This is the second post in a series telling the story of the process, challenges and lessons learned in a pilot study aimed at applying clinical research in a community setting.
Upon discovering that an overlay of maps revealed possible correlations between food deserts and violent crime in Chicago, Lynn Todman, PhD, began reading clinical research studies in order to better understand the relationship between diet and behavior.
For several decades, scholars have documented relationships between diet and antisocial behaviors. Their research has found that deficiencies of Essential Fatty Acids (EFAs), key vitamins and minerals, as well as excessive intake of highly processed foods laden with sugars, preservatives, colorings, trans fats, and other additives, are strongly associated with problematic behaviors. These include impulsivity, aggression, violence, other mood and conduct disorders and mental illnesses such as anxiety, depression, Attention Deficit Hyperactivity Disorder (ADHD) and schizophrenia.
One research study was designed as a stratified randomized, double-blind, placebo-controlled trial with pre-test and post-test measures of antisocial behavior. There, Dr. Stephen Schoenthaler found that children (aged 6 to 12 years) who were given low dose vitamin-mineral tablets exhibited a 47% lower rate of antisocial behavior (e.g., threats/fighting, vandalism, being disrespectful, disorderly conduct, defiance, obscenities, refusal to work or serve, endangering others) than children who received placebos.
In another investigation, a placebo-controlled, double-blind study of 166 children between the ages of 9-12, researchers found that girls fed fish oil-fortified foods committed fewer acts of aggression as compared to a control group.
Most recently, in 2013, Gow et al. found that callous unemotional (CU) traits were related to both eicosapentaenoic acid (EPA), and total omega-3 in a group of adolescent boys with ADHD . The findings unveiled for the first time that CU and anti-social traits in individuals with ADHD are associated with lower omega-3 levels.
Translating the Research: From Clinic to Community
For children who live in food deserts (i.e., places where residents have limited or no access to nutritious foods), these research findings prompt concern. They suggest that, because of where they live, such children are at heightened risk for mental and behavioral health problems, as well as a series of collateral outcomes like educational under-achievement and contact with the juvenile justice system. Thus, food deserts, which are disproportionately occupied by low-income people, reinforce and entrench existing inequities in health, education, incarceration, employment, income, housing, and other social outcomes.
While clinical science is critical in shaping policy and programmatic interventions required to address real-world issues, such as community violence, it is not sufficient. There must also be community-based investigations that provide a “reality check” on the science. That is, community-based investigations are necessary to test the underlying assumptions of clinical investigations and to illuminate factors that either do not arise in or are controlled for in clinical settings.
For instance, three assumptions in many clinical investigations on the link between food and behavior are that: health-promoting foods, such as those with high omega-3 content, are readily available (e.g., they can be purchased at food retail outlets); are accessible (e.g., they are affordable); and are palatable (e.g., people will actually eat them). Relatedly, a factor that is controlled for in clinical settings is exercise of “agency”; studies are structured so that participants, such as prisoners or children in school settings, have far less choice in the foods they eat than people in real-world settings.
These underlying assumptions are often untrue in real world settings. In the world outside of clinical studies, challenges abound around the affordability and availability of healthy foods and whether certain foods are deemed palatable across cultures. To the extent that underlying assumptions are weak and critical factors may not be managed, the translation of clinical science into real-world settings may be challenged. Community-based investigations provide a context for developing strategies and tactics for overcoming those challenges.
For more information on the science linking diet and brain health, watch CAPT Joseph Hibbeln, M.D. speak as part of the Brain and Behavior Institute for Human and Machine Cognition Lecture Series or visit The Institute for Food, Brain and Behaviour.
Post by The Sorter Project Team. Photo Credit: WNDU.