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ASBOs vs Nutrition

Pat Thomas

1st April, 2006

Over 1,000 juvenile delinquents showed a 44 per cent drop in antisocial behaviour when put on a low sugar diet. So why is the government completely ignoring what we are feeding our children, and yet is happy to spend £2,500 on administering each ASBO?

In October 2003 the UK government launched the latest offensive in its war on crime, the ‘Together Campaign’, across England and Wales – sold to the public as a tough stand against crime in the local community. The campaign manifesto emphasised the ‘wide ranging’ powers that local agencies have to keep the peace: acceptable behaviour contracts (ABCs); anti-social behaviour orders (ASBOs); parenting orders; injunctions; vehicle removal; mediation; diversionary schemes; preventive work; and witness protection programmes.

Like all wars, the war on crime comes with an aggressive moralistic rhetoric that sets up an adversarial dynamic ultimately more effective at preventing insight than it is at preventing crime. Methods of enforcement such as the much publicised ASBOs are appealing weapons because they represent discernable action, at least in the short term. But consider what’s happening over the longer term.

Home office figures show that more than 60 per cent of young male thugs and muggers are convicted of another offence within two years of ending their sentence. Three quarters of young male burglars and thieves also reoffend within two years. A massive 90 per cent of offenders on the drug treatment and testing order, a community sentence for offenders who misuse drugs, go on to commit more crimes.

The ASBO is hailed as an effective way of keeping petty offenders, particularly juveniles, from moving on to more serious offences. In some cases this may be true. But according to the National Association for the Care and Resettlement of Offenders (NACRO), the national crime reduction charity, there is little research available on their effectiveness and little proof that they actually work. Figures released in June 2005 show that 40 per cent of juveniles have breached an ASBO, and 46 per cent of these young people have ended up in custody for the breach.

While the government continues to plough its enforcement furrow, polls suggest that most of us would like to understand what’s causing the aggressive behaviour and crime in the first place. For instance, a 2005 report commissioned by the social policy charity the Joseph Rowntree Foundation, on behalf of the Institute for Criminal Policy Research (ICPR), found that just 20 per cent thought it would be better to get tougher with offenders, while around 66 per cent believed that prevention was the best way to tackle rowdiness and vandalism.

Radical findings
Enter Bernard Gesch, physiologist at the University of Oxford and director of the behavioural research charity Natural Justice. In 2002 Gesch and his colleagues produced a remarkable piece of research showing a direct link between nutritional status and criminal behaviour. In a British prison, 231 men between the ages of 18 and 21 were divided into two study groups. One was given nutritional supplements along with their meals, the other group placebos. Neither the prisoners, nor the guards, nor the researchers at the prison knew who had the real supplements and who had the fakes.

The researchers then monitored the number of times participants violated prison rules, and compared the results to data that had been collected in the months leading up to the nutrition study.

The supplements given in this study provided little more than the recommended daily requirement of vitamins, minerals and fatty acids; they were not the ‘mega-doses’ often used in nutritional studies. Yet the results were staggering. Prisoners given supplements for four consecutive months committed an average of 26 per cent fewer violations compared to the preceding period. For serious breaches of conduct, particularly the use of violence, the number of violations decreased 37 per cent. Those given placebos showed no marked change in behaviour. This particular study differed from many in the social sciences in its thoroughness and scientific rigour. The carefully constructed experiment ruled out the possibility that ethnic, social, psychological or other variables could affect the outcome. As a result, Gesch and colleagues emerged with convincing scientific proof that poor nutrition plays a significant role in triggering aggressive behaviour.

Voluminous research
Gesch was not the first in his field to produce these results. As far back as 1978 researchers reporting in the Journal of Orthomolecular Psychiatry compared the success of standard probation with nutritional education to rehabilitate 102 offenders in the community over 12 months. They found that the re-offending rates of the nutrition education group were almost a third of that of the probation group.

Over the last 30 years there has been a steady accumulation of similar studies linking poor prisoners given supplements for 4 consecutive months committed an average of 26 per cent fewer violations compared to the preceding period diet to anti-social behaviour. But in particular Gesch’s findings build on those of Dr. Stephen Schoenthaler, a professor of Criminal Justice at the California State University in Stanislaus, who has long argued that better food equates with better behaviour, as well as with increased IQ and school performance.

Schoenthaler and his colleagues have studied nutrition and behaviour at numerous juvenile and adult correctional facilities and in US public schools (UK state schools). His catalogue of studies over the last two decades is voluminous and has produced impressive results simply by making adjustments in food intake and/or adding nutritional supplements.

For instance, in a typical study, Schoenthaler supplemented the diets of 71 residents of a state juvenile treatment facility. During the treatment phase of the double-blind, placebo-controlled, crossover study, overall violence fell 66 per cent from 306 incidents to 104. Total AWOL and escape attempts fell 84 per cent from 79 to 13 incidents and destruction or theft of state property dropped 51 per cent from 49 to 24 incidents.

In another study involving two California Youth Authority prison camps, 402 inmates were divided into groups and given vitamin supplements or placebos for 15 weeks. Those given 100 per cent of the US recommended daily allowance (RDA) of vitamins and minerals showed a 38 per cent decline in serious rule violations – an almost identical finding to that of Gesch and his colleagues. In contrast, the group given placebos actually showed a small but statistically insignificant increase in violations.

Much of Schoenthaler’s early work, though observational, is also interesting because of what it took out of the diet – junk foods and in particular high sugar snacks.

In a 1983 study of 3,000 imprisoned teenagers, snack foods were replaced with healthier options containing reduced refined and sugary foods. During the year in which diets were changed, violent and anti-social incidents decreased by almost half. There was also a 21 per cent reduction in anti-social behaviour, 100 per cent reduction in suicides, 25 per cent reduction in assaults and 75 per cent reduction in use of restraints.

In a smaller study of 68 juveniles receiving a nutritionally superior diet, the incidence of assault dropped 82 per cent; theft dropped 77 per cent; general rule violations dropped 23 per cent; and fighting dropped 13 per cent within seven months of instigating a junk food free diet. A follow-up trial with 276 children gave one group healthy foods while the other stayed on their junk food diets. The rate of anti-social behaviour among the children on the healthy diet was half that of those eating a poor diet. On the basis of these results Schoenthaler went on to work with the Los Angeles Probation Department on a diet behaviour programme.

Over 1,000 juvenile delinquents showed a 44 per cent drop in anti-social behaviour when put on a low sugar diet. Gesch drew similar conclusions from a 1990 UK pilot project called the South Cumbria Alternative Sentencing Options (SCASO). In it serious juvenile offenders were subjected to a number of tests for: vitamin and mineral deficiencies;the presence of toxic metals; poor blood sugar control; and an individual dietary assessment. What he found was that habitual offenders had several biochemical problems in common, in particular glucose intolerance and zinc deficiency.

Remarkably, every single person in the study exhibited abnormal glucose tolerance (reactive hypoglycaemia), a problem triggered by consumption of sugar, sugary foods and stimulants (such as coffee, tea and colas), but also carbohydrate-rich foods (e.g., crisps or fruit) without protein alongside. Research has shown that an inability to metabolise blood glucose properly is a common problem among habitual offenders. When Gesch placed the volunteers on a programme of ‘nutritional rehabilitation’, their behaviour improved.

With all this accumulated evidence Gesch believes that, ‘Having a bad diet is now a better predictor of future violence than past violent behaviour. In fact, predicting future criminal behaviour from a criminal past has statistically little better than a random chance of being correct. Likewise, a diagnosis of psychopathy, generally perceived as being a better predictor than a criminal past, it is still miles behind what you can predict just from looking at what a person eats.’ While diet is by no means the only influence on the way the mind functions and on behaviour he adds, ‘We may have seriously underestimated its importance.’

In fact it is quite possible that given the strength of these effects, poor diets could be altering social norms of behaviour without our even being aware of it, since inadequate nutrition not only affects behaviour, it also affects perception and insight to the extent that a nutritionally deprived person may not have the mental faculties to differentiate between Over 1,000 juvenile delinquents showed a 44 per cent drop in anti-social behaviour when put on a low sugar diet right or wrong, or appropriate and inappropriate behaviour.

‘The take home message may be that through our dietary complacency we may have destroyed our ability to think. And if it is true that we are what we eat, since we have made unprecedented changes to what we are now eating, shouldn’t we be concerned as to what we are turning ourselves into?’

Joining the dots
While the link between food and physical health is more widely accepted by professional and lay people alike, the relationship between nutrition and a healthy mind continues to be controversial.

In part this is because during their education, doctors and psychologists are given little training in nutrition. Likewise criminologists are rarely educated in biochemistry and nutritionists are offered no hands-on experience with lawbreakers or the mentally ill. Professionals in these disciplines rarely interact with each other and this isolation means that evidence gleaned from studies into the link between nutrition and behaviour often ends up in a scientific no-man’s-land with no single group knowing how to interpret it or put its findings into action. Nevertheless, Gesch maintains: ‘It isn’t too hard to join up the dots.’

Our reticence also stems from the belief that the brain has formidable defences. Encased in bone and surrounded by the blood brain barrier, which in theory prevents all but necessary glucose from reaching the brain, we have assumed that the brain was separate from the other organs of the body and impenetrable.

This blithe assumption has for many years stalled large-scale, in-depth studies into the link between nutrition and behaviour. But although the brain is better protected than other organs, it’s been known for decades that toxins can and do regularly get through and that it does change in response to what the body is being fed. In particular, children who are brought up on diets where there are not adequate nutrients to support this extraordinary organ can exhibit permanent changes in brain structure, which are played out in their day-to-day behaviour.

For instance, in 2004 a major study published in the American Journal of Psychiatry found that children who suffered certain nutritional deficiencies – specifically of zinc, iron, B vitamins and protein – early in life demonstrated a shocking 41 per cent increase in aggressive behaviour over well fed children by the age of eight. By 17 years of age they were showing a 51 per cent increase in violent and anti-social behaviours.

Modern diets that are high in sugar, fat and synthetic additives and low in nutrients amount to what Gesch calls ‘high calorie malnutrition’, a recent trend in human evolution. ‘In the last 200 years we have made unprecedented changes to the human diet. The astonishing thing is that these changes have occurred without any systematic evaluation of the possible impact on the human brain.’

The result, says Gesch, is ‘a global, uncontrolled experiment on the human brain.’

Scientists are now seeing the effects of this ‘uncontrolled experiment’ in seemingly diverse conditions such as dementias, depression, schizophrenia, ADHD and learning difficulties (see sidebar). The results of these studies have attracted the interest of expert bodies such as the World Health Organization (WHO) which are concerned, if unable to understand, why human behaviour is changing so dramatically and why mental health problems are becoming more commonplace. WHO estimates, for example, that the incidence of children’s mental illness will double by 2020. Among adults, it says that depression will surpass heart disease as the number one cause of avoidable early death by that time.

Body and mind
The brain is a metabolic powerhouse. While it accounts for just two per cent of our body weight, it uses a massive 20 per cent of our energy.

To stay healthy the brain needs to work synchronously with other major organs, especially the heart. ‘The heart is the nutrient pump for the brain,’ says Gesch, and around 40 per cent of its energy output is geared towards feeding the brain.

Blood flow carries the brain’s supply of energy and nutrients, and without a steady flow of nutrients the brain’s information processing capacity becomes restricted.

But the brain also has a very different composition from other organs. It’s probably the most chemically sophisticated organ in the body and a steady supply of nutrients is crucial to produce the chemicals, for instance neurotransmitters like serotonin and dopamine, which help it function properly and are known to affect mood.

Manipulation of these brain chemicals is fundamental to many of the pharmaceutical solutions we employ to modify mental states and behavioural problems. Without an understanding of the body/mind/food connection, medicine and psychiatry have relied heavily on pharmaceutical solutions to behavioural problems. But often drug solutions-which strive to alter the same brain chemicals produced by a healthy diet-just make things worse. Indeed no psychiatric drug is free from profound adverse effects, and none tackle the root of the problem or produe permanent changes in behavior.

A study found that children who suffered certain nutritional deficiencies early in life demonstrated a 41 percent increase in aggressive behaviour over well fed children by the age of eight solutions – which strive to alter the same brain chemicals produced by a healthy diet – just make things worse. Indeed no psychiatric drug is free from profound adverse effects, and none tackle the root of the problem or produce permanent changes in behaviour.

Drugs used to control both adult and juvenile behaviour can trigger paradoxical reactions that cause behaviour and impulse control to deteriorate. The scientific research documenting the connection between violence, suicide and the use of psychiatric drugs which ‘work’ by manipulating brain chemistry, is now overwhelming.

The anti-depressant Prozac, for example, can provoke anxiety and agitation, as well as insomnia and bizarre dreams, in a large percentage of patients. It can also cause hypoglycaemia with anxiety, chills, cold sweats, confusion, weakness and other symptoms of low blood sugar. Ritalin is another example. In the US alone, approximately four million children are currently taking this amphetamine-like drug widely prescribed to treat

Backwards Britain
In light of the alternatives, a dietary approach to behaviour seems both sensible and humane, and yet governments have been slow to act. The Netherlands is the only country where the results of Gesch’s research are being put into practice. Dutch prison authorities are currently trailing nutritional supplements in 11 institutions as a means of improving prisoners’ behaviour.

While British authorities have largely refused to embrace the nutritional model, there is hope. In 2004, Prisons Minister Paul Goggins revealed that the Home Office was considering research on offenders’ diets, which would involve giving daily supplements of fatty acids, trace minerals and vitamins to see if they reduce anti-social behaviour among young offenders who are serving community sentences, or who have recently been released from jail. However, the move was made dependent on results from the Dutch trials and has yet to be implemented.

Given that problems in the UK prison system have become worse in the interval since Gesch’s research was published, and that reoffending rates are so unacceptably high, it makes sense to ask the question: why are we waiting?

Gesch maintains some critics say that allowing offenders to ‘blame’ their diets for the choices they have made allows them to escape responsibility for their own actions. Such detractors, he says, cling to the theory that how we behave is a function of free will – a central rationale of the criminal justice system that allows us to assign notions such as culpability and guilt. ‘But how exactly can you exercise free will without involving the brain? More to the point, how exactly can the brain function without its nutrient supply?’

Schoenthaler has stated publicly that: ‘People should be responsible for what they eat, just like they are held responsible for when they drink and drive.’ But if such people are incarcerated, and must choose daily from a contrived menu of available food items, then it is beholden on those creating the menu to ensure that every item on it is nutrient rich and supportive of the mind as well as the body. It is also incumbent on the powers that be to ensure prisoners are given a programme of nutritional rehabilitation that will stick with them once they are released. Clearly, the responsibility for what they eat rests on individual as well as institutional shoulders.

A way forward
Proponents of the dietary approach aren’t arguing that diet is the only cause of anti-social or violent behaviour. But providing a healthy diet simply has no downsides. Based on available research it will work irrespective of social, legislative or racial boundaries because human metabolism is common to us all.

One of the problems with criminal justice, particularly with young offenders, is knowing when to intervene. If you intervene too early and drag youngsters into facilities for young offenders, it introduces what is known as ‘net widening’, where someone who may not be an offender quickly becomes one through association with criminal peers. But if you intervene too late you are also going to end up with an escalation of offending.

The complicated geometry of when to intervene with a youngster in trouble is a good illustration of the saneness of the dietary approach espoused by Gesch and others. After all, says Gesch, ‘Can you think of any reason at any stage where providing a youngster with a better diet is going to be prejudicial?’

The nutritional approach is also cost effective. In May 2005 – prompted by outspoken and very public criticism on a TV series by chef Jamie Oliver – British Prime Minister Tony Blair announced his plans to make an additional £280 million available for improving the nutritional quality of school lunches. Natural Justice estimates that it would cost just £3.5 million to provide supplements to all the prisoners in the UK – a mere fraction of the current prison catering budget of £100 million and the total prison budget of £2 billion a year.

Likewise, it costs on average £2,500 to administer an ASBO. If the order is breached and the person ends up in custody, it costs a minimum of £4,450 a month to keep them there – an expensive process set against a current re-offending rate for young people released from custody fluctuating around the 80 per cent mark.

Gesch argues that such sums could be better spent on cost effective schemes that have a proven track record of tackling and reducing anti-social behaviour. ‘Let’s just say – and this is just a simple hope – if this approach works the implications are fairly massive. At the moment we are spending untold billions on dealing with the problems of mental illness and on building more prisons to contain behaviour problems. Communities are suffering. The people who are victims of mental problems and who are committing these crimes are suffering.

‘What if some of that suffering could be prevented? What if something as simple as nutrients could actually result in a situation where a significant proportion of people – and I’m not claiming all – are less likely to become offenders in the first place. That must mean there will be fewer victims, implying the potential for a more peaceful society. That must be a prize worth pursuing fully.’



FEEDING MINDS
The most recent figures show that mental ill-health is costing the UK almost £100 billion a year. A recent review by the Mental Health Foundation in conjunction with Sustain, the alliance for better food and farming, concluded that this figure could be slashed if individuals at risk were put on better diets. The report, Changing Diets, Changing Minds drew on data from more than 500 studies and concluded that food can have an immediate and lasting effect upon a person’s mental health and behaviour because of the way it affects the structure and function of the brain. It also noted that changes to the human diet in the last 50 years or so are an important factor behind the major rise of mental ill-health in the UK and other countries.

These changes include higher consumption of nutritionally inferior convenience foods, which are laden with salt, fat, sugar and additives. There are now 320,000 different packaged foods in the marketplace. The convenience factor means we grow less food ourselves and we prepare less fresh food ourselves. Comparing today’s diets to those of 1942 Britain, for example, the researchers found a 34 per cent decline in our vegetable consumption, Britons eat 59 per cent less fish and half as much milk and eggs. In contrast, our consumption of refined cereals and sugar has risen dramatically; cereals now comprise up to 30 per cent of our total diets and we now consume 44kg of sugar per person per year. Alcohol consumption has increased 19 per cent in the last decade, and in the UK the average person drinks 186 litres of soft drinks a year. At the same time breastfeeding rates have declined. Breastmilk provides substantial energy and nutrition for the brain and yet globally only 35 per cent of infants are breastfed exclusively.

But declines in the nutritional value of fresh foods – something that has hitherto not been factored into the diet/mental health equation – have also left their mark. Pointing the finger at industrialised farming, the report Changing Diets, Changing Minds notes that the drive to increase global agricultural output has resulted in a loss of genetic diversity in food crops, higher use of pesticides, depletion of the nutrient content of the soil, and loss of micro-nutrients as the foods are shipped halfway across the world. In short, even when we do eat fresh food, it is now substantially less nutritious than it once was.

The effects of these substantial changes in our diets on mental health are, according to the authors, already apparent. Four conditions in particular have shown strong links with the kinds of nutritional deficiencies common in modern diets:

ADHD
ADHD is most common in childhood and adolescence.
Recent studies have found that children diagnosed with ADHD may be suffering from essential fatty acid (EFA) deficiency. EFAs are found in abundance in oily fish and grass fed beef, and low levels of omega-3 fatty acid in particular can worsen symptoms.

So can deficiencies in zinc and magnesium. There is some evidence that high sugar intake can also provoke behavioural problems in children with ADHD.

Depression
Severe depression has increased dramatically in the past century due not only to more life stress and changing social networks, but also changes in nutrition. Research has established that rates of major depression, post-partum depression and seasonal affective disorder are consistently lower in fish eating nations. In contrast, high consumption of polyunsaturated fats – especially the omega 6 fats so abundant in junk foods – have been found to worsen major depression and bipolar disorder. Depression is also associated with deficiencies zinc and vitamins B (especially folate) and C. Schizophrenia Schizophrenia is the only disease that is distributed roughly equally throughout every population in the world. There is no evidence that general nutritional deficiencies cause schizophrenia, but western industrialised diets high in fat and sugar can substantially aggravate the condition. Research
suggests that low intakes of saturated fat or high intakes of EFAs from vegetables, fish and seafood translate into lower levels of schizophrenia, as does breastfeeding, which supplies essential fats and nutrients to the infant brain. More data shows that essential fatty acids, vitamins and folate supplements can mediate symptoms of schizophrenia.

Alzheimer’s Disease
A generally healthy diet can have a substantial protective effect against different types of dementias including Alzheimer’s. While high intakes of saturated fat can lead to Alzheimer’s disease, high fish consumption (which boosts levels of essential fatty acids) leads to low levels of the disease among the elderly in countries like Japan. Elsewhere in the world high intakes of monounsaturated fatty acids, cereals and fish appear to decrease the risk of dementia. High dietary intakes of B vitamins, especially folate, and vitamins C and E also appear to reduce the risk of developing Alzheimer’s.



NO MORE EXCUSES, NO MORE DELAYS
Let’s stop making feeble excuses about the lack of conclusive data, how much it would cost and how complicated it would be to implement nutritional programmes in UK prisons. It is time for doctors, scientists, psychologists, prison authorities and politicians acknowledge the proven link between diet and behaviour and to formulate a programme of nutritional rehabilitation for offenders that has been proven to cut reoffending rates.

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Visit Natural Justice on the web at
www.physiol.ox.ac.uk/natural.justice
The report Changing Diets, Changing Minds can be downloaded at www.sustainweb.org.
A mirror report Feeding Minds can be downloaded from www.mentalhealth.org.uk.
Natural Justice estimates that it would cost just £3.5 million to provide supplements to all UK prisoners - a mere fraction of the prison catering budget

This article first appeared in the Ecologist March 2006

 

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