and other serious antisocial behavior were studied for 3 months on 62 confined delinquents aged 13 to 17 years. A significant difference between 32 active and 30 placebo subjects was found for violent and non-violent antisocial behavior. The net difference in rule infractions between the active and placebo groups in violence was 28% (95% confidence interval 15-41%). This direction and magnitude of effect were seen with both violent and non-violent rule violations. Twenty-six habitually violent subjects donated pre- and post-intervention blood samples. Among 10 subjects who maintained their normal or low blood concentrations of vitamins throughout the trial, there was no marked change in violence (i.e. 39 acts during baseline and 37 during intervention). In contrast, the 16 subjects who corrected their low blood vitamin concentrations during intervention produced 131 violent acts during baseline and 11 during intervention. The correction of low blood vitamin concentrations with vitamin-mineral supplements improves brain function and significantly reduces violence among delinquents confined in correctional facilities.
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Although current evidence confirms the importance of diet for mental health, many psychologists avoid discussing dietary intake with clients, questioning whether this information is within their scope of practice. This article provides psychologists with a review focused on the connection between what we eat and how we feel. Eating a healthy, whole-foods-based diet is an important tool to promote mental health recovery and maintenance. We begin by reviewing several mechanisms by which nutrients maximize brain health, including enabling metabolic reactions to occur, supporting mitochondrial function, reducing inflammation and assisting with detoxification. Understanding the vital role of nutrients for brain health will aid clients in understanding the importance of optimizing their intake of a range of nutrients in order to maximize their mental health: no single nutrient is sufficient. Next, we summarize evidence relating diet to mental health, followed by a consideration of circumstances that may contribute to a client requiring additional nutrients, such as chronic stress, medication use, individual biochemistry, and consuming nutrient-depleted food. The evidence base for treating psychological problems in children with supplementary nutrients is then reviewed, and a case study of a child whose self-regulatory skills improved with broad-spectrum multinutrients is used to illustrate this treatment. The breadth and consistency of the research highlights the importance of children receiving a good foundation of nutrients for optimizing brain health. Finally, we offer practical suggestions for psychologists to incorporate this information into their clinical practice and discuss these suggestions within the context of informed consent.
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We investigated whether vitamin-mineral supplementation could reduce serious rule violations. In this randomized, controlled, double-blind trial, young adult male inmates were included. For 15 weeks, they received a daily dose with vitamin-mineral supplements of approximately 100% Recommended Dietary Allowance (RDA) ( n = 149), or a higher-dose formula ( n = 150), or placebo ( n = 150). Serious rule violations were the primary outcome. In the lower-dose group there were 39% fewer rule violations than in the placebo group (relative risk = .61; 95% confidence interval [ CI]:.41–.90, p = .01). In the higher-dose group the difference did not reach statistical significance. About 100% RDA, but not higher doses supplements, resulted in less serious rule violations than placebo.
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This systematic review and meta-analysis focused on randomized controlled trials (RCT) of multinutrients consisting of at least four vitamins and/or minerals as interventions for participants with psychiatric symptoms. A systematic search identified 16 RCTs that fit the inclusion criteria (n = 1719 participants) in six psychiatric categories: depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, and autism. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to rate the evidence base. Significant clinical benefit was assessed using minimal clinically important differences (MIDs). Due to heterogeneity in participants, multinutrient formulas, outcome measures, and absence of complete data, only the Attention-Deficit/Hyperactivity Disorder (ADHD) category was eligible for meta-analyses. In ADHD populations, statistically and clinically significant improvements were found in global functioning, Mean Difference (MD) −3.3, p = 0.001, MID −3.26; Standardized Mean Difference (SMD) −0.49 p = 0.001 MD −0.5), clinician ratings of global improvement (MD −0.58, p = 0.001, MID −0.5) and ADHD improvement (MD −0.54, p = 0.002, MID −0.5), and clinician (but not observer) measures of ADHD inattentive symptoms (MD −1.53, p = 0.05, MID −0.5). Narrative synthesis also revealed a pattern of benefit for global measures of improvement, for example: in autism, and in participants with behavioral deficits in dementia. Post-natural disaster anxiety and the number of violent incidents in prison populations also improved. Broad-spectrum formulas (vitamins + minerals) demonstrated more robust effects than formulas with fewer ingredients. This review highlights the need for robust methodology-RCTs that report full data, including means and standard deviations for all outcomes-in order to further elucidate the effects of multinutrients for psychiatric symptoms.
Chapter
Adolescents in juvenile detention have a unique set of health needs and face a complex set of barriers to optimal nutritional health. With thousands of adolescents being detained in juvenile correctional facilities every year it is important to have context for the system that influences their lives while detained and after they are released. This chapter provides a general overview of the current system of juvenile detention and how food and nutrition regulations are implemented, along with recommendations for how to better support improved-long term health outcomes. The current youth detention system is not always funded to optimize the rehabilitation and long-term health of youth, and little is known about the potential long-term impact of nutrition counseling within the juvenile justice system. Youth in detention enter the system with medical vulnerabilities due to exposure to early childhood adversity and ongoing chronic stress. Improving the uniformity of healthcare for adolescents in juvenile detention may lead to improvements in long-term physical and mental health outcomes.
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Background Under- and over nutrition as well as nutrition risk factors such as communicable and non-communicable diseases are a common and major cause of morbidity and mortality in correctional facilities. Consequently, medical nutrition therapy (MNT), a spectrum of nutrition services aimed at optimizing individual well-being, is being recognized as integral to the health of people who experience incarceration. However, there is a paucity of research that explores the delivery of MNT in correctional facilities. Methods A scoping review combined with secondary analysis of qualitative data (field notes, in-depth stakeholder interviews) from a 2-year ethnographic study about food insecurity and incarceration was undertaken to gain insights about the delivery of corrections-based MNT in Canada. Thematic analysis of all documents was done using an interpretive framework. Results An understanding about MNT was developed within three themes: 1) specialized service provision in a unique environment; 2) challenges with the provision of MNT; and 3) consideration of corrections-based MNT alternatives. An incarcerated individual’s nutritional health was conceptualized as culminating from various factors that included dietary intake and health status, enabling environments, access to quality health services, and clinical nutrition services. Nutrition care practices, which range from health promotion to rehabilitation, are challenged by issues of access, visibility, adequacy, and environmental barriers. Their success is dependent on demand (e.g., ability of recipient to act) and factors that enable quality health and food services. Advancing corrections-based MNT will require policies that provide supportive food and health environments and creating sustainable services by integrating alternatives such as peer approaches and telehealth. Conclusions Professional associations, government, researchers and other stakeholders can help to strengthen corrections-based MNT by fostering shifts in thinking about the role of health practitioners in these contexts, preparing future health professionals with the specialized skills needed to work in these environments, generating evidence that can best inform practice, and cultivating collaborations aimed at crime prevention, successful societal reintegration, and the reduction of recidivism. Electronic supplementary material The online version of this article (10.1186/s12913-019-3926-3) contains supplementary material, which is available to authorized users.
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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 638 mg docosahexaenoic acid (DHA) and 772 mg 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 if 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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Ten juvenile correctional institutions in three states had a 47% reduction in assaults, insubordination, horseplay, suicide attempts, and general rule violations in 6,033 youths following similar dietary intervention. Seven theories have been offered to explain these improvements in behavior: placebo effects, maturation effects, reactive hypoglycemia, the reduction of marginal malnutrition, neurotransmitter (serotonin) uptake, food intolerances, and absolute low blood sugar. Juvenile facilities in Alabama, Florida and Virginia empirically tested these 7 theories. A 36 month time-series design involving 125 Alabama juveniles showed a 61% reduction in antisocial behavior which was only consistent with the malnutrition theory. The Virginia site used an a-b-a-b-a design for 24 months. Support was present for the marginal malnutrition hypothesis on 856 children. The testing of the reactive hypoglycemia-causing-crime theory with 35 Florida delinquents showed that hypoglycemia does exist in delinquents, but the frequency is too low to explain the 47% improvements in behavior. However, a significant but weak correlation was found between low blood sugar and behavior which is also consistent with marginal malnutrition theory. The data was not consistent with placebo effects, maturation effects, neurotransmitter changes, food intolerances, nor reactive hypoglycemia as the primary causes of the 47% improvements in behavior.
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Presents an empirical multistate examination of the behavioral changes in 10 correctional institutions after diet was modified. In 1982, a juvenile detention home lowered the frequency of antisocial behavior resulting in formal disciplinary actions 48% during the 12-mo experimental stage of a 2-yr double-blind study by using dietary intervention. Widespread dissemination of this study resulted in numerous states adopting similar or identical programs: Nine additional institutions, involving over 5,000 institutionalized juveniles. All 10 facilities were successful in significantly reducing their institutional behavior problems from a low of 21% to a high of 54% under controlled experimentation. The primary dietary revisions involved reducing foods and liquids high in sucrose and food additives (e.g., candy and soft drinks). These foods were replaced with complex carbohydrates (e.g., fruit juices and vegetables). Theories concerning the ways in which food affects behavior are listed. (24 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The Cambridge Study in Delinquent Development is a prospective longitudinal survey of 411 London males from 8 to 32 yrs (most born in 1953). Just 24 chronic offenders committed half of all the recorded offenses. The chronic offenders differed from the nonchronic offenders and from nonoffenders in childhood, adolescence, and adulthood. The most important childhood risk factors for chronic offending were troublesomeness, daring, a delinquent sibling, and a convicted parent. Most of the chronics might have been predicted at age 10 yrs on the basis of troublesome behavior or social background features. Vulnerable males who did not become convicted offenders tended to be socially isolated and to be living relatively unsuccessful lives at age 32. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Conducted a study in which the incidence of antisocial behavior resulting in formal disciplinary actions was lowered 48% using a double-blind design over a 2-yr period with a sample of 276 incarcerated juveniles by reducing the quantity of sugar Ss consumed. The primary dietary revisions involved the replacement of soft drinks and "junk" food with fruit juices and nutritious snacks and the elimination of high sugar content desserts and cereals. The percentage of well-behaved Ss increased 71% and the percentage of chronic offenders decreased 56%. Adding controls for gender, race, age, and type of offender (violent, property, or status) did not diminish the reduction in antisocial behavior. (37 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Ageing is associated with impaired immune responses and increased infection-related morbidity. This study assessed the effect of physiological amounts of vitamins and trace elements on immunocompetence and occurrence of infection-related illness. 96 independently living, healthy elderly individuals were randomly assigned to receive nutrient supplementation or placebo. Nutrient status and immunological variables were assessed at baseline and at 12 months, and the frequency of illness due to infection was ascertained. Subjects in the supplement group had higher numbers of certain T-cell subsets and natural killer cells, enhanced proliferation response to mitogen, increased interleukin-2 production, and higher antibody response and natural killer cell activity. These subjects were less likely than those in the placebo group to have illness due to infections (mean [SD] 23 [5] vs 48 [7] days per year, p = 0.002). Supplementation with a modest physiological amount of micronutrients improves immunity and decreases the risk of infection in old age.
N utritiona l policies and institutional antisocial behavior
  • S Schoenthaler