108115 February 2007 - BBC News - Fish in pregnancy benefits babyfish in pregnancyEating fish and seafood during pregnancy has long-lasting benefits for the child, a UK study has suggested.15/02/2007
Children of mothers who had eaten lots of fish during pregnancy had better communication and social skills at seven years old, the Lancet paper says.
There are fears surrounding the possible toxic damage from eating fish during pregnancy.
The Food Standards Agency advise that pregnant women should eat one or two portions of oily fish a week.
But they warn against eating certain types of fish, such as shark and marlin - or lots of tuna - because of the risks to the developing foetus associated with mercury.
Previous research from the Avon Longitudinal Study Group has shown that omega-3 fatty acids contained in fish - particularly oily fish - are associated with boosting children's future brain power and social skills.
However, the team had only looked at the effects up until the age of three or four.
In the new analysis, researchers from Bristol University and the US National Institutes of Health questioned 11,875 pregnant women on their fish and seafood consumption.
They looked at social and communication skills as well as hand-eye co-ordination and total IQ in the children up to the age of eight years.
Socioeconomic factors were taken into account as well as information on the rest of the women's diet.
Eating less than 12oz (340g) of fish and seafood a week was associated with a 48% increased risk of children being in the lowest group for verbal intelligence.
Low fish and seafood intake during pregnancy was also associated with increased risk of poorer behaviour, motor, communication and social development scores.
The lower the consumption of fish, the higher the risk of poorer scores on the neurodevelopmental tests, said the researchers.
Professor Jean Golding, emeritus professor of paediatric and perinatal Epidemiology at the University of Bristol, and head of the study, said women should follow the FSA advice and eat a mixture of different types of fish.
Oily fish, the most widely available source of omega-3 fatty acids, that women should eat include salmon, mackerel, pilchards and sardines.
She said: "The findings we had previously were very much earlier in a child's life so it was quite possible the effect would have worn off.
"But here we have very convincing findings up to the age of seven or eight."
Professor Robert Grimble, professor of nutrition at the University of Southampton said omega-3 fatty acids were very important for brain development.
"This idea of fish being toxic has been around for a long time but this study seems to be saying that is a minor problem compared with the benefits you get from fish."
"Studies have shown improvement in brain ability and reduction in antisocial behaviour."
He added that infants would get omega-3 through the placenta when they were in the womb but also through breast milk once they were born.
In 2004 the US government issued advice to women on limiting their intake of overall seafood and fish to 340g per week to avoid foetal exposure to trace amounts of neurotoxins.
In the UK, pregnant women are advised not to eat more than two tuna steaks a week (weighing about 140g cooked or 170g raw) or four medium-size cans of tuna a week (with a drained weight of about 140g per can) because of the levels of mercury.
The McCarrison Society assembles scientific knowledge & evidence worldwide on sound nutrition, free from economic and political pressures, for the physical and mental health of future generations; runs conferences & lectures; encourages and initiates research projects; liaises with the scientific and agricultural communities, and urges the inclusion of nutrition as a mandatory subject in medical departments and its teaching in schools.
http://www.mccarrisonsociety.org.ukThe McCarrison Society
1732Katzen-Luchenta 2007 - The declaration of nutrition, health, and intelligence for the child-to-be.The declaration of nutrition, health, and intelligence for the child-to-be.The declaration of nutrition, health, and intelligence for the child-to-be.
Katzen-Luchenta J.01/02/2007Nutr Health. 19(1-2):85-102.
The Declaration of Nutrition, Health, and Intelligence for the Child-to-be is an urgent cry from the unborn child for a life-span of nutrients for physical and mental wellness. It is a proclamation of paramount importance for everyone involved in child development: parents, health professionals, teachers, government agencies, all producers of food--and children, so they may learn how to feed themselves well. The Declaration of Olympia on Nutrition and Fitness, 1996, came from a group pf nutritional scientists and medical doctors to commemorate the Olympic Games' 100th anniversary. They based it on the health principles of Hippocrates: genetics, the age of the individual, the powers of various foods, and exercise. Following today's vast wealth of nutritional research and expressing it with my teaching experience, I have revitalized the Declaration of Olympia by writing from the heart of the little learner and the hope of the child-to-be.
The nutrients implicated in healthy reproduction and lifelong health include B vitamins, particularly B1, B6, folate, B3, B12, antioxidants, particularly vitamins C and E: minerals such as iron, zinc, magnesium, selenium, iodine, and copper; and essential fatty acids, particularly DHA. These nutrients also lower the risk of neural tube defects: autism, dyslexia, Down's syndrome: childhood cancers, obesity, and defective fetal cell membranes associated with maternal diabetes. Our metabolism is hugely influenced also by activity and by affection. Today's foods are often processed beyond the cells' recognition and can result in neurological and physical morbidity and mortality. A diet of unprocessed free-range animals and seafood: legumes, deep-colored vegetables and fruits: nuts, seeds, and whole grains, germ and bran, reinstates nutritional potency.
nutrition, pregnancy, children, diethttp://www.ncbi.nlm.nih.gov/pubmed?term=Katzen-Luchenta%20View this and related abstracts via PubMed here
1077Schulz et al. 2007 - Vitamin A deficiency in pregnant womenVitamin A and beta-carotene supply of women with gemini or short birth intervals: A pilot study Vitamin A and beta-carotene supply of women with gemini or short birth intervals: A pilot studySchulz C, Engel U, Kreienberg R, Biesalski HK.01/02/2007European Journal of Nutrition46(1)12-20Steinkopff Darmstadt
BACKGROUND: An adequate supply of vitamin A during pregnancy and breastfeeding plays an important role for development of foetus and neonate, especially in lung development and function.
AIM OF THE STUDY: Aim of this pilot study was to analyze vitamin A and beta-carotene status and to investigate the contribution of nutrition to the vitamin A and beta-carotene supply in mother-infant pairs of gemini or births within short birth intervals.
METHODS: Twenty-nine volunteers aged between 21 and 36 years were evaluated for 48 h after delivery. During this time frame a food frequency protocol considering 3 months retrospective was obtained from all participants. In order to establish overall supply retinol and beta-carotene levels were determined in maternal plasma, cord blood and colostrum via HPLC analysis.
RESULTS: Regardless of the high to moderate socio-economic background, 27.6% of participants showed plasma retinol levels below 1.4 mumol/l which can be taken as borderline deficiency. In addition, 46.4% showed retinol intake <66 % of RDA and 50.0% did not consume liver at all although liver contributes as a main source for preformed retinol. Despite high total carotenoid intake of 6.9 +/- 3.6 mg/d, 20.7% of mothers showed plasma levels <0.5 mumol/l beta-carotene. Retinol and beta-carotene levels were highly significantly correlated between maternal plasma versus cord blood and colostrum. In addition, significantly lower levels were found in cord blood (31.2 +/- 13.0% (retinol), 4.1 +/- 1.4% (beta-carotene) compared with maternal plasma.
CONCLUSIONS: Despite the fact that vitamin A and beta-carotene rich food is generally available, risk groups for low vitamin A supply exist in the western world.
Pregnant and breastfeeding mothers need an adequate supply of vitamin A for normal development of their babies, both in the womb and after birth. Vitamin A is especially important at these stages for lung development and function.
In this study, Vitamin A status in 29 mothers was assessed just after they gave birth, using blood and first breastmilk samples as well as questionnaires about dietary intake over the previous 3 months. All were mothers of twins, or children born only a short time after a previous child, and they were between 21 and 36 years of age.
More than 25% (one in every four) of these mothers showed borderline deficiency of active Vitamin A (retinol) from blood samples, and food frequency questionnaires showed that almost half had a low dietary intake of this essential nutrient. (Liver is a particularly rich source, but one in two mothers reported that they never ate liver).
Over 20% of mothers (one in every five) showed low blood levels of beta-carotene, despite reporting a dietary intake that appeared satisfactory. (Beta-carotene and other carotenoids are found in many fruits and vegetables, and can be converted within the body into active Vitamin A).
Measures of both active Vitamin A and beta-carotene in the mothers’ blood were directly related to the levels found in umbilical cord blood and first breast milk (colostrum). However, the levels of these nutrients in cord blood were significantly lower than those in the mothers’ general blood circulation.
The researchers emphasized that these mothers were from high- to moderate socio-economic backgrounds, and pointed out that vitamin A and beta-carotene rich food is generally available in the western world (this study was carried out in Germany). Despite this, the findings from this study clearly show that risk groups for low vitamin A supply do exist in developed countries.
vitamin a, beta-carotene, pregnancy, experimental study, blood biochemistryhttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17103079&query_hl=20&itool=pubmed_DocSumview full abstract via PubMed here
105023 January 2007 - Glasgow - Diet, Behaviour and The Junk Food GenerationA MacKay Hannah conference produced in association with FAB Research23/01/200723/01/2007
How diet affects children's behaviour, learning and mood
What we feed our children is at the heart of political and public debate - primarily in relation to physical health and well-being. However, a growing body of evidence now supports the view that the right nutrition is just as important for the optimal mental development and functioning of children. In terms of the policy challenge to promote holistic health and well-being, the link between diet and behaviour is a crucial part of this agenda.
Are the many behaviour problems which impact upon learning, teaching and welfare of our children diet related? How does the food we are feeding children affect their brains - and what can be done about it?
This one day conference will focus on how food affects children's behaviour, learning and mood: in particular the potential links between food and the growth of known disorders such as ADHD, Dyslexia, Dyspraxia and Autistic Spectrum.
An essential conference for educators, healthcare professionals and others involved with the care and well-being of children and young people.
Topics to be covered:
The development of the post-war diet in Britain
The relationship between diet and brain function (from a scientific perspective)
The importance of nutrition for behaviour, learning and mood (with reference to Omega 3)
Nutritional approaches to learning disorders
Diet and anti-social behaviour
Science-based dietary intervention to combat behaviour and low attainment
How practical strategies can be deployed nationally within the education service to help pupils and teachers
The evidence base: bridging the gap between science fact and science fiction
The role and responsibilities of Government
Keynote speaker: Dr Alex Richardson, Senior Research Fellow, University Laboratory of Physiology, Oxford and Director of FAB Research
Dr Paul Montgomery - Leader, Evidence-Based Intervention Unit, University Department of Social Policy & Social Work, Oxford
Professor John Stein - Professor of Neurophysiology, University of Oxford and Chair of the Dyslexia Research Trust
David Rex - Lead Child Health Dietician, NHS Highland
Dr Mary Bellizzi - National Development Officer (Food & Nutrition), Scottish Health Promoting Schools Unit (SHPSU)
Bernard Gesch, Senior Research Scientist, University Laboratory of Physiology, Oxford and Director of the research charity, Natural Justice
Dr Tom Gilhooly, Glasgow-based GP, Managing Director of The Centre for Nutritional Studies Ltd and Clinical Director of Glasgow Health Solutions Ltd.
FULL RATE £230.00 + VAT (£270.25) (local authorities, public and private sector organisations)
LOWER RATE £110.00 + VAT (£129.95) (academics & community organisations)
Booking forms and payments to be submitted to MacKay Hannah (address details included on booking form).
SPECIAL RATES FOR FAB ASSOCIATE MEMBERS
We have negotiated a 30% reduction in delegate fees to all those who are current Associate Members of FAB Research. This reduction will apply to whichever rate is applicable to you above. FAB Associate Members who wish to attend the conference at the reduced rate should contact Jasmin Guenther, MacKay Hannah, on 0131 556 1500 to make their booking. If you are unsure of your associate membership status, please contact FAB Research on 01463 667318.
One dayGlasgowThe Radisson Hotelenquiries@mackayhannah.comhttp://www.ultrasoft.hostinguk.com/mackayhannah/diet2.htmVisit the MacKay Hannah website here for further details13358 Mackay Diet_Mackay Diet.pdfDownload full brochure, agenda and booking form hereMacKay Hannah Conference Folder.jpgPhoto of brochure
1172Toxic Childhood - by Sue PalmerToxic Childhood: How the modern world is damaging our children and what we can do about itToxic Childhood; Sue PalmerSue Palmer10/01/2007
Ever heard someone talking disparagingly about the "youth of today"? Ever thought that kids today seem unable to hold a conversation, behavioural disorders seem to be on the rise and that the old-fashioned adage of 'respecting your elders' has withered away?
Sue Palmer neatly labels this as "toxic childhood syndrome" - and we soon see how apt this diagnosis is as she produces a mind-boggling cocktail of causes, consequences and potential cures.
Ingredients such as sleep deprivation, family time, television and advertising and others are placed under the microscope, and you could say that this book is a societal autopsy which yields alarming results. Sue Palmer treads with caution, however, in urging us to resist the common temptation to brazenly lay blame in one area, (ie the parents). What arises from these factors is a vicious circle of epic proportions.
Importantly for a book with so much to offer, her findings are laid out in bite-sized sections. More importantly still, Palmer keeps a tight rein on herself and never digresses into the patronising tone that often accompanies books on this topic. Each chapter is succinctly rounded up with practical suggestions that can be adopted to suit the needs of individual children.
Her many years of experience in education are obvious from the start, and they provide a solid grounding for her thorough research. Fluent writing and sparse touches of humour maintain the reader's interest and while never light-hearted, Toxic Childhood makes very accessible work of what could easily become a depressing subject.
Whether or not you are a teacher, youth worker, parent or anyone else who comes into contact with kids, this book is both an uplifting battle-cry and an essential tool in our understanding of the children of today and of tomorrow.
Sue Palmer; Toxic ChildhoodTixic Childhood.jpgToxic Childhoodhttp://www.amazon.co.uk/exec/obidos/ASIN/0752880918/fabresearfood-21http://www.amazon.com/exec/obidos/ASIN/0752880918/fabresearch-20
Foods Matter is a monthly magazine providing information, support and inspiration for anyone with a food allergy, food intolerance or food sensitivity and who has to live on a wheat-free, gluten-free, dairy-free or anything-else-free diet.
You can receive the magazine on line (UK or US version) or in print, and they offer three trial issues to new subscribers. Visit their website and go straight to their subscription page and see what is in the current month's Foods Matter.
The Foods Matter website is built around a substantial archive of articles focusing on the many conditions related to food allergy and food intolerance - which can require a wheat-free, dairy-free or other-food-free diet - and some of the therapies that have proved helpful.
There is a 'Conditions' home page where you can find the condition that interests you; and a 'Therapies' home page.
To keep a finger on the pulse of food intolerance you can sign up for free 'Updates' on Foods Matter. Or, if you know someone who might find Foods Matter useful, you can email them and send them direct to the site.
Food allergy or food intolerance sufferers who wish to eat out or to create wheat-free, dairy-free and other 'free from' foods should look at their Allergy Catering Manual and their Allergy Aware Schools Catering Manual.
http://www.foodsmatter.comVisit the Foods Matter website hereJanuary-07-cover.jpgFoods Matter cover
10933 January 2007 - Reuters - Jury still out on fish oil for depressionfish oil, depression, reviewThough some research has suggested that fish oil may fight depression, the evidence from clinical trials is too mixed to draw any conclusions, according to a new research review.03/01/2007
NEW YORK (Reuters Health) - In an analysis of 12 recent clinical trials, British researchers found little evidence that omega-3 polyunsaturated fatty acids (PUFAs) improved participants' depression. In general, they report in the American Journal of Clinical Nutrition, the studies were small, short-term and had substantial differences in their methodology that make it hard to draw firm conclusions.
One problem is that the trials included a wide range of patients, according to Dr. Katherine M. Appleton and her colleagues at the University of Bristol. Some studies examined adults with major depression, while others focused on bipolar disorder. Some assessed depression in people with other disorders, such as chronic fatigue syndrome or obsessive-compulsive disorder.
In addition, the treatment type and doses varied widely. In some studies, participants took omega-3 supplements along with their standard therapy, while other studies used only the supplements. One study looked at the effects of eating fish.
"Trial evidence that examines the effects of omega-3 PUFAs on depressed mood is limited and is difficult to summarize and evaluate because of considerable heterogeneity," Appleton and her colleagues write. What evidence there is, they conclude, offers "little support" for using fish oil to fight depression.
In theory, omega-3 fats could affect depression symptoms through their action in the brain. Several studies have suggested the fatty acids aid in the function of certain chemical messengers in the brain that are linked to depression. In addition, some population studies have found that people who regularly eat fish have a relatively lower risk of depression.
However, the promise from studies like these is not always duplicated in clinical trials, where researchers rigorously test a treatment against a placebo, or inactive treatment.
According to Appleton's team, larger, well-conducted clinical trials of fish oil for depression are still needed.
1072Kang et al. 2006 - Vitamin E and cognitive function in women - RCTA randomized trial of vitamin E supplementation and cognitive function in women. A randomized trial of vitamin E supplementation and cognitive function in womenKang JH, Cook N, Manson J, Buring JE, Grodstein F.11/12/2006Archives of Internal Medicine166(22)2462-8American Medical Association
BACKGROUND: Oxidative stress may play a key role in the development of cognitive impairment. Long-term supplementation with vitamin E, a strong antioxidant, may provide cognitive benefits.
METHODS: The Women's Health Study is a randomized, double-blind, placebo-controlled trial of vitamin E supplementation (600 IU (alpha-tocopherol acetate), on alternate days) begun between 1992 and 1995 among 39 876 healthy US women. From 1998, 6377 women 65 years or older participated in a cognitive substudy. Three cognitive assessments of general cognition, verbal memory, and category fluency were administered by telephone at 2-year intervals. The primary outcome was a global composite score averaging performance on all tests. Repeated measures analyses were conducted to examine mean performance and mean differences in cognitive change, and logistic regression was used to estimate relative risks of substantial decline. RESULTS: There were no differences in global score between the vitamin E and placebo groups at the first assessment (5.6 years after randomization: mean difference, -0.01; 95% confidence interval (CI), -0.04 to 0.03) or at the last assessment (9.6 years of treatment: mean difference, 0.00; 95% CI, -0.04 to 0.04). Mean cognitive change over time was also similar in the vitamin E group compared with the placebo group for the global score (mean difference in change, 0.02; 95% CI, -0.01 to 0.05; P = .16). The relative risk of substantial decline in the global score in the vitamin E group compared with the placebo group was 0.92 (95% CI, 0.77 to 1.10).
CONCLUSION: Long-term use of vitamin E supplements did not provide cognitive benefits among generally healthy older women.
Many aspects of physical and mental degeneration associated with aging involve ‘oxidative stress’ - in which damaging substances called free radicals overwhelm the body’s antioxidant defences. Vitamin E is a potent antioxidant, so this study was designed to test whether it might offer some protection against age-related cognitive decline if provided as a dietary supplement.
In a long-term randomized controlled trial (RCT), 6377 women aged 65 years or older from the larger ‘Women’s Health study’ were given either Vitamin E supplements or placebo every other day for almost 10 years. After more than 5 years of supplementation they were then assessed (by telephone) on measures of general cognition, verbal memory, and category fluency three times at 2-year intervals. Scores on these tests were combined to provide a total ‘cognitive function’ score on which the women taking Vitamin E supplements (in the form of alpha-tocopherol acetate, 600 IU) were compared at each timepoint with those taking placebo.
No significant differences were found between the two groups on any of these measures at any timepoint. The researchers concluded that long-term use of vitamin E supplements did not provide cognitive benefits among generally healthy older women.
Population studies have indicated that diets rich in Vitamin E may offer protection from a number of conditions linked with oxidative stress, including age-related cognitive decline. However, RCTs (such as this trial) are the only kind of study that can provide definitive evidence of cause-and-effect relationships.
No obvious benefits for cognitive function were found in women aged over 65 years who took Vitamin E supplements for several years. The supplements provided only one (synthetic) form of Vitamin E, however, which is found naturally in at least 8 different forms. Even more important is the fact that foods rich in vitamin E (such as nuts, seeds and whole grains) also provide many other micronutrients, macronutrients and dietary fibre. Nutrients work in ‘synergy’ – meaning that their combined effects on physical and mental health are likely to be more important that the effects of any one nutrient in isolation.
It may well be that Vitamin E per se is not a critical factor in protecting against age-related cognitive decline. But it would be wrong to dismiss the potential benefits of Vitamin E (or any other nutrients) purely on the basis of controlled trials like this one, which are far better suited to the assessment of pharmaceutical drugs. Changes in actual diet are extremely difficult to study under controlled conditions like this, of course – but to improve our understanding of the role of nutrition in health this challenge needs to be addressed, and the overall balance of different kinds of evidence should always be considered.
vitamin e, cognitive function, ageinghttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17159011&query_hl=14&itool=pubmed_docsumread full abstract via PubMed here
1100Morse & Clough 2006 - A meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczemaA meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries?A meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries?Morse, N L and Clough P M07/12/2006PMID: 17168667 [PubMed - indexed for MEDLINE]
The global incidence of atopic eczema is escalating. While new treatment options are becoming available, previous treatments with certain confirmed benefits are still worth investigating as safe and effective therapies.
One such treatment, Efamol evening primrose oil (EPO), was proven efficacious in a 1989 meta-analysis of randomized, double-blind, placebo-controlled clinical trials. A decade of further testing and subsequent independent reanalysis of 26 clinical studies including 1207 patients presented here, establishes that Efamol EPO has a simultaneous, beneficial effect on itch/pruritis, crusting, oedema and redness (erythema) that becomes apparent between 4 and 8 weeks after treatment is initiated.
However, the magnitude of this effect is reduced in association with increasing frequency of potent steroid use. This and other confounding variables that are now being reported in the literature may account for historically reported inconsistent patient response.
Recent research has uncovered unique complexities in fatty acid metabolism and immune response in the atopic condition beyond those previously reported and may well have identified a subcategory of non-responders and has helped established those that can consistently derive significant benefit. Further research is needed to provide a better understanding of the physiology behind this complex disorder and the beneficial role that fatty acids can play in its development and management.
CONCLUSION: Efamol EPO has a simultaneous, beneficial effect on itch/pruritis, crusting, oedema and redness (erythema) that becomes apparent between 4 and 8 weeks after treatment is initiated. However, the magnitude of this effect is reduced in association with increasing frequency of potent steroid use.
eczema, atopy, evening primrose oil, clinical trials, treatment, RCT, meta-analysis, human studieshttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17168667&query_hl=4&itool=pubmed_docsumView this extract via PubMed here
104924th Nov 2006 - Cardiff - Diet, Nutrition and Behaviour24th Nov 2006 - Cardiff - Diet, Nutrition and BehaviourThe Association for Child and Adolescent Mental Health in Wales, with FAB Research24/11/200624/11/2006
Diet, Nutrition and Behaviour
A full-day conference organised by the ACAMH in Wales, in collaboration with FAB Research.
Find out about the latest research into the effects of diet on child hehaviour, learning and mood, and its implications for parents and practitioners in health, education and allied disciplines.
Material covered will be generally applicable, but with particular relevance to conditions such as ADHD, dyslexia, dyspraxia, mood disorders and the autistic spectrum.
Dr Alex Richardson Senior Research Fellow at the University of Oxford; Founder Director of Food And Behaviour Research; and author of 'They Are What You Feed Them'
David Rex Child Health Lead Dietitian for NHS Highland; and Healthy Eating in Schools Co-ordinator
ACAMH is multidisciplinary and welcomes attendance from those in learning support, psychology, education, educational psychology, psychiatry, nursing, social work, youth justice, indeed anyone working within Child & Adolescent Mental Health.
9.15 - 4.15Cardiff, South WalesThe Holiday Inn Hotel, Cardiff City CentreRosemary Mackenzie0141 445 4340http://WWW.ACAMH.ORG.UKVisit the ACAMH website here
104617 Oct 2006 - The Guardian - Omega-3, junk food and the link between violence and what we eatOmega-3, junk food and the link between violence and what we eat17/10/2006by Felicity Lawrence
Research with British and US offenders suggests nutritional deficiencies may play a key role in aggressive behaviour
That Dwight Demar is able to sit in front of us, sober, calm, and employed, is "a miracle", he declares in the cadences of a prayer-meeting sinner. He has been rocking his 6ft 2in bulk to and fro while delivering a confessional account of his past into the middle distance. He wants us to know what has saved him after 20 years on the streets: "My dome is working. They gave me some kind of pill and I changed. Me, myself and I, I changed."
Demar has been in and out of prison so many times he has lost count of his convictions. "Being drunk, being disorderly, trespass, assault and battery; you name it, I did it. How many times I been in jail? I don't know, I was locked up so much it was my second home."
Demar has been taking part in a clinical trial at the US government's National Institutes for Health, near Washington. The study is investigating the effects of omega-3 fatty acid supplements on the brain, and the pills that have effected Demar's "miracle" are doses of fish oil.
The results emerging from this study are at the cutting edge of the debate on crime and punishment. In Britain we lock up more people than ever before. Nearly 80,000 people are now in our prisons, which reached their capacity this week. But the new research calls into question the very basis of criminal justice and the notion of culpability. It suggests that individuals may not always be responsible for their aggression. Taken together with a study in a high-security prison for young offenders in the UK, it shows that violent behaviour may be attributable at least in part to nutritional deficiencies.
The UK prison trial at Aylesbury jail showed that when young men there were fed multivitamins, minerals and essential fatty acids, the number of violent offences they committed in the prison fell by 37%.
Although no one is suggesting that poor diet alone can account for complex social problems, the former chief inspector of prisons Lord Ramsbotham says that he is now "absolutely convinced that there is a direct link between diet and antisocial behaviour, both that bad diet causes bad behaviour and that good diet prevents it."
The Dutch government is currently conducting a large trial to see if nutritional supplements have the same effect on its prison population. And this week, new claims were made that fish oil had improved behaviour and reduced aggression among children with some of the most severe behavioural difficulties in the UK. Deficiency
For the clinician in charge of the US study, Joseph Hibbeln, the results of his trial are not a miracle, but simply what you might predict if you understand the biochemistry of the brain and the biophysics of the brain cell membrane. His hypothesis is that modern industrialised diets may be changing the very architecture and functioning of the brain.
We are suffering, he believes, from widespread diseases of deficiency. Just as vitamin C deficiency causes scurvy, deficiency in the essential fats the brain needs and the nutrients needed to metabolise those fats is causing of a host of mental problems from depression to aggression. Not all experts agree, but if he is right, the consequences are as serious as they could be. The pandemic of violence in western societies may be related to what we eat or fail to eat. Junk food may not only be making us sick, but mad and bad too.
In Demar's case the aggression has blighted many lives. He has attacked his wife. "Once she put my TV out the door, I snapped off and smacked her." His last spell in prison was for a particularly violent assault. "I tried to kill a person. Then I knew something needed be done because I was half a hundred and I was either going to kill somebody or get killed."
Demar's brain has blanked out much of that last attack. He can remember that a man propositioned him for sex, but the details of his own response are hazy.
When he came out of jail after that, he bought a can of beer and seemed headed for more of the same until a case worker who had seen adverts for Hibbeln's trial persuaded him to take part. The researchers at the National Institute on Alcohol Abuse and Alcoholism, which is part of NIH, had placed adverts for aggressive alcoholics in the Washington Post in 2001. Some 80 volunteers came forward and have since been enrolled in the double blind study. They have ranged from homeless people to a teacher to a former secret service agent. Following a period of three weeks' detoxification on a locked ward, half were randomly assigned to 2 grams per day of the omega-3 fatty acids EPA and DHA for three months, and half to placebos of fish-flavoured corn oil.
An earlier pilot study on 30 patients with violent records found that those given omega-3 supplements had their anger reduced by one-third, measured by standard scales of hostility and irritability, regardless of whether they were relapsing and drinking again. The bigger trial is nearly complete now and Dell Wright, the nurse administering the pills, has seen startling changes in those on the fish oil rather than the placebo. "When Demar came in there was always an undercurrent of aggression in his behaviour. Once he was on the supplements he took on the ability not to be impulsive. He kept saying, 'This is not like me'."
Demar has been out of trouble and sober for a year now. He has a girlfriend, his own door key, and was made employee of the month at his company recently. Others on the trial also have long histories of violence but with omega-3 fatty acids have been able for the first time to control their anger and aggression. J, for example, arrived drinking a gallon of rum a day and had 28 scars on his hand from punching other people. Now he is calm and his cravings have gone. W was a 19st barrel of a man with convictions for assault and battery. He improved dramatically on the fish oil and later told doctors that for the first time since the age of five he had managed to go three months without punching anyone in the head.
Threat to society
Hibbeln is a psychiatrist and physician, but as an employee of the US government at the NIH he wears the uniform of a commander, with his decorations for service pinned to his chest. As we queued to get past the post-9/11 security checks at the NIH federal base, he explained something of his view of the new threat to society.
Over the last century most western countries have undergone a dramatic shift in the composition of their diets in which the omega-3 fatty acids that are essential to the brain have been flooded out by competing omega-6 fatty acids, mainly from industrial oils such as soya, corn, and sunflower. In the US, for example, soya oil accounted for only 0.02% of all calories available in 1909, but by 2000 it accounted for 20%. Americans have gone from eating a fraction of an ounce of soya oil a year to downing 25lbs (11.3kg) per person per year in that period.
In the UK, omega-6 fats from oils such as soya, corn, and sunflower accounted for 1% of energy supply in the early 1960s, but by 2000 they were nearly 5%. These omega-6 fatty acids come mainly from industrial frying for takeaways, ready meals and snack foods such as crisps, chips, biscuits, ice-creams and from margarine. Alcohol, meanwhile, depletes omega-3s from the brain.
To test the hypothesis, Hibbeln and his colleagues have mapped the growth in consumption of omega-6 fatty acids from seed oils in 38 countries since the 1960s against the rise in murder rates over the same period. In all cases there is an unnerving match. As omega-6 goes up, so do homicides in a linear progression. Industrial societies where omega-3 consumption has remained high and omega-6 low because people eat fish, such as Japan, have low rates of murder and depression.
Of course, all these graphs prove is that there is a striking correlation between violence and omega 6-fatty acids in the diet. They don't prove that high omega-6 and low omega-3 fat consumption actually causes violence. Moreover, many other things have changed in the last century and been blamed for rising violence - exposure to violence in the media, the breakdown of the family unit and increased consumption of sugar, to take a few examples. But some of the trends you might expect to be linked to increased violence - such as availability of firearms and alcohol, or urbanisation - do not in fact reliably predict a rise in murder across countries, according to Hibbeln.
There has been a backlash recently against the hype surrounding omega-3 in the UK from scientists arguing that the evidence remains sketchy. Part of the backlash stems from the eagerness of some supplement companies to suggest that fish oils work might wonders even on children who have no behavioural problems.
Alan Johnson, the education secretary, appeared to be jumping on the bandwagon recently when he floated the idea of giving fish oils to all school children. The idea was quickly knocked down when the food standards agency published a review of the evidence on the effect of nutrition on learning among schoolchildren and concluded there was not enough to conclude much, partly because very few scientific trials have been done.
Professor John Stein, of the department of physiology at Oxford University, where much of the UK research on omega-3 fatty acid deficiencies has been based, agrees: "There is only slender evidence that children with no particular problem would benefit from fish oil. And I would always say (for the general population) it's better to get omega-3 fatty acids by eating fish, which carries all the vitamins and minerals needed to metabolise them."
However, he believes that the evidence from the UK prison study and from Hibbeln's research in the US on the link between nutritional deficiency and crime is "strong", although the mechanisms involved are still not fully understood.
Hibbeln, Stein and others have been investigating what the mechanisms of a causal relationship between diet and aggression might be. This is where the biochemistry and biophysics comes in.
Essential fatty acids are called essential because humans cannot make them but must obtain them from the diet. The brain is a fatty organ - it's 60% fat by dry weight, and the essential fatty acids are what make part of its structure, making up 20% of the nerve cells' membranes. The synapses, or junctions where nerve cells connect with other nerve cells, contain even higher concentrations of essential fatty acids - being made of about 60% of the omega-3 fatty acid DHA.
Communication between the nerve cells depends on neurotransmitters, such as serotonin and dopamine, docking with receptors in the nerve cell membrane. Omega-3 DHA is very long and highly flexible. When it is incorporated into the nerve cell membrane it helps make the membrane itself elastic and fluid so that signals pass through it efficiently. But if the wrong fatty acids are incorporated into the membrane, the neurotransmitters can't dock properly. We know from many other studies what happens when the neurotransmitter systems don't work efficiently. Low serotonin levels are known to predict an increased risk of suicide, depression and violent and impulsive behaviour. And dopamine is what controls the reward processes in the brain.
Laboratory tests at NIH have shown that the composition of tissue and in particular of the nerve cell membrane of people in the US is different from that of the Japanese, who eat a diet rich in omega-3 fatty acids from fish. Americans have cell membranes higher in the less flexible omega-6 fatty acids, which appear to have displaced the elastic omega-3 fatty acids found in Japanese nerve cells.
Hibbeln's theory is that because the omega-6 fatty acids compete with the omega-3 fatty acids for the same metabolic pathways, when omega-6 dominates in the diet, we can't convert the omega-3s to DHA and EPA, the longer chain versions we need for the brain. What seems to happen then is that the brain picks up a more rigid omega-6 fatty acid DPA instead of DHA to build the cell membranes - and they don't function so well.
Other experts blame the trans fats produced by partial hydrogenation of industrial oils for processed foods. Trans fats have been shown to interfere with the synthesis of essentials fats in foetuses and infants. Minerals such as zinc and the B vitamins are needed to metabolise essential fats, so deficiencies in these may be playing an important part too.
There is also evidence that deficiencies in DHA/EPA at times when the brain is developing rapidly - in the womb, in the first 5 years of life and at puberty - can affect its architecture permanently. Animal studies have shown that those deprived of omega-3 fatty acids over two generations have offspring who cannot release dopamine and serotonin so effectively. "The extension of all this is that if children are left with low dopamine as a result of early deficits in their own or their mother's diets, they cannot experience reward in the same way and they cannot learn from reward and punishment. If their serotonin levels are low, they cannot inhibit their impulses or regulate their emotional responses," Hibbeln points out.
Here too you have one possible factor in cycles of deprivation (again, no one is suggesting diet is the only factor) and why criminal behaviour is apparently higher among lower socio-economic groups where nutrition is likely to be poorer. These effects of the industrialisation of the diet on the brain were also predicted in the 1970s by a leading fats expert in the UK, Professor Michael Crawford, now at London's Metropolitan University. He established that DHA was structural to the brain and foresaw that deficiencies would lead to a surge in mental health and behavioural problems - a prediction borne out by the UK's mental health figures.
It was two decades later before the first study of the effect of diet on behaviour took place in a UK prison. Bernard Gesch, now a senior researcher at Stein's Oxford laboratory, first became involved with nutrition and its relationship to crime as a director of the charity Natural Justice in northwest England. He was supervising persistent offenders in the community and was struck by their diets. He later set out to test the idea that poor diet might cause antisocial behaviour and crime in the maximum security Aylesbury prison.
His study, a placebo-controlled double blind randomised trial, took 231 volunteer prisoners and assigned half to a regime of multivitamin, mineral and essential fatty acid supplements and half to placebos. The supplement aimed to bring the prisoners' intakes of nutrients up to the level recommended by government. It was not specifically a fatty acid trial, and Gesch points out that nutrition is not pharmacology but involves complex interactions of many nutrients.
Aylesbury was at the time a prison for young male offenders, aged 17 to 21, convicted of the most serious crimes. Trevor Hussey was then deputy governor and remembers it being a tough environment. "It was a turbulent young population. They had problems with their anger. They were all crammed into a small place and even though it was well run you got a higher than normal number of assaults on staff and other prisoners."
Although the governor was keen on looking at the relationship between diet and crime, Hussey remembers being sceptical himself at the beginning of the study. The catering manager was good, and even though prisoners on the whole preferred white bread, meat and confectionery to their fruit and veg, the staff tried to encourage prisoners to eat healthily, so he didn't expect to see much of a result.
But quite quickly staff noticed a significant drop in the number of reported incidents of bad behaviour. "We'd just introduced a policy of 'earned privileges' so we thought it must be that rather than a few vitamins, but we used to joke 'maybe it's Bernard's pills'." But when the trial finished it became clear that the drop in incidents of bad behaviour applied only to those on the supplements and not to those on the placebo.
The results, published in 2002, showed that those receiving the extra nutrients committed 37% fewer serious offences involving violence, and 26% fewer offences overall. Those on the placebos showed no change in their behaviour. Once the trial had finished the number of offences went up by the same amount. The office the researchers had used to administer nutrients was restored to a restraint room after they had left.
"The supplements improved the functioning of those prisoners. It was clearly something significant that can't be explained away. I was disappointed the results were not latched on to. We put a lot of effort into improving prisoners' chances of not coming back in, and you measure success in small doses."
Gesch believes we should be rethinking the whole notion of culpability. The overall rate of violent crime in the UK has risen since the 1950s, with huge rises since the 1970s. "Such large changes are hard to explain in terms of genetics or simply changes of reporting or recording crime. One plausible candidate to explain some of the rapid rise in crime could be changes in the brain's environment. What would the future have held for those 231 young men if they had grown up with better nourishment?" Gesch says. He said he was currently unable to comment on any plans for future research in prisons, but studies with young offenders in the community are being planned.
For Hibbeln, the changes in our diet in the past century are "a very large uncontrolled experiment that may have contributed to the societal burden of aggression, depression and cardiovascular death". To ask whether we have enough evidence to change diets is to put the question the wrong way round. Whoever said it was safe to change them so radically in the first place?
Young offender's diet
One young offender had been sentenced by the British courts on 13 occasions for stealing trucks in the early hours of the morning. Bernard Gesch recorded the boy's daily diet as follows: Breakfast: nothing (asleep) Mid morning: nothing (asleep) Lunchtime: 4 or 5 cups of coffee with milk and 2? heaped teaspoons of sugar Mid afternoon: 3 or 4 cups of coffee with milk and 2.5 heaped sugars Tea: chips, egg, ketchup, 2 slices of white bread, 5 cups of tea or coffee with milk and sugar Evening: 5 cups of tea or coffee with milk and sugar, 20 cigarettes, £2 worth of sweets, cakes and if money available 3 or 4 pints of beer.
http://www.guardian.co.uk/food/Story/0,,1924088,00.htmlView this article in the Guardian online hereYoung offender.jpg
104417 October 2006 - BBC News - 'Hidden' fats removed from foodhidden fats; trans fats; hydrogenated fats; bad fats17/10/2006
Trans fats, made from vegetable oil and used in processed foods, have been linked to raised cholesterol.
The Food and Drink Federation has said hundreds of well-known brands, such as Horlicks, Mars and Weetabix, are being reformulated to eliminate trans fats.
Heart experts called for food labels to list trans fats levels. Denmark has already banned their use in foods, and the British Heart Foundation said there appeared to have been no impact on the consumer.
The FDF polled 20 top food and drink manufacturers, asking about their position on trans fats. Of those, 11 companies came back with details while the other nine either had no trans fats in their products or did not release details.
Based on these responses, the FDF has put a retail value of £1.5 billion on the products being reformulated.
Julian Hunt of the FDF said many companies had "dramatically" cut trans fats over the past two years. "The industry is committed to reducing the level of trans fats to as low as is technically possible and has been actively reducing these levels.
A report in the British Medical Journal published earlier this year called for trans fat content levels to be shown on product labels. Alex Callaghan of the British Heart Foundation said: "It's good to see some food manufacturers and retailers committing to reducing trans fats from their products.
"But until they are completely removed we can only take manufacturers' word for it that these levels are being reduced, since most continue to refuse to label trans fats on their products."
The BHF said it wants the listing of trans fat levels on food labels to be made compulsory.
http://news.bbc.co.uk/1/hi/health/6058416.stmRead the BBC News item hereMargarine.jpg
104517 October 2006 - BBC News - Benefits of fish 'outweigh risks'mercury; toxins in fish; pollutants; oily fish; salmon; mackerelThe benefits of eating fish outweigh any potential health risks from pollutants, a study has concluded.17/10/2006
The Harvard School of Public Health reviewed existing studies that looked at the health effects of eating fish. They concluded eating up to two portions of fish a week was beneficial, and eating fish could cut the risk of death from heart disease by a third.
Experts said the Journal of the American Medical Association findings backed UK recommendations. The evidence across different studies showed that fish consumption lowers the risk of death from heart disease by 36%.
The reduced rated of heart disease comes, researchers say, from eating about three ounces of farmed salmon or six ounces of mackerel each week. The benefit was related to the level of intake of omega-3 fatty acids, and thus benefits are greater for oily fish such as salmon, which are higher in such acids, than lean fish, such as haddock and cod.
The researchers also suggest eating that amount of fish or fish oil intake reduces total mortality by 17%.
Dariush Mozaffarian, lead author of the study said: "Overall, for major health outcomes among adults, the benefits of eating fish greatly outweigh the risks. "Somehow this evidence has been lost on the public."
Concerns have been raised about chemicals found in fish from pollution. These include mercury, polychlorinated biphenyls (PCBs) and dioxins. Mr Mozaffarian added: "The levels of PCBs and dioxins in fish species are low, similar to other commonly consumed foods such as beef, chicken, pork, eggs, and butter.
"Importantly, the possible health risks of these low levels of PCBs and dioxins in fish are only a small fraction of the much better established health benefits of the omega-3 fatty acids."
The researchers conducted a search of publications to evaluate studies that looked at the relationship between fish intake and major health benefits, as well as the health risks from pollutants.
Researchers also say they found omega-3 fatty acids from seafood were likely to improve early brain development for infants and young children, and that these benefits can be obtained for babies from pregnant or nursing mothers who consumed fish.
Researcher Eric Rimm said: "Unfortunately, the media and others may have contributed to this confusion by greatly exaggerating the unsubstantiated claim of a health risk from fish.
"These results, from over two decades of research, clearly show there is a health risk if adults don't eat fish."
Judy More, a dietician from the British Dietetic Association, said the research reinforces the advice given by the Food Standards Agency. "The advice in the UK is to eat two servings of fish a week and make one of them oily," she said.
"This research backs that up, which is a good thing because the UK population doesn't eat enough fish. "But the biggest problem with fish testing is that the figures vary. You will get different levels of pollution in different parts of the Atlantic. "The figures provided here are mainly from North America, so whether we would see a difference in Europe we don't know."
The researchers say they did not find definite evidence that low-level mercury exposure from seafood consumption had harmful effects on health in adults. They did, however, find that mercury may lessen the cardiovascular benefit - but not cause overall harm - from eating some fish.
The research paper appears in the October issue of The Journal of the American Medical Association.
http://news.bbc.co.uk/1/hi/health/6057732.stmRead the BBC News item hereoily fish.jpg
1033Liu & Raine 2006 - The effect of childhood malnutrition on externalizing behavior.The effect of childhood malnutrition on externalizing behavior. Liu J, Raine A. 2006 The effect of childhood malnutrition on externalizing behavior.Liu J, Raine A. 01/10/2006Curr Opin Pediatr.18(5):565-70
PURPOSE OF REVIEW: Childhood externalizing behavior (aggression, hyperactivity, and conduct disorder) has been increasingly viewed as a public health problem because of its etiology and outcome. The association between malnutrition and externalizing behavior has begun to receive attention. This review summarizes recent empirical findings on malnutrition as a risk factor for the development of externalizing behavior, with an emphasis on micronutrient deficiency, and explores brain dysfunction as a possible mechanism.
RECENT FINDINGS: Externalizing behavior is associated with both macromalnutrition (e.g. protein) and micromalnutrition (e.g. iron and zinc). Both prenatal and postnatal malnutrition is implicated. The long-term effects of malnutrition on behavior could be reversible. The effects of docosahexaenoic acid/omega-3 long-chain essential fatty acid on externalizing behavior are more mixed. From animal and human findings, it is hypothesized that malnutrition impairs neurocognitive functioning by reducing neurons, alternating neurotransmitter functioning, and increasing neurotoxicity, and that such neurocognitive impairments predispose to externalizing behavior.
SUMMARY: Different lines of evidence support the view that poor nutrition contributes to the development of child behavior problems. More randomized, controlled trials that manipulate nutritional intake and evaluate behavior in children are needed to evaluate the etiological role of nutrition in externalizing behavior in order to inform intervention and prevention efforts.
ADHD, nutrition, diet, conduct disorder, aggression, violencehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16969174&query_hl=16&itool=pubmed_docsumView this and related abstracts via PubMed here
95429 September 2006 - FAB CONFERENCE - Diet, Behaviour and the Junk Food Generation - ManchesterManchester conference; Diet, Behaviour and the Junk Food GenerationFood and Behaviour Research29/09/200629/09/2006
About the conference The dietary habits and overall fitness of our children have become a major cause for concern. Obesity in children continues to rise - but their physical health is not all that's at risk. How does the food we are feeding them affect their brains - and what can be done about it? This conference focuses on the potential links between nutrition and children's behaviour, learning and mood. Hear from some of the UK's leading experts in these areas, who will report on the latest scientific evidence and share best practice in addressing key issues that affect all of our children.
Who should attend This one day event will be of interest to a wide range of Education and Health Professionals including teachers, support workers in education, paediatricians, dieticians, nutritionists, general practitioners, nurses, health visitors, health promotion specialists, catering managers, public health specialists, academics, researchers, prison officers, voluntary and community groups, parents and others involved in the health and care of children and young people.
9.00-9.30am Registration and Coffee
9.30am Welcome & Introduction Lois MacDonell, Associate Research Psychologist
9.35am The importance of nutrition for behaviour, learning and mood Dr Alex Richardson, Senior Research Fellow, Dept of Physiology, Anatomy and Genetics, University of Oxford; Director of FAB Research
10.05am The health implications of dietary changes over the last 50 years Dr Paul Clayton, Fellow of the Royal Society of Medicine; Research Director of Medical Nutrition Matters
10.45-11.15am Refreshment Break
11.15am ADHD, dyslexia, dyspraxia and the autistic spectrum - the role of diet Dr Alex Richardson, Senior Research Fellow, Dept of Physiology, Anatomy and Genetics, University of Oxford; Director of FAB Research
11.55am Nutritional approaches to ADHD & the autistic spectrum David Rex, Child Health Dietician for NHS Highland & Healthy Eating in Schools Co-ordinator
12.30pm Questions and discussion: All speakers
2.00pm Diet and antisocial behaviour Bernard Gesch, Seniour Research Scientist, University Lab of Physiology, Oxford and Founder of the research charity Natural Justice
2.40pm Impact of Fresh, Healthy Foods on Learning and Behaviour a short film showing a real life example of what can be achieved in practice
3.00-3.30pm Refreshment Break
3.30pm Encouraging healthy eating - practical tips and guidance for schools and other organisations David Rex, Child Health Dietician for NHS Highland & Healthy Eating in Schools Co-ordinator
4.00pm Questions and discussion: All speakers
4.15-4.30pm Summary by Dr Alex Richardson
A few special bursary places are still available for this event (priority to parents/carers, students or other special applicants) Call NOW for details
One dayManchesterThe Bridgewater Hall, ManchesterFiona O'Fee - Conference Bookingsadmin@fabresearch.org0870 756 5960http://www.events.fabresearch.org/registration.phpBook and pay online hereManchester flyer - final.pdfDownload Programme and Conference Booking Form hereconf flyer front smaller.jpgFAB Folder
104327 Sept 2006 - The Guardian - Grease is the wordThe British public is belatedly waking up to dangers of trans fats - the cheap, chemically treated oils that lurk unlabelled in many processed foods. Alex Renton investigates the ingredient viewed with suspicion even by the junk food-loving Americans27/09/2006
The brick of vegetable fat is tacky to the touch, grey-white and translucent - like the skin on a corpse, I think, but this is unscientific. We are here to test the semi-solid vegetable fat Cookeen against butter and we must be objective. But the butter looks so much prettier on the baker's rolling board: its genteel yellow makes you think of primroses and little-girls' dresses, not of morgues.
Drew Massey, the baker, makes his mind up pretty quickly. "It just doesn't feel right," he says, as he rubs the vegetable fat into the flour and baking powder. "It's really tough." But he smiles when he turns to do the same with the butter. "That's better." When the eggs and milk are mixed in and both lumps of dough are lying like deflated footballs on the board, ready for cutting into scones, Massey tries to articulate the feeling. "I haven't got the words - it's 30 years of doing it that tells you. This one is ropey, tough. It's not going to be a nice product. But this is nice - it's short. There's no pull on it."
Pull is bad and short is good if you are a scone-baker: the scone will have a crumbly texture because the butter has properly coated the gluten molecules, preventing it from making the chains that will result in "pull" - the elasticity you want in bread but not scones. The hydrogenated vegetable oil (HVO) of the Cookeen, by contrast, seems to have penetrated the gluten. While the two sets of scones bake, Massey reveals his philosophy of ingredients: "I do what my dad did and he did what his dad did."
Massey's father, Ivan, was a traditional master-baker with a chain of shops around Lincoln. He held out against the rise in the 60s of the mega-bakeries, which exploited the new technologies. "He just didn't do any of the new things - no vacuum-processors for the bread, no instant yeasts, no industrial fats - he just didn't see that he was going to bake better."
With these principles as their business plan, Drew and his two partners opened the Manna House in Edinburgh just over a year ago on Easter Road, not the smartest street in central Edinburgh. But despite the presence of a chain-store baker, Gregg's, and a Co-op half a minute's walk down the road, there are queues every morning outside Manna House for rye loaves, bloomers, sourdough and pains au chocolat.
Curiously, when the scones emerge from the oven after 15 minutes the vegetable fat one is a clear winner on looks. It's gold and brown on top, with that classic toppled look, aching to be filled with cream and strawberry jam. Massey starts looking nervous for his butter scones, which are rather squat. But when it comes to the taste test there is no contest. The butter scone melts on the tongue. It crumbles. It's sweet and nutty. The Cookeen scone is sort of rubbery when broken and the taste is metallic, a tap- water flavour: if I hadn't watched the process I would swear it was made with different flour. The Cookeen scone has hydrogenated vegetable oil in it. The Food Standards Agency describes what hydrogenation means: "Hydrogenation is one of the processes that can be used to turn liquid oil into solid fat ... During the process of hydrogenation, trans fats may be formed. This means that foods that contain hydrogenated vegetable oil (always declared in the ingredients list) may also contain trans fats."
When Massey's father was baking in the 50s with eggs and milk, Canadian flour and butter, his colleagues were modernising. That meant using chemical bread-improvers, preservatives such as ascorbic acid, powdered eggs - "My dad hated those" - and, of course, the new hydrogenated fats. These were the result of a simple process perfected at the end of the 19th century. By attaching hydrogen atoms to oil molecules in the high-temperature process called hydrogenation you could raise the melting point of all sorts of previously useless oils - thus making them more stable and suitable for manufacturing everything from soap to axle grease.
In 1911 Procter & Gamble, then a soap and candle-maker, spotted how hydrogenation could be applied to food oils. It made a vegetable fat, Crisco, from cottonseed oil, using unwanted seeds from cotton mills. Tinned Crisco was an immediate hit in US households, cheaper than the lard it replaced and with a life of two years at room temperature before it went off. A replacement for butter followed: the oils for margarine precisely hydrogenated to remain solid at room temperature but giving the sensation of melting in the mouth.
The hydrogenated fats usefully mimicked the properties of pork and beef fats so they went into halal, kosher and vegetarian foods. By the 60s, 60% of American vegetable oils used in food were partly hydrogenated, and some research declared the trans fats actively healthy. In the baking business, the oils were crucial for the new fast-mixing and proving techniques, that needed oils that kept their solidity at widely different temperatures. The fact that these fats didn't go off, like butter or lard, gave bread and pastries a longer shelf life. They also had higher flashpoints, making them safer for frying. And best of all was that the hydrogenated oils - whether they first came from whales or palm trees, soya beans or rapeseed - were fabulously cheap.
Before, the process of baking was designed around the ingredients: now the ingredients were altered for the process. As with so many additives, once the food industry had found the cheapest method (and catering fats based on hydrogenated oil are about 12% the price of butter) it set about justifying it in other ways. Always ready with a euphemism, the industry sold HVOs as "vegetable fats" or "shortening", which certainly sounded nicer than animal fats. And it worked. British home cooks turned from lard and butter to margarine and vegetable fat.
To ascertain what an ordinary consumer might be told about this, I rang the Liverpool helpline of Princes Foods, Cookeen's manufacturers, and asked if I should be worried about the hydrogenated vegetable oil listed on the back of the wrapper. "It's been used for years and we haven't had any problems with it whatsoever," said a friendly woman on the customer-care line. "It's not a health issue."
But, I said, I had read about coronary disease. "Oh, it's just had some adverse publicity. There's been some newspapers talking about heart problems. But it's been used since the early part of this century."
Despite what the helpline said, Cookeen has announced that it will be "reformulating" in the autumn to remove trans fats.
Trans fats, or trans-fatty acids, are the more popular name for HVOs (which, confusingly, are more correctly PHVOs, partially hydrogenated vegetable oils). They have been the food scare of this summer. TF or TFAs are - a quick Google will tell you - the "killer fat", the "Franken-fat that will not die", "more deadly than saturated fats", "furring up our bodies like old kettles". Look a bit further and you can find trans fats "linked" - that dangerous health campaigner's verb - to disorders from Alzheimer's to autism. "Over the years there has been some very good research on TFAs," says Tom Sanders, professor of nutrition and dietetics at King's College, London. "And there has been some ridiculous crap written about them."
But it seems generally agreed that trans fats, like saturated fats, can raise cholesterol levels, put "plaque" on our artery walls and thus in some cases bring about heart attacks. Our bodies find the hydrogen-altered oils hard to break down - in a standard campaigner's formulation: "Would you melt Tupperware and put it on your toast?" Or as the Food Standards Agency puts it, in less loaded language: "The trans fats found in food containing hydrogenated vegetable oil are harmful and have no known nutritional benefits. They raise the type of cholesterol in the blood that increases the risk of coronary heart disease. Some evidence suggests that the effects of these trans fats may be worse than saturated fats."
Alex Richardson is senior research fellow at Oxford University's department of physiology, and director of the campaigning charity Food and Behaviour Research. She believes that Britain should follow Denmark, which has had legislation since 2003 limiting the amount of trans fats in food. "There's nothing to say in trans fats' defence," she says. "They appear to be more dangerous than saturated fats, they have no nutritional value, they are an artificial, toxic fat that we don't need. I don't see just why we can't have them out of the food supply. We have a major public-health problem here with diabetes and heart disease, and losing one contributory fat is a step towards the solution."
The novelty of trans fats in Britain, as opposed to the US, is that they are virtually invisible, lurking on most food labels only in the gap between the number given for "total fats" and the sum of poly-unsaturated, mono-unsaturated and saturated fats listed. If they are listed. Thus, unless you shop with a calculator and a magnifying glass, you are consuming unknowable quantities of trans fats in "healthy" butter substitutes, pastries, cakes, breakfast cereals, snack bars, pizzas, doughnuts, processed cream and ice cream, prepared food designed for vegetarians and, most significantly, deep-fried food.
There is more. Trans fat-laden pastries are abnormally stable - there is a campaigning nutritionist in Chicago who goes on television with a 22-year-old cupcake that still looks as fresh as the day it was baked. And - get this - the invention of the hydrogenation of oil was the trigger for the mechanised slaughter of whales during the 20th century. Whale oil, stabilised by the hydrogenation process, became the most valuable part of the animal. It provided up to 40% of margarines such as Stork and Echo whose taste spoiled so many childhood sandwiches in the 50s and 60s. And so campaigners such as Oliver Tickell, who runs the British anti-trans fat campaign, TFX, now maintain that butter may be healthier for you than trans-fatty margarine.
The food scare of the summer has also been a food campaigner's triumph. In this country, before June, many people probably hadn't heard of trans fats. But then came a rush of scary research - that adverse publicity the Cookeen lady talked of. First, via New Scientist magazine, which reported how 51 vervet monkeys fed trans fats in an experiment in North Carolina appeared to grow dangerously barrel-shaped (it is better to put fat on your bottom, the pear-shape, than around your tummy, where your heart and lungs may suffer). The monkeys, who had been on a high trans-fat diet for seven years, had fared worse than a control group fed merely on saturated fats - the traditional "bad fats". They were also showing early signs of diabetes.
At the end of July, the British Medical Journal published a review of a vast amount of disparate research, which concluded that a 2% rise in our energy intake from trans-fatty acids (say 5g of trans fats a day) "was associated with a 23% increase in the incidence of coronary heart disease". Trans fats had "no nutritional value" and adverse effects showed that even when intake was very low, at about 2-7g a day (100g of Cookeen has 2g of trans fats in it, according to the product's label, while a KFC Colonel's Regular Crispy Strips and Fries can - acccording to a New England Journal of Medicine article earlier this year - contain 4.4g a portion, derived chiefly from its frying oil. Butter contains anything from zero to 3g, but trans fats derived naturally from animals are not believed to be harmful).
In its editorial, the BMJ called on the government to legislate to reduce trans fats to less than 2% of food content (as in Denmark) and force manufacturers to quantify trans fats on labels (as has been done in the US since the beginning of this year). And at least two studies have shown that hydrogenation destroys the healthy Omega 3 oils, and that eating trans fats may block their uptake.
By the end of August, four big British supermarkets (Marks & Spencer, Tesco, Sainsbury's and the Co-op) had all issued deadlines by which they said trans-fatty acids would be gone from their own-label products. Kellogg's, United Biscuits, Nestlé and Cadbury Schweppes issued pledges to reduce or remove TFAs from theirs. The food industry was waving a big white flag: the trans-fat war seemed to have been won before it had really got going. Surprising: Big Food is normally more tenacious. But there is, of course, more to the story.
For a start, trans fats were fast becoming history anyway. This is chiefly because of the rather more advanced anti-TFs campaign in the US, which has been boosted by an unequivocal view from the medical establishment: banning trans fats could save 30,000 American lives per year, the Harvard School of Public Health announced as long ago as 1994. The US campaigners have had some stunning results: McDonald's settled a class-action suit last year with a donation of $7m (£3.7m), admitting it had failed to follow through on a 2002 promise to reduce trans fats in its cooking oil. In 2003 Kraft was successfully sued over trans fats in Oreo biscuits; KFC is now facing a similar lawsuit over its cooking oil. Since January 2006, food labels in the US have had to state trans fat quantities. And Chicago, which in August became the first US city to ban foie gras, may soon be the first to ban trans fats in restaurant cooking oil.
The growing row over trans fats led the US food industry to start researching substitutes: the availability of the new oils may explain why the British food giants are apparently acceding to the campaigners' wishes so swiftly and gracefully. A new refining process called interesterification has meant that the trans-fatty acid- bearing oils can be replaced without extra cost, while retaining what the industry calls "pleasing mouth-feel". If you really want to check this out, take a swig of Unilever's unaccountably popular Elmlea cream substitute - which stays "fresh" for eight weeks with its top off and contains an amazing 26% hydrogenated vegetable oil.
So for the British supermarkets and food processors, the expectation is that it may cost very little to get rid of trans fats and mollify the increasingly suspicious shopper. But there has been little movement from the fried-food industry, which seems wedded to its cheap deep-frying oils, whose hydrogenation means you can use them for longer without changing them (up to three months in some chippies). McDonald's uses EU-subsidised rapeseed oil for frying in Britain and it contains 16% trans fats. The company told me it is "currently evaluating even lower trans content frying media".
Oliver Tickell, of TFX, is calling for legislation to force the food-service sector to be open about trans fats. "Fast food, pub food, restaurant food, high-street bakeries and fish-and-chip shops don't have to label the presence of hydrogenated oil on their products. They haven't come under significant consumer pressure to get the hydrogenated oil out for the simple reason that people do not know it is there."
In the supermarkets, though, we will soon catch up with the US, where snack bars and pastries increasingly carry "Now with no trans fat!" banners. This has led, say some, to higher sales. "People think they mean 'no fats'," says a lobbyist from the Washington-based Centre for Science in the Public Interest, "But a 'No trans fats' sticker sits on a Nestlé Crunch ice cream bar that still contains 11g of saturated fat."
"That's the problem with labelling," says Sanders. "It's the concerned middle class that read them - not the low socio-economic groups. It's rather like putting warnings on cigarette packets. Availability is the key."
Since the late 70s, Sanders has seen partially hydrogenated vegetable oil researched and re-researched, declared safe, unsafe and very unsafe. So what does he think now? Are TFAs more dangerous than saturated fats? He is more equivocal than Richardson, but still concludes that trans fats are best avoided. "I wouldn't call either of them dangerous," he says. "That implies an acute and substantial risk to health. Cigarettes and alcohol are dangerous. I would say that trans fats may entail an increased risk: they are avoidable, so why eat them?
"Trans-fatty acids do not raise cholesterol as much as saturated fatty acids do. I think saturated fat probably causes a greater proportion of the overall risk. We've watched huge economic change in countries like Poland, seen their whole oil and fat supply change (away from animal fats), and we've seen heart disease drop."
During the post-communist 90s, the move away from a controlled economy brought a decline in subsidised dairy and animal fat production. So the Poles started eating more vegetable oils, mainly from rape seed and soy. Consumption of saturated fats dropped by 7% between 1990 and 1999, according to a paper produced by the Warsaw Cancer Centre and the Harvard School of Public Health. And their intake of polyunsaturated "good" fat rose 57% (trans fats weren't measured) - by the end of the decade, they were eating nearly four times as much fruit. By 2002, heart disease in Polish women aged 45-64 had fallen by 42%, compared with 1990, in men by 38%.
Sanders argues that much is hard to prove in this area of food and health - the obesity "epidemic", for example, does not appear to be accompanied by a rise in heart disease. It's a classic case of what he calls residual confounding, where the relationship between the chemistry and the problem may not be causal but it may be associative.
Most important of all, it's the poor who eat high levels of trans fats (the average British intake is just 1.2g a day, well within the strictest guidelines). "And people who eat a lot of deep-fried food and cheap pastries - well, their lifestyle is likely to be pretty bad as well. Cardio-vascular disease is always likely to be related to socio-economic station," Sanders says.
Richardson and Sanders agree that labelling on food products isn't working. "Trying to educate the people who eat the most fats is very difficult," Richardson says, "and all this bleating about voluntary self-regulation, letting the industry police itself just won't wash. Get real. The industry looks after its profits - the real costs of these foods are paid by the people who eat them and by the taxpayers who fund the health service. We need education, we need transparency from the food industry, and we need legislation."
Back on Easter Road in Edinburgh, I go in to Giovanni's fish and chip bar, where Jean Watson sells me a spam fritter for 90p. What was it cooked in, I ask? "Danish oil." What's that? She goes to look at the box. "Well, it's 20% vegetable oil, it says, and the rest is just ordinary oil, like." Jean has never heard of trans fats but she has had some bread rolls from the new bakery up the road. "They were lovely!"
Claire Coussmaker is a partner in the Manna House bakery and is its pastry chef. When she blind-tasted Drew's scones she had no trouble distinguishing the Cookeen one from the one made with butter. "This is a scone. This is cardboard." She held the Cookeen scone up as you might a dead mouse.
"It's like so many things you get in shops - they look great but they are just disappointing. I think that's the problem - that's why people eat so much. If the taste is not there, you just keep on eating. If it's made properly, with pure ingredients, it's satisfying from the inside out. You don't need any more."
http://environment.guardian.co.uk/food/story/0,,1881919,00.htmlView this article via the Guardian website hereFRY-UP ON A PLATE.jpg
101909 Sep 2006 - The Guardian - It's business, and it's fishyfish oil, trials, school, Durham trial09/09/2006by Ben Goldacre
Fish oil is clearly a matter of huge national importance. Channel 4 and ITV (and the Daily Mail, and the BBC) all report on a plan by education officials in County Durham to give £1m worth of omega-3 fish oils to 5,000 children as they approach their GCSEs, and see how it improves performance.
Contrary to what the pill-peddlers would tell you, the evidence as it stands is incredibly thin. There is a handful of small trials published in proper journals, at last count three positive, two negative and none in "normal" mainstream children. All these "studies" you keep hearing about in the media are little more than cheap promos for the pill pushers, with no control group, and crippled by inadequate research methods. So bravo for Durham.
Oh, hang on. The Eye-Q study is a cheap promo for Equazen's Eye-Q range: there is no placebo, in fact there is no control group whatsoever. They're going to the trouble of giving 5,000 children the tablets, six a day, under the watchful eye of the nation, hyping the study, with all their hopes pinned on success, and then they're going to measure their performance against ... what the council predicts it should have been without the tablets.
This is - let me be quite clear - a rubbish study, which has been designed in such a way that it cannot provide useful results: it is therefore a waste of time, resources, money, and parents' goodwill.
In the name of fairness, I decide to put this modest proposal to Dave Ford, chief schools inspector for Durham, the mastermind behind the project. Then it all gets a bit weird. "We've been quite clear," he says, "this is not a trial."
Well, hang on. I call up to tell you it's a bad trial, and suddenly that's OK because it's not actually a trial? The Press Association called it a trial. The Daily Mail called it a trial. Channel 4 and ITV and everyone covering it all present it, very clearly, as research (damning quotes and clips at badscience.net). In four solid years of moron baiting, this is definitely the most surreal defence I've come across. I look at Durham council's press release for it. They call it a "trial" twice, and a "study" once. You are giving something and measuring the result. Your own descriptive term for this activity is "trial". How is this not a trial? To excuse you out of a hole?
Exasperated, I move on to Equazen. Their Eye-Q tablets cost £7.99 for a 10-day supply, and they have given £1m worth to Durham (street value, as the drug squad say). This has bought them flattering news items on peaktime terrestrial television, and large colour photos of their products on prominent news pages.
Adam Kelliher, director of Equazen, clarifies further: this is not a "trial", so I cannot critique it as such. Nor is it a "study". It's an "initiative". By now I'm losing the will to live. Madeleine Portwood, the senior educational psychologist running the study, calls it a "trial" (twice in the Daily Mail). You are giving "X" and measuring change "Y". Every write-up describes it as research. The Equazen press release, for God's sake, calls it a "trial". This is a trial, a stupid trial, and simply saying "ah but this is not a trial" is not an adequate - nor indeed a particularly adult - defence.
We do not have good evidence that omega-3 will improve normal children's behaviour and intellect. We need proper research. It is clearly of burning interest to the nation. You could take this rubbish Eye-Q "trial" (yes: trial) and give half the kids placebo, and you'd have a perfectly serviceable bit of research, giving useful data.
Add in a couple of baseline and endpoint tests, maybe shave off some of these thousands of children, and it would cost no more than this foolish promotional sham. You'd be sitting on a huge, definitive study. The very thing that is needed. The very thing that mainstream academics are struggling to get funding for. It might well be positive. But what if the result is negative? Scary huh, Equazen?
So I asked the director: "Would you give a million pounds' worth of free supplements (and dummy pills without the active ingredient) to a research team who were doing a methodologically meticulous randomised double blind placebo controlled trial of omega-3 fatty acids in mainstream children?" And he said yes. Let me know if they tell you no, at the usual email address.
Please send your bad science to email@example.com
by Dr Alex Richardson
So when is a trial not a trial? Thank goodness that someone in the media has exposed this non-story for what it really is.
For those of us trying to get proper scientific research done in this area, it is more than frustrating to see the media promoting this sort of nonsense yet again. (I long ago lost count of the number of supposed 'Durham Trials' I have been asked to comment on by the media. In fact the only published, peer-reviewed and properly controlled trial from there is our own Oxford-Durham study)
Ben Goldacre has done a fine job here (as he usually does). For additional commentary and responses on this topic, and other pseudo-science he has exposed, see his excellent column Bad Science - The Trial That Ate Itself.
102206 Sep 2006 - Channel 4 - Fish oil for studentsDurham Trials, fish oil, childrenDurham school kids offered omega-3 fish oil. Can it really boost exam performance? 06/09/2006by Darshna Soni
All Year 11 pupils will be signing-up to take a fish oil supplement for the next nine months.
The initiative, which is the largest-ever programme using fatty acids in the classroom, came from the county council's chief schools inspector Dave Ford, who has followed the progress of children involved in earlier studies taking the omega-3 fish oil supplement.
Mr Ford is convinced that the same improvements in concentration and learning, if applied to Year 11 pupils, could have a direct impact on their GCSE results.
The countywide trial at 36 schools will continue until the pupils finish their exams next summer. The first test of the supplement's effectiveness will be when they sit their mock GCSEs in December.
However, Dr Alex Richardson of Oxford University, the leading scientist in this area, poured scorn on the initiative.
She told Channel 4 News: "This is not a 'trial', because with no control group, it can tell us absolutely nothing about the possible effects of fish oils.
"Quite frankly, at best it's a wasted opportunity - and at worst, it could seriously mislead many parents and professionals."
"The media attention alone means that these students will feel 'special' and may well perform better than expected. The whole exercise is therefore utterly pointless, except as a cheap advertisement - and I'm very disappointed that the media keep giving coverage to this kind of non-story."
"To say anything at all about cause and effect, you need properly randomised, double-blind, placebo-controlled trials. So far, only five small trials of this kind have been published in peer-reviewed journals. Only three showed any benefits; and all involved children with behavioural or learning difficulties such as dyslexia, dyspraxia or ADHD."
"While it's possible that the behaviour and learning of many more children might be improved by enriching their diets with the omega-3 fatty acids found in fish and seafood, properly run trials are the only way to find this out." Dr Richardson is director of the charity Food And Behaviour Research which is seeking funds for a nationwide study into the possible effects of omega-3.
Channel 4 Health Durham County Council Food and Behaviour Research
By Alex Richardson
To appreciate more of the background to this story, it's worth seeing what 'Bad Science' had to say about it a few days later. (And no - I had no input whatsoever into Ben Goldacre's article on this subject)
http://www.channel4.com/news/special-reports/special-reports-storypage.jsp?id=3191Visit the Channel 4 website herefish in a bowl.jpg
101805 Sep 2006 - The Scotsman - Treatment with 'friendly' bacteria could counter autism in childrenTreatment with 'friendly' bacteria could counter autism in childrenIan Johnston - Science correspondent05/09/2006
PROBIOTIC bacteria given to autistic children improved their concentration and behaviour so much that medical trials collapsed because parents refused to accept placebos, a scientist revealed yesterday.
The effect of the bacteria was so pronounced that some of the parents taking part in what was supposed to be a blind trial realised their children were taking something other than a placebo. A number then refused to give their children the placebo when they were due to switch, resulting in the collapse of the trial.
Glenn Gibson, a microbiologist who ran the study of 40 autistic children aged between four and eight, said this meant it was difficult to draw any firm conclusions and he is planning to carry out further research. However, he said parents had told him the probiotic bacteria was having a beneficial effect, resulting in "better concentration and better behaviour".
One parent said it was "heartbreaking" to have to stop their child taking it. "It was really challenging for us and the parents. I'd really like to go back to it and do it in a better way, with perhaps more professional help from people who know how to deal with autistic children," said Prof Gibson. "The trial ultimately failed because of the large number of drop-outs. About half the kids dropped out. Some of the parents worked out their child was on the test and didn't want to move on to the placebo."
Autistic children often suffer bowel conditions and Prof Gibson said a previous study had found high levels of a "bad" bacteria called clostridia in the gut. The probiotic was then designed to reduce the levels of clostridia and promote "friendly" bacteria instead to see what effect this would have.
Prof Gibson, from Reading University, said the children appeared to show fewer signs of autism when taking the probiotic supplement, which was given in a powder once a day. "Very subjectively, we asked the parents to fill in diaries about the mood of the children. We got very positive feedback generally," he said.
He said that certain kinds of clostridia produced neuro- toxins, which potentially could be the cause of autism or a contributory factor. However, he said this was speculation and the apparent improvement could also simply be because the children had felt better. "If your gut is not behaving yourself, you feel rough," Prof Gibson said.
The first bacteria in the gut is received from the mother during birth and then comes from the outside environment, with diet playing an important role. "They (infants) may be under medication for an infection and that may have an effect," Prof Gibson said. "There are all sorts of different factors that may affect that (the bacterial make-up of the gut)."
There was a scare over widely discredited claims that autism was linked to the MMR - measles, mumps and rubella - vaccine given to children. Asked whether he thought childhood vaccines could have an effect, Prof Gibson said: "No. I don't think there is anything in this MMR business at all."
It is estimated that 535,000 people in the UK have some kind of autism, including a milder form called Asperger's Syndrome. The condition affects four times as many boys as girls for reasons that are not clearly understood.
A spokeswoman for the National Autistic Society (NAS), the UK's leading charity for people with the condition and their families, said it followed new research into possible treatments with great interest. She went on: "There is anecdotal evidence that certain vitamins and diets do have benefits for some people with autism. However, a great deal more research remains to be done in this area.
"The NAS looks forward to seeing the results of the further research that Professor Gibson hopes to conduct in the future." She said that "rigorous scientific evaluation" was necessary to gauge the effects of any new treatment. A whole range of therapies had been tried in the past, from medication and behavioural therapy to aromatherapy and swimming with dolphins, with varying degrees of success.
Until proper placebo-controlled trials can be conducted, it is simply not possible to know whether probiotics can really be of any benefit in autism - so the 'collapse' of this attempt at a controlled trial is extremely disappointing.
It is very easy to understand why parents of autistic children would be unwilling to forgo anything that might help - but unless some are willing to accept the risk of being allocated to a placebo (dummy) treatment for at least a short time, we will never know if this approach can genuinely help.
Professor Gibson is one of the leading researchers in this area, and it can only be hoped that he will try again to demonstrate causal effects with a well-controlled trial - perhaps with a simple 'parallel groups' design. (Parents who may already have noticed apparent 'benefits' would not then be required to switch treatments; instead, only a fairly short delay should be needed before those taking a placebo could then be offered the treatment being tested).
Gut And Psychology Syndromes for accessible information on the possible role of abnormal gut flora in autism and related conditions, and practical dietary advice, written by a medical doctor and parent of a child diagnosed with autism.
http://news.scotsman.com/uk.cfm?id=1308572006View this article via the Scotsman's website here
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