The Abell Report

August 2010
Volume 23, Number 6

What we think about, and what we’d like you to think about
Published as a community service by The Abell Foundation

VITAMINS AND VIOLENCE: Can Micronutrients Make Students

T
he notion that vitamins, minerals, ner of advocates tout the behavioral won- ly, leaps of faith in supplementation so
and other “supplemental” nutri- ders of an alphabet of nutrients, notably lack scientific affirmation that “the taint
ents profoundly change behavior, B vitamins (including folic acid, niacin, of pseudoscience,” as one expert puts it,
mood, and intellect has origins as old as thiamin, and riboflavin), zinc, magne- falls on almost everyone studying diet
recorded history. Plato, Ovid, and Hip- sium, iron, chromium, calcium, seleni- and behavior. Unsurprisingly, a vast
pocrates all weighed in with dietary um, choline, essential fatty acids, trypto- majority of credible educators, nutrition-
advice for the ideal mental life, long ago phan, cysteine, and glutamine. Foods al scholars, funding organizations, and
connecting nutrition, behavior, and the rich in antioxidants and other micronutri- behavioral scientists consider claims in
brain. By the 18th century, aggression, ents are said to “rebalance” neurotrans- support of the vitamins-and-violence
irritability, and depression were linked to mitters like dopamine and serotonin to hypothesis intellectually dead on arrival,
pellagra and beriberi, diseases treatable reduce depression, aggression, irritabili- “junk science,” or the province of unprin-
with foods rich in what would later be ty, and learning problems. Adding to the cipled vitamin peddlers.
identified as thiamin and niacin, members movement is mounting worry about Their skepticism is understandable.
of the vitamin B family. Vitamins-and- stress hormones, environmental chemi- Consider the case of Ariel Academy, a
violence theories built steam as epidemi- cals, food additives, and a trans-fat rich neighborhood public “magnet” school on
ologists compared diets and behavior Western diet that puts our Stone Age Chicago’s heavily minority and poor
across large populations, and fish became biologies under siege—all topped off by South Side. In 2004, Ariel signed on with
fashionable as “medicine for hot tempers” the output of the 1990’s “Decade of the Pfeiffer Treatment Center (PTC) in near-
long before omega-3 fatty acids (found Brain,” a neuroscientific juggernaut that by Warrenville, Illinois, a self-described
abundantly in seafood) were linked by led to a growing appreciation of an ener- “world leader” in nutrient treatment of
U.S. government researchers to reduced gy-hungry brain that’s 2 percent of our “chemical imbalances” to treat autism,
homicides and aggression. body mass but uses 20 percent of our for a study of a small number of students
In the 20th century, scientists began energy intake. with behavior and/or learning problems.
exploring the molecular make-up of While scientifically distorted After a battery of chemical tests, 20 stu-
foods and their links to hormones, brain hypotheses like the “Twinkie Defense,” dents got specially compounded supple-
chemistry, and behavior, and by 1968, which blamed sugar for violent behavior, ment capsules twice a day. Five dropped
Nobel Laureate Linus Pauling would deservedly fell by the wayside, assorted out because of nausea; of the 15 who
contribute the concept of “orthomolecu- vitamin, mineral, and fatty-acid schemes remained, PTC reported “dramatic
lar” psychiatry in a famous paper in the for improving intellect, and preventing or improvements… especially in the cases
journal Science, promoting treatments reducing antisocial and criminal behav- of severe behavioral problems.”
based on “the provision of the optimum ior in children, teens, and young adults, But experts in the design of clinical
molecular environment for the mind.” have aligned nicely with urban Ameri- trials say it is unclear what was wrong if
Although his belief that mega doses of ca’s growing rate of “fast food” addic- anything with the children’s “chemical
vitamins could prevent or cure serious tion, school failures, and rising juvenile- balances” to begin with, because there
mental illness was discredited, his work delinquency rates. are no agreed upon standards or pre-
reinforced the idea that nutrients and Research has indeed suggested con- dictable consequences of the “imbal-
foods have powerful effects on behavior. nections between nutrient deficiencies ances.” There was no control group of
These days, aided by the $60 billion-a- and behavior problems, but correlations similarly affected children to compare to
year U.S. supplements industry, all man- are not the same as causality. Historical- the treated group, nor did PTC or the
continued from page 1 same subject, a study design considered in the schools say opportunities to safely
so weak that even Walsh and his team and effectively improve the lives and
school submit its data for independent concluded that “to confirm these results achievements of children are equally vast.
peer review. and evaluate the potential of biochemical Some blame the failure of their cause on
Similar is the story of an Appleton, therapy as a crime-prevention measure close-minded thinking, the lack of cross-
Wisconsin, high school, which in 1997 will require double-blind, placebo-con- talk and cooperative research between
was reported to be full of students trolled studies.” behavioral scientists and neuroscientists,
described in one news account as “rude, The bottom line is that no one can fig- and the complexity of information pour-
obnoxious, and ill-mannered.” Several ure out what actually happened to those at ing out of nutrition research and neuro-
years later, the student body was reputed- Ariel or Appleton or the PTC subjects, science. Says one noted British psychobi-
ly transformed into a happy band of the because studies like these are highly ologist, David Benton, “nutritionists
“calm and well behaved.” According to a unreliable, and carry hidden booby traps know nothing of the brain, mental illness,
popular documentary, the change came for the unwary seeker of simple solutions and criminal behavior; social scientists
after the principal replaced all the soda to complicated problems. know nothing of biology or psychology;
pop machines with water coolers, and the Nevertheless, vitamin-violence theo- and physicians and biologists often know
usual fat- and starch-laden school menu ries remain tantalizing because if there nothing of nutritional, environmental,
with fresh fruits, whole grains, and were reliable evidence that supplements social, or psychological influences.”
salad bars. make a difference in behavior and learn- For its part, the pharmaceutical and
Scientists, however, point out that any ing, school and prison officials are likely supplements industries, which would
number of factors besides dietary to want to try them. The costs and risks appear to have vested interests in getting
changes could have altered student of daily vitamin pills are generally con- better information, know they cannot get
behavior over a period of years. How sidered low and their use, like chicken patents on vitamins, minerals, and other
about different (better) teachers? A soup, widely perceived as harmless at micronutrients, so the cost of expensive,
turned-over student population with more worst. Finally, the idea just seems like rigorous, “gold standard” clinical trials
involved parents? Economic prosperity “common sense” to many. “Suggesting are trumped by promoting their products
and better home diets? Differences in that the vast changes in human nutrition more cheaply on the basis of anecdotal or
how teachers and security staff sorted out in the past 50 or 100 years haven’t had suggestive evidence.
normal rambunctiousness from “discipli- something to do with alterations in Into this morass of uncertainty has in
nary” problems? behavior doesn’t pass the silly test,” says fact come a small cadre of American,
In one other example, William J. Bernard Gesch, a British criminologist British, Dutch, and other European inves-
Walsh, a chemical engineer and founder and nutrition researcher. tigators who have conducted and pub-
of PTC and its Health Research Institute, The problem is that before even lished—in peer-reviewed journals—more
gave proprietary “customized” collections “chicken soup” becomes public policy, rigorous and competitively funded stud-
of vitamins, minerals, amino acids, and scientists insist on clarity of purpose, proof ies tying nutrient deficiencies to miscon-
other nutrients to 207 patients with atten- of principle, and measurable outcomes. duct and academic failure.
tion deficit disorder, physical aggression, Critics of the idea of supplementation This Abell Report is an attempt to get
destructive behaviors, and “oppositional say opportunities for misunderstanding, past the “he said/she said” debate, and to
defiant” disorders diagnosed by analyzing misinterpretation of data, unethical review, analyze, and come to some con-
90 biochemical “factors.” All were report- “labeling” of “troublesome” children, clusions about the evidence for and
ed to have “imbalances” in copper/zinc and unintended consequences are vast. against providing mass supplementation
ratios, depressed blood histamine, heavy They argue that the complexity of the in the schools as a means of influencing
metal overload, and glucose “dyscontrol.” interactions of nutrients cries out for pay- behavior and cognition. It looks for com-
PTC published a paper concluding ing more attention to an overall balanced mon ground between the skeptics and the
that 92 percent of the test subjects them- diet similar to what our evolutionary biol- advocates, and offers some next steps if
selves reported reduced frequency of ogy was built on: occasional meat and fat; school officials find sufficient evidence to
assaults. There were no independent lots of fish, fruits, nuts, and vegetables; warrant a look at designing a supplemen-
comparisons between or among test pop- and certainly no processed carbohydrates, tation pilot program or study in Baltimore
ulations, only observations or self reports or sugary treats from the 7-11 cave. City schools.
of “before-and-after” symptoms in the Champions of mass supplementation

The Abell Report is published bi-monthly by The Abell Foundation

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continued from page 2 with poor behavior as coming from a bro- supplementation to reduce childhood and
ken home or being exposed to street or youth aggression and improving behav-
The Scope of the Problem domestic violence. ior? And how strong is it?
The nationwide rise in school-age The evidence falls into several cate-
youth violence and aggression over the The Claims gories: studies on youthful offenders in a
past 50 years has been amply document- In the last decade, the search for prison setting that reduce so-called
ed, with estimates of the direct financial affordable solutions has produced fertile “crime diets;” studies that attempt to
cost alone at $158 billion in 2006. Steal- ground for those convinced of micronu- reduce the “expected” number of behav-
ing, vandalism, tantrums, bullying, irri- trient solutions. ioral problems in populations by using
tability, impulsivity, and disruptive behav- Typical are those of Stephen Schoen- supplements; studies that infer from
iors, along with depression, substance thaler, a criminologist at California State undernourished populations the role of
abuse, and learning problems are creating University, who claims low levels or micronutrients in behavior and learning;
costly, sometimes devastating, problems imbalances of nutrients “can seriously and “literature review” articles that try to
for schools, children, the labor markets, disturb the electrical activity in the brain,” analyze and make sense of dozens of
and civil society. particularly the making of serotonin and studies that lack standardized study
Less clear is why. School-based vio- other brain chemicals tied to mood and designs, treatments, or outcomes.
lence and aggression are recognized as learning. His beliefs are rooted in neuro- Most compelling are studies by a
part of a constellation of juvenile behav- science showing that poor brain function small number of investigators associated
iors ranging from tantrums and discipline is driven by disruptions in serotonin, with major academic institutions or gov-
problems, to bullying, attention deficit dopamine, and other neurotransmitters, ernment organizations whose experi-
disorder, and outright assaults and psy- which, in turn, are associated with mem- ments satisfy at least some of the require-
chosis. But scientists have yet to find reli- ory and learning problems, depression, ments of well-designed protocols. These
able and predictable common origins, or sleep deprivation, irritability, and some scholars provide details of their work to
any “unified theory” of causation. antisocial behaviors. colleagues and the public, subject their
Some things are complicated—send- Other claims center around particular studies to peer review, and seriously
ing a man to the moon requires lots of minerals or amino acids, or around too- acknowledge the limitations of their find-
steps but the tools needed are clear. low cholesterol levels or sugar overloads. ings. Here is a sampling:
Human behavior, however, is complex, Deficiencies in essential fatty acids, • In a multi-year study begun in 2003,
and needs and rational interventions are notably omega-3 fatty acids commonly Stephen Schoenthaler at California
difficult to find. In a “State of the Sci- found in seafood, are especially au State University, and his colleague
ence Report on Violence Prevention,” courant in research into the causes and Ian D. Bier, partnered with Anthony
published in 2006 in the Journal of prevention of aggressive behavior. Elementary School in Leavenworth,
Abnormal Child Psychology by the The most reasonable claims fall into Kansas, because the school’s offi-
National Institute of Mental Health and the “promising if unproven” category, cials suspected that their students’
the universities of Pittsburgh and Ala- summarized well by Michael Jacobson, a inadequate academic performances
bama, the authors concluded that there is microbiologist by training and co-founder were due to high amounts of delin-
not even a fully comprehensive or man- of the Center for Science in the Public quency and violence related to
ageable systematic picture of the pub- Interest. “More and more research is lifestyle and nutrition factors. In a
lished research, nor agreement on showing that supplementing diets with study designed to reduce antisocial
whether there are common roots to child vitamins, minerals, or omega-3 fatty acids behavior and improve math and
and youth aggression, delinquency, drug can significantly improve the behavior of English scores on statewide tests,
abuse, and sexual risk taking. prisoners, people in mental hospitals, and children in kindergarten through
Even if nutritional deficiencies are a possibly poor nourished students,” Jacob- fifth grade got low-dose vitamin and
“common” link, the issue is compounded son stated recently. “While more research mineral tablets, nutrition education,
by general community food shortages, needs to be done, health departments have more nutritious school lunches, dai-
skipped meals, and the poverty-laden life major opportunities to utilize inexpensive ly exercise, and family-style group
that accompanies these phenomena. An dietary supplements to conduct studies meals. The economically disadvan-
Abell Report in 1998, for example, docu- and improve the welfare of people in the taged elementary school, with 350
mented the impact of a semester-long, in- city/county/state’s custody....” students, two-thirds of whom were
classroom school breakfast pilot program minorities, was chosen for its simi-
on academic achievement and classroom The Evidence larity to large East Coast inner-city
behavior, concluding that the absence of So what is the credible evidence for schools, marked by the highest lev-
breakfast alone can have as much to do using vitamins, minerals, or fatty-acid els of violence and antisocial behav-

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continued from page 3 • A study by Schoenthaler and Bier, ed results of a study on 231 offend-
reported in 2000 in the Journal of ers, 18 to 21 years old, in a maximum
ior, and lowest scores on standard- Alternative and Complementary security prison in England. The pris-
ized tests in the 10-school district. Medicine, gave school children, oners were divided into two groups,
The daily supplement supplied 100 ages 6 to 12 years old, low-dose with one group given supplements
percent of the U.S. Recommended vitamin and mineral tablets in line with meals in the same amounts that
Daily Allowance (RDA) for every- with National Academy of Sciences would approximate a One-A-Day
thing except calcium and magne- supplement guidelines to see if they style supplement for fatty acids, vita-
sium. Violent and nonviolent delin- would behave better in school than mins, and minerals; the other group
quencies were measured by official classmates given placebos. The got look-alike placebos. Neither pris-
school disciplinary records and researchers chose two working-class oners, nor guards, nor researchers
scores on the Kansas Assessment Hispanic elementary schools in knew who got the real pills. Before
tests given to fourth- and fifth-grade Phoenix, Arizona. Violent and delin- the supplements were given, Gesch
Kansas school children each year. quent behavior was measured by the and his colleagues tracked the pris-
Results showed that before supple- number of students referred to the oners’ behavior for nine months,
ments, two students every day were principal’s office. Eighty students recording incidents of such antisocial
referred to the principal’s office for disciplined at least once between behavior as “mouthing off” to guards
disciplinary action related to “out of September and May served as the and fights. The prison, they noted,
control” behavior, or a total of 428 research sample. During the pill-giv- offered fairly healthy choices of
incidents for that baseline year. Dur- ing phase, the 40 children who got foods, but many prisoners opted for
ing the vitamin “intervention,” refer- active tablets were disciplined, on the “chips” instead of the salad bar.
rals dropped to 18, or by 95 percent. average, one time each, a 47 percent At the end of the 18-month study
Referrals stayed low the second year; lower mean rate of antisocial behav- period, those who got the nutrient
suspensions dropped from 52 to 13, ior than the 1.875 times each for the supplements for at least two weeks
and violent acts from three to one. 40 on placebo. The children who were reported to be involved in 35
Scores on math and English tests rose took the real pills were reported to percent fewer disciplinary infrac-
from 10th to first in the district. be involved in fewer threats, fights, tions than those on placebo. Minor
vandalism, disrespectful behavior, offenses were reported to have
• To the degree that better nutrition and obscenities. The study was small dropped by 33 percent and serious
and improved learning are linked to and the differences between the offenses, including violence, fell
lower levels of antisocial behavior, a treatment and placebo groups were 37 percent.
report published in the American small as well. Yet even critics agree
Journal of Clinical Nutrition in 2007 that this study as well as their later • Spurred by these results, in 2008,
has also received positive attention. research have some value. Wendy Britain’s Wellcome Trust announced
Researchers with the Nutrition Smith, Ph.D., of the National Insti- it would bankroll a $2.3 million trial
Enhancement for Mental Optimiza- tutes of Health, in a commentary of supplements among more than
tion Study Group assessed the effect written for the Journal of Alternative 1,000 prisoners from three United
of vitamins, minerals, and omega-3 and Complementary Medicine in Kingdom prisons. The three-year
fatty acids in a double-blind test in 2000 said the “authors continue to study, which began in the spring of
Adelaide, South Australia, and at six strive to improve their own work” 2009, will include more rigorous
primary schools in Jakarta, Indone- with randomization and other better measures of blood chemistries and
sia. Some 396 children, ages 6 to 10 measures and assessment features. computerized behavioral and IQ
years, in Australia, and 384 in tests to confirm the earlier study, and
Indonesia, got drinks with various • Bernard Gesch, a criminology and try to figure out just how and why
nutrient mixes comprised of iron; nutrition researcher at the University vitamins might do what they are
zinc; folate; vitamins A, B6, B12, and of Oxford’s Department of Physiolo- doing. Gesch believes that the most
C; the fatty acid docosahexaenoic gy, is best known for his notion that common diets in the Western world
acid (DHA) or eicosapentaenoic acid “crime diets” can be replaced with now—full of refined sugars and
(EPA); or a placebo. The one-year “peace diets,” and that vitamins can meat fats—“wash out” or replace
study showed that the micronutrient prevent fights even among adjudicat- essential nutrients such as omega-3
therapy resulted in “significant ed delinquents and prison popula- fatty acids that contributed to our
increases” in scores on tests repre- tions. In 2002, writing in the British ancestors’ survival. Whether or not
senting verbal learning and memory. Journal of Psychiatry, Gesch report- theirs was a more peaceable king-

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continued from page 4 was asked whether it believed it had such as illicit drug use, cruelty, and
gotten supplements or placebos—an stealing. Compared to those without
dom is arguable, but Gesch says that effort to see if the subjects them- nutritional deficiencies, the mal-
“to look at the quirk of evolution that selves noticed differences in their nourished children showed a 41 per-
made our brain such an energy hog, feelings and behaviors. cent increase in aggression at age 8,
and conclude that nutrition has noth- a 10 percent increase in aggression
ing to do with behavior and learning Results showed a 34 percent drop in and delinquency at age 11, and a 51
is bizarre thinking.” the number of reported incidents for percent increase in violent behavior
the group on supplements, and a 14 at age 17. At the time, Raine noted
• A study in the Netherlands, pub- percent increase in reported incidents that 7 percent of American toddlers
lished in 2010 in the journal Aggres- in the placebo group. The reductions had iron deficiencies, as many as 16
sive Behavior, tested the effects of in violent incidents, documented by percent of teen girls were anemic,
nutritional supplements on rule- the prison staff did not, however, and up to 22 percent of black and
breaking, aggression, and psy- reflect any real differences reported by Mexican-American girls were ane-
chopathology among young adult the subset of prisoners asked about its mic as well.
offenders in eight Dutch prisons. level of aggression or general health.
Sponsored by the Dutch Ministry of • Raine says the study suggests that
Justice and Radboud University, a • In a 14-year study, a research team at “biological disposition to antisocial
team of university psychiatrists led the University of Southern Califor- and aggressive behavior” can be
by Ap Zaalberg gave vitamins, min- nia (USC) showed that malnutrition changed and has received NIH
erals, and essential fatty acids, or in the first years of life leads not grants to further test and refine the
placebos, to 221 young adults ages only to lower IQ but also to antiso- violence-and-vitamins hypothesis.
18 to 25 years over a one- to three- cial behavior later in life, including He currently is recruiting 500 male
month period. Reported incidents teenage aggression. In their study, and female 11-year-olds from high-
were significantly reduced in the reported in 2004 in the American risk communities in Philadelphia for
active intervention group of 116, Journal of Psychiatry, Jianghong a “biosocial” study integrating
compared to the placebo group of Liu, then a postdoctoral student, and genetics, brain imaging, hormone
106. The reductions were observed Adrian Raine, then a professor of levels, and nutritional and psycho-
and recorded by prison staff. The psychology at USC (now at the Uni- logical factors, along with neighbor-
supplements included 25 vitamins versity of Pennsylvania), followed hood, family, school, and social fac-
and minerals, and four separate fatty the diet, behavior, and learning of tors, and mental-health features such
acids, a regimen similar to what about 1,000 children on Mauritius, as ADHD, depression, anxiety, post-
Gesch devised but more comprehen- an island in the Indian Ocean off the traumatic stress disorder, and schiz-
sive, and in larger doses, in some coast of Africa. The group included ophrenia. Describing the new study
instances. The Dutch study supplied children with Indian, Creole, Chi- as “perhaps the most systematic”
substantially more magnesium and nese, English, and French back- look yet at the neurological and
different amounts of vitamin D, grounds. After testing them at age 3 social foundations of aggression,
phosphorus, and beta-carotene, for for deficiencies in B vitamins, pro- Raine says the goal is to “predict
example. Before supplementation tein, zinc, and iron, the children got and treat” both proactive and reac-
began, the prisoners completed IQ tests and home visits to tive aggressions, which he believes
questionnaires to assess aggression, document living conditions. The are likely to have different origins
and prison staff also rated the level researchers checked behavior at ages and responses to treatment.
of hostile and aggressive behavior 8, 11, and 17. Teachers were asked
using incident reports for infractions to assess the children at age 8 for The group at Penn also plans to devel-
such as possessing illegal drugs and such things as irritability, picking op a genetic mouse model of aggres-
bad behavior. Again, neither partici- fights, and acting out; at age 11, par- sion to test nutritional treatments and
pants, nor staff members, nor ents were asked to tell researchers prevention of aggression. Of the 500
researchers knew which prisoners about whether or how much their children Raine hopes to recruit, 300
were getting real supplements or children got into fights, bullied oth- will get baseline assessments for
placebos. After the intervention peri- ers, lied, cursed, and vandalized aggression risk factors and then be
od, the same questionnaires and property. Further, at age 17, parents randomly assigned to one of four,
assessments were administered and teachers both were asked to three-month interventions: treatment
again, and one subgroup of prisoners report again on antisocial behaviors as usual, cognitive behavioral therapy,

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continued from page 5 when performing a difficult task. pills for all. “The brain,” Benton
Those on placebo declined 1.7 wrote, “is the most complex and
nutritional supplementation, or a points. Most tellingly, perhaps, was metabolically active organ in the
combination of cognitive behavioral when they were faced with a difficult body, thus behavior reflects the sum-
therapy and supplementation. Over task, they were more likely to con- mated outcome of countless millions
the four years of the study, Raine pre- centrate longer, sustain efforts, and of metabolic processes.” The big
dicts that those with low omega-3 fat- deal better with frustration, an under- question, Benton says, is “what are
ty acid levels and high lead exposure lying theoretical element in antiso- the active ingredients in the effects
will benefit most from supplementa- cial behavior. seen in the positive trials so far?
tion, while those with cognitive and Many think fatty acids are the key, but
emotional risk factors will benefit In Benton’s and Cook’s study, for no one is sure.”
most from behavioral intervention. example, the reactions of the children
were observed while they played a • If there is a “granddaddy” of
• Psychobiologist David Benton of the commercially available electronic research on nutritional factors in
University of Wales in Swansea, UK, game called Tele Match 4. It consists antisocial and violent behaviors, he
has spent decades studying the of an electronic representation of a is Joseph R. Hibbeln, a physician,
impact of diet on antisocial, violent, ball moving from the left to the right psychiatrist, lipid biochemist by
and criminal behavior in children of a TV screen. By moving a knob, training, Commander in the U.S.
and adults, as well as the impact of the subject can try to “bat” the ball. Public Health Service, and a long-
micronutrient supplements on intelli- The experimenters made the task very time researcher at the National Insti-
gence and learning in children. He hard for 6-year-olds because the real tute of Alcohol Abuse and Alco-
also has studied the impact of sugar test wasn’t their ability to bat the ball, holism of the NIH. He has spent
on behavior and learning, conclud- but to see how they reacted to failure decades in international collabora-
ing essentially there is no evidence and frustration. Researchers wrote tions for clinical trials of omega-3
of an adverse effect on behavior, irri- down the behavior of each child as fatty acids for the prevention of sui-
tability, aggression, or attention falling into one of four categories: cide, depression, and violence, and
deficit from consuming sucrose. In quietly concentrating; fidget- was one of the first scientists to
one of his earliest studies, in 1988, ing/shuffling; roughly handling the bring attention to the potential role
he asked 90 12- and 13-year-olds to controls, kicking their feet, sighing, of omega-3 fatty acids in psychiatric
keep a daily diary for three days and and other signs of frustration; and disorders. In a 2004 paper published
found the average intake of vitamins negative comments. in the Journal of Biological Psychi-
was close to the recommended atry, Hibbeln and a team from the
amounts for most of the children. He These same children were random- NIH and the University of Missis-
then gave a multivitamin and miner- ized to get vitamin supplements. The sippi Medical Center in Jackson
al supplement, or placebo, in a dou- experimenters also asked the parents sought evidence that omega-3 fatty-
ble-blind trial for eight months to 60 to report a food diary using a list of 24 acid deficiencies had an impact on
of the children. The supplement foods, including the frequency with those predisposed to commit domes-
group, but not the placebo group or which the children ate foods such as tic violence. They chose 21 convict-
the remaining 30 who took nothing, milk, eggs, fruits, vegetables, grains, ed domestic abusers, all with docu-
showed “a significant increase in meat, fish, sugar, and so on. Benton mented tendencies to develop rage
nonverbal intelligence on a standard- and Cook concluded that there was a and panic-like responses to anxiety.
ized test. In 1991, he followed up small decline in performance in those The researchers then obtained sam-
with a report in the Journal of Per- taking placebo, and improvements in ples of cerebrospinal fluid and plas-
sonal and Individual Differences. concentration and intelligence in ma from the subjects after three days
Along with colleague Richard Cook, those who got the supplements. The in which participants were on a diet
he gave 47 6-year-olds either a authors were quick to point out that it that lowered blood levels of
placebo or tablet with vitamins and is almost impossible to determine or monoamine neurotransmitters such
minerals, and took baseline meas- “even begin to suggest” what the crit- as serotonin. Low serotonin levels
ures before and after up to two ical ingredients were that made the have long been linked to anxiety and
months of treatment. The intelli- difference because of the wide variety other psychological mood disorders.
gence scores of those taking the of nutrients used in their own and so Fatty acids were then measured along
active tablets increased by 7.6 points many different studies. But the results with blood levels of corticotrophin-
on tests that looked at their behavior suggest further work if not vitamin releasing hormones (CRH) in the

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continued from page 6 were related to trends in murder ly unimpeachable. Steven Goodman, a
rates and found “a striking correla- professor and biostatistician at Johns
spinal fluid because inflammatory tion” between what appears to be Hopkins University, read two of the stud-
chemicals called prostaglandins more intake of linoleic acid (an ies conducted among young offenders
increase the genetic expression of omega-6 fatty-acid source) from and concluded that from what was report-
these hormones and omega-3 fatty vegetable and seed oils and ed, supplementation seems at best mar-
acids have been found to decrease increased risk of murders from 1961 ginally significant and that culling con-
prostaglandin release. to 2000. Hibbeln’s conclusion is that sistent, applicable lessons from them is
lowering linoleic-acid intake and tricky if not impossible. If a pilot study
Their results showed low levels of improving omega-3 fatty acids and were to be done in Baltimore City, Good-
omega-3 fatty acids associated with other basic nutrients “can potential- man says the following elements must be
elevated CRH levels, and that the ele- ly become relatively cost-effective made a high priority:
vated levels increased fear and anxi- measures for reducing the pandemic • Recruitment of subjects from class-
ety, common components of defen- of violence in western societies, just rooms with balanced and similar
sive and violent behavior. as dietary interventions are reducing groups of students, along with teach-
cardiovascular mortality.” The con- ers who supervise them.
• In a second study published in 2004 sumption of omega-6 linoleic acid
in the European Journal of Clinical (found in soy, corn, and sunflower • Study designs that follow best prac-
Nutrition, Hibbeln and another team oils; used for frying, prepared meals, tices for reducing biased interpreta-
studied the relationship between potato chips, and ice cream) has tions, errors, deceptive behavior, and
hostility, the development of coro- vastly increased relative to seafood- self deception—especially difficult
nary disease in young adults, and the derived omega-3 fatty acids. in studies that try to measure sub-
dietary intake of fish and fatty acids. tleties in human behavior.
They sampled 3,581 urban white Conclusions and Recommendations
and black young adults, using a Although suggestive studies continue • Study “designs” that are “double-
standard assessment of hostility, and to pile up, ongoing scientific uncertainty blinded,” i.e., tests in which neither
found that the odds of scoring in the remains a major obstacle to public-health those conducting the study nor the
upper fourth on the hostility scale initiatives to feed supplements to at-risk subjects know which people are in a
were linked to increases in DHA, populations. Too little is understood “control” group for comparison, and
one of those essential fatty acids. about the role each nutrient might be which people are getting the vita-
Eating any fish rich in fatty acids, playing in these studies. There is no mins or other interventions.
compared to having none, was asso- agreement on doses, relative ratios in
ciated with lower odds of hostility. relation to each other across a life span, • Double-blinded, independent verifi-
Again, association does not prove or what dangers there might be in supple- cation of all behavioral measures and
causality, but the results, Hibbeln mentation. Excessive doses of vitamins, observations, meaning that neither
says, are cause for further study. especially vitamin E; minerals; herbals those conducting the study nor the
Hibbeln’s studies also suggest that such as ginkgo biloba and turmeric; and subjects have influence over the out-
lower levels of essential fatty acids salmon oil have caused disease, including comes or interpretations of measure-
and low cholesterol are associated increased bleeding and clot formation. ments and observations.
with self harm, impulsivity, and bad Vitamins A, B6, B12, C, E, and K, along
mood. Others have suggested a role with niacin, calcium, magnesium, iron, • Impeccable selection, measurement,
in aggression for imbalances in the zinc, and folic acid can be dangerous in and accounting of relevant “covari-
ratios of omega-3 and omega-6 fatty combination with some prescription ates,” a fancy term for factors that are
acids (the former associated with drugs and cold remedies. likely to affect one or more of the
lower levels of inflammation and the So if there is a reasonable next step for groups being studied, and thus likely
latter to higher levels). In one of a urban school systems interested in using to distort the outcome. These could
series of studies examining the supplements to prevent or reduce anti- include patterns of disciplinary
effects of omega-3 and omega-6 fat- social behavior, what would it look like? actions in a particular school, or pro-
ty-acids levels on aggression, hostil- Experts consulted for this report all files of teachers’ human tendencies
ity, and homicides, Hibbeln and his said that further research is needed to to treat students with the same
colleagues analyzed measures of make the case for vitamins against vio- behavior problem in different ways.
omega-6 consumption over time and lence, and that projects must be the “Cae-
in many countries to see if these sar’s wives” of studies—i.e., scientifical- • Direct observation of supplement use.

7
continued from page 7 scientific, and ethical challenges, Gold- alternative. Supplements, notes Gesch,
stein suggests a “reasonable first step” is are no “magic bullet” to stop violence,
• Scientifically sensible and agreed- to convene an international assembly of antisocial behavior, depression, or any
upon “endpoints” and study proce- experts to plan a specific and direct other behavior in schools or anywhere
dures in which all children who are assault on the uncertainties that make the else. If solutions to complex problems
randomized (assigned at random to vitamins-and-violence hypothesis so were that simple, they would long since
be “controls” or treated groups) are unsettling to mainstream scientists. In have been applied. “We’re not,” Gesch
counted in the final results. separate interviews, Gesch and Benton says, “going to be able to transform soci-
agree and would help organize such a ety with our teeth.”
Ruth Faden, director of the Johns meeting if invited to do so.
Hopkins Berman Institute of Bioethics, The goal “is not a talk-fest,” Goldstein Joann Ellison Rodgers, an award-
says any pilot study or program of sup- says, but a roll-up-your-sleeves workshop winning science journalist, directed
plementation must be grounded in under- with a diverse group of eight to 10 serious Johns Hopkins Medicine’s media rela-
standing the benefits and risks for the experts, both proponents and skeptics. tions and public affairs division for 25
children, the schools, and the larger soci- Attendees should include an epidemiolo- years, and now serves as senior advisor.
ety. A proper study would also focus on gist, nutritionist, criminologist, behavioral A graduate of Boston University and the
younger, rather than older, children. “If psychologist with knowledge of neuro- Columbia University Graduate School
poor nutrition is a behavioral issue, then science, an ethicist, and a pediatrician of Journalism, she is a board member
the earlier the intervention, the better with special knowledge of brain develop- and past president of the Council for the
because of what scientists already know ment and childhood behavior. Advancement of Science Writing; past
about brain development. Focusing on The workshop, he says, would pro- president of the National Association of
older kids, like teenagers, would continue duce a proposal that identifies very spe- Science Writers; a Fellow of the Ameri-
to disadvantage the group that needs pre- cific behavioral outcomes, and a working can Association for the Advancement of
vention most,” Faden says. group to design a pilot study for Balti- Science (AAAS); and a member of Sig-
Several experts argued for programs more schools as close to ideal as possi- ma Xi, the Scientific Research Society.
that give consideration to “broader out- ble. One arm of the study, Goldstein The author of seven books, including
comes” such as overall well-being and says, should include the benefits of a Sex: A Natural History (Henry Holt and
health, but that still answer questions generally healthy diet. “If you examine Company, NY), she has contributed
about supplementation and violence only children with a terrible diet and see articles on medicine, genetics, risk com-
reduction. If there is reason enough to a benefit, that might lead parents and munications, and psychology for The
think there would be a benefit, the ethical schools to think that a pill can substitute New York Times Magazine, Psychology
framework is better if a study looks at for a good diet.” Today, The Los Angeles Times, and
outcomes that go beyond antisocial “It’s plausible to me,” says David other magazines. Her awards include a
behavior, because just going after the nar- Benton, “that if people are marginally Lasker Award for medical journalism.
rower outcome risks negatively “label- malnourished, giving vitamins in correct
ing” already disadvantaged children. Get- arrays would bring measurable improve-
ting informed consent from parents and ments in behavior. But what and how to
older children is also vital, Faden adds, do that is easy to oversimplify. When you
along with agreement about how the vita- change diet, you are changing biological
mins would be given and options for par- potential, but that potential is also under
ents to continue what they are already the influence of social and environmental The August 2010
doing at home, such as special diets. forces. To think that after a lifetime of bad Full Report,
Gary Goldstein, a physician, head of social environment, poor parenting, and
the Kennedy Krieger Institute, and an negative feedback that giving someone a
VITAMINS AND VIOLENCE:
expert on developmental brain chemistry vitamin pill or better diet is going to keep Can Mircronutrients Make
and biobehavioral science, says, “There’s him out of prison is delusional. This is an Students Behave, Schools Safer
no question that good nutrition has an area of work that is dear to my heart, but and Test Scores Better?
impact on behavior and cognitive devel- we need to move forward with scientific
is available in "Publications"
opment. The question is whether it’s pos- rigor and caution.”
sible to properly and convincingly meas- The recommendation to conduct more on the Abell website,
ure a reduction in antisocial behavior by studies—or just better ones—is likely to http://www.abell.org
giving vitamin supplements.” frustrate those who want faster action, but
Highlighting the statistical, logistical, the credible experts in the field see no real