Jurriaan Kamp

Can Diet Help Stop Depression and Violence?

The best way to curb aggression in prisons? Longer jail terms, maybe, or stricter security measures? How about more sports and exercise? Try fish oil. How can children enhance their learning abilities at school? A well-balanced diet and safe, stimulating classrooms are essential, but fish oil can provide an important extra boost. Is there a simple, natural way to improve mood and ward off depression? Yoga and meditation are great, but -- you guessed it -- fish oil can also help do the trick.

A diet rich in vitamins, minerals and fatty acids like omega-3 is the basis for physical well-being. Everybody knows that. But research increasingly suggests that these same ingredients are crucial to psychological health too. And that's a fact a lot of people seem to find hard to swallow.

The relationship between nutrition and aggression is a case in point. In 2002, Bernard Gesch, a physiologist at Oxford University, investigated the effects of nutritional supplements on inmates in British prisons. Working with 231 detainees for four months, Gesch gave half the group of men, ages 18 to 21, multivitamin, mineral and fatty-acid supplements with meals. The other half received placebos.

During the study, Gesch observed that minor infractions of prison rules fell by 26 percent among men given the supplements, while rule-breaking behaviour in the placebo group barely budged. The research showed more dramatic results for aggressive behaviour. Incidents of violence among the group taking supplements dropped 37 percent, while the behaviour of the other prisoners did not change.

Gesch's findings were recently replicated in the Netherlands, where researchers at Radboud University in Nijmegen conducted a similar study for the Dutch National Agency of Correctional Institutions. Of the 221 inmates, ages 18 to 25, who participated in the Dutch study, 116 were given daily supplements containing vitamins, minerals and omega-3 for one to three months. The other 105 received placebos. Reports of violence and aggression declined by 34 percent among the group given supplements; at the s;ame time, such reports among the placebo group rose 13 percent.

Gesch is quick to emphasize that nutritional supplements are not magic bullets against aggression, and that these studies are just "promising evidence" of the link between nutrition and behaviour. "It is not suggested that nutrition is the only explanation of antisocial behaviour," he says, "only that it might form a significant part."

But Gesch is just as quick to emphasize that there is no down side to better nutrition, and in prisons in particular, the cost of an improved diet would be a fraction of the cost of other ways of addressing the problem of violence among inmates.

Still, the menu in British prisons hasn't changed in the five years since Gesch published his results, even though the former chief inspector of prisons in the UK, Lord Ramsbotham, told the British newspaper The Guardian last year 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."

Yet the effect of nutrition on psychological health and behaviour is still controversial, at least in part because it is so hard to study. Our moods, emotions and actions are influenced by so many factors: everything from our genes to our communities to our personal relationships. How can the role of diet be isolated among all these competing influences? That's exactly why Gesch conducted his study in prisons. In a prison, there are far fewer variables, since all detainees have the same routine. Do the results of the inmate trials reach beyond the prison walls? Gesch thinks so: "If it works in prisons, it should work in the community and the society at large. If it works in the UK and in the Netherlands, it should work in the rest of the world."

Another place improved nutrition seems to be working is in the city of Durham in northeastern England. There, Alex Richardson, a physiologist at Oxford University, conducted a study at 12 local primary schools. The research examined 117 children ages 5 to 12, all of whom were of average ability but were underachieving.

Instructors suspected dyspraxia, a condition that interferes with co-ordination and motor skills and is thought to affect at least 5 percent of British children. Possible signs of dyspraxia may include having trouble tying shoelaces or maintaining balance, for example. The condition frequently overlaps with dyslexia and attention deficit hyperactive disorder (ADHD), and is part of a range of conditions that include autistic-spectrum disorders.

Half the group of children in Richardson's study was given an omega-3 supplement for three months; the other half received an olive oil placebo. The results: Children given the omega-3 supplements did substantially better at school than those in the control group. When it came to spelling, for example, the omega-3 group performed twice as well as expected, whereas the control group continued to fall behind.

Richardson came to the study of nutrition through neurology. Her interest was sparked by the rapid rise of conditions like ADHD, autism, dyslexia and dyspraxia. The incidence of these disorders has increased fourfold in the past 15 to 20 years. "These disorders overlap considerably," she says, "but a real solution is rarely offered. A dyslexic child is assigned a special teacher. A kid with dyspraxia is sent to a physical therapist. One with ADHD is prescribed Ritalin. And you've got to learn to live with autism."

But as Richardson writes in They Are What You Feed Them: "There is always something that can be done. Don't ever believe it if anyone tells you otherwise." One of the things that can be done, according to Richardson, is to boost your child's intake of omega-3.

Of course, Omega-3 is not the only answer to ADHD, autism, dyslexia, dyspraxia or other psychological or behavioural disorders, which also include Alzheimer's disease. Studies like Richardson's suggest, however, that it may play an important role in stimulating the brain, keeping it healthy and helping it ward off debilitating conditions.

And it looks like we need all the help we can get. Behavioural dysfuntions like ADHD are currently the fastest-growing type of disorder worldwide. Twenty years ago, no one had even heard of ADHD. Today, everyone knows a kid who is taking Ritalin.

The World Health Organization (WHO) estimates that the number of people with psychological disorders will double by 2020 -- and that around that time, depression will surpass heart and vascular disease as the No. 1 most preventable cause of death. The WHO adds that psychological disorders account for four of the 10 most common causes of disability and that a quarter of the general population will be affected by them at some point in their lives.

Diet could well play a central role in all this. The quality -- and quantity -- of the food we eat has increased dramatically over the past century or so. But we are eating more and more processed foods, which contain less and less of the essential minerals, vitamins and fatty acids that appear to be so crucial for mental health. Tomato juice, for example, contains 64 percent less vitamin C, 49 percent less carotene and 17 percent less niacin than a fresh tomato.

Gesch says we "seem to have made unprecedented changes to human diets in recent years with little or no systematic evaluation of the effects on our brain or behaviour." He wants to reverse "high-calorie malnutrition" by encouraging nutritionists, physicians and educators to concentrate not just on calorie intake but on the consumption of nutritional components like vitamins, minerals and fatty acids as well.

In our distant evolutionary past, we all had much more varied diets. Research among native tribes in remote areas suggests that our hunter-gatherer forebears consumed between 100 and 150 different types of plants during the course of a year.

Nowadays, our grain consumption is heavily dominated by wheat. Soy oil accounts for more than 80 percent of the fat Americans consume. Health authorities recommend a minimum of 400 grams (14 ounces) of vegetables and fruit each day, but lots of people don't even come close to that. And even those who do eat lots of fruit and vegetables often don't get the full nutritional benefit because intensive farming has depleted the soil of key minerals.

So what's a consumer to do? Eat fish. Working with the U.S. National Institutes of Health (NIH), American physician and psychiatrist Joseph Hibbeln compared data on fish consumption with figures on depression and murder in a large number of countries around the world. Fish are a rich and ready source of omega-3. In countries in which fish consumption is low, Hibbeln found the likelihood of suffering from depression was up to 50 times greater than in countries where it is high.

Some 6.5 percent of New Zealanders suffers from severe depression; these citizens also eat very little fish. In Japan, where fish consumption is high, 0.1 percent of the population suffers from depression. Manic depression (bipolar disorder) is rare in Iceland, which has the highest per capita fish consumption in the world, but is quite common in Brazil and Germany, where people don't eat as much fish. Hibbeln also found that, on average, the risk of being murdered is 30 times greater in countries where fish consumption is low compared to countries where it is high.

Cultural and other factors certainly influence these statistics, but the comparisons are nevertheless illustrative. Overall, in subsequent trials, Hibbeln found that depressive and aggressive feelings diminished by about 50 percent after taking fish-oil capsules for two to four weeks.

Based on this and other research, the WHO concluded in a report last year: "Certain dietary choices, including fish consumption, balanced intake of micronutrients and a good nutritional status overall, also have been associated with reduced rates of violent behaviour."

How can something like omega-3 have such an impact on behaviour and psychological health? Communication between the nerve cells in the brain depends on the circulation of neurotransmitters, such as serotonin and dopamine. Low serotonin levels are associated with an increased risk of suicide, depression and violent behaviour.

Omega-3, a long, flexible molecule, appears to facilitate the circulation of neurotransmitters like serotonin in the brain, thus boosting communication among nerve cells. And nerve cells that talk a lot with each other make new connections in the brain, a process crucial for learning. Less flexible fatty acids than omega-3, though, do not as efficiently support the chatter.

Hibbeln's work has shown that the brain tissue of Americans is different from that of the Japanese. American cell membranes contain much higher levels of the less flexible omega-6 fatty acids; Japanese cell membranes are significantly richer in omega-3. Processed foods happen to be rich in omega-6, and Americans eat a lot of them. These omega-6 fatty acids seem to have displaced the omega-3 fatty acids found so abundantly in fish, of which the Japanese are so fond.

Other studies have found that depressed patients and children with ADHD and autism are deficient in omega-3. So some scientists speculate that this change in the fatty acids contained within our brains could be causing the modern rise in psychological disorders.

Although more and more research underlines the importance of nutrition for psychological wellness, these findings have not been widely translated into action. "Politicians, policymakers and business leaders keep asking for more research involving thousands of people, like the trials done for every new drug," Richardson complains. "But I say, We have done the uncontrolled experiments now [in the general population] for quite some time." Pharmaceutical firms have few incentives to organize their own studies, since omega-3 is derived primarily from fish oil -- and you can't patent fish.

This frustrates many scientists in the field. "Do we want to wait for more studies that confirm these findings, or do we want to do something today about the level of crime and aggression in our societies?" asks Stephen Schoenthaler, a sociologist at California State University at Stanislaus, in Turlock, California, who has studied the link between food and behaviour for the past 25 years and led several studies among prisoners and schoolchildren showing the social benefits of a healthier diet.

It's not all good news, though. Consumers should watch out for manufacturers that make exaggerated claims about these nutritional supplements. "Never use supplements as a substitute for a good diet," counsels Richardson. "The key thing that most people seem to have forgotten is that food is not just fuel, it is nourishment. Food is not just a source of energy that one can consume on the run. A healthy diet needs to provide a minimum of essential nutrients in a dosage recommended for daily use."

A multivitamin and mineral supplement is a good "insurance policy," Richardson says, and 500 mg of omega-3 every day is not a bad idea either. But buyer beware: Not all supplements are good supplements, so seek the advice of a qualified professional before deciding which supplement, if any, is right for you.

It almost sounds too good to be true, but research is beginning to confirm that vitamins, minerals and fatty acids can reduce aggression and improve psychological well-being. That could be a simple recipe for a more peaceful world.

The Untied States of America

Looking a half-century into the future, a maverick businessman warns that America may fall apart as a nation. He believes the U.S. can avoid this fate -- but that it will require some radical steps right now.

In 1950 the United Nations had 50 members. Today there are 191 U.N. member states. The vast majority of these new countries came from Africa, Asia and Europe. Only three countries (Surinam, Guyana and Belize) out of the 141 new ones came from the North and South American continents.

These are interesting facts to Juan Enriquez, an American businessman, bestselling author and former Harvard academic. In his new book, "The Untied States of America" (Crown, 2005), Enriquez warns of the coming disintegration of the United States and explores how that will affect the nation's status as the unparalleled superpower.

This is a challenging, controversial subject at a time in history when American power around the world appears supreme. The Soviet Union no longer stands as a military, political or economic rival now that capitalism has triumphed over communism. While America is increasingly affected by the fast economic rise of China, this challenge doesn't appear to threaten America's leadership in global politics. Americans dominate the world community today in the same way as the British did a century ago. But that comparison also contains a warning.

In the beginning of his book, Enriquez presents readers with an experiment. Imagine you're a member of the British cabinet in 1905. A world map hangs on the wall of the elegant conference room in Number 10 Downing Street delineating the greatest empire that has ever existed: an area encompassing nearly 30 million square kilometres (11.5 million square miles), 20 percent of the world's land and nearly one-quarter of the total human population. The question is: How will the world look in 50 years -- in 1955?

What would you have thought? Would Britain's territory expand? Stay the same size? Would there have been someone who could have conceived that the British Empire would completely fall apart between 1905 and 1955? That British territory would only comprise some 250,000 square kilometres (97,000 square miles) in 1955?

Imagine asking George W. Bush the same question now, in 2006. How will the United States look in 50 years? How many stars will the American flag have? Still 50? The chances of finding a prominent politician in Washington today who could imagine the disintegration of the United States seem miniscule. But readers of Enriquez's book realize it is in fact quite probable that America in 2056 will not be the same powerful country it is today. Based on a great deal of historical, financial, political and cultural data, Enriquez convincingly demonstrates that the future does not augur well for the unity of the United States.

While the title and the subject of his new book don't immediately indicate it, Enriquez is driven by his love of science. Enriquez set up the Life Sciences Project at the Harvard Business School, is chairman of Biotechonomy, a venture-capital fund specializing in biotechnology, and author of an earlier book on the same general subject, "As The Future Catches You."

That short biography explains why Enriquez was in attendance at the conference, "Celebrating a Decade of Genome Sequencing." This international summit on DNA research, genetics, biochemistry and biology took place in December at the University of California, San Diego, which heads global research in this area. Even the casual visitor quickly becomes aware that this is where the future of energy, food, health and computer science, and therefore of society itself, is generated, largely separate from politics, the media and ordinary citizens. The conference illustrates the crucial role prominent scientific research plays in a country's future success and its economic wealth. In the numerous PowerPoint presentations given by authorities in many fields, it becomes clear that technology offers enormous opportunities for the future, and that it is easy for some societies to miss the boat.

Enriquez knows that countries that emphasize the importance of science will be the future leaders. And he sees that the United States -- despite, for example, the leading position of the University of California, San Diego -- is increasingly losing ground. He believes this is a sign of America's waning strength. "The future depends on how you treat people today," he says, noting that the performance of the U.S. in this regard is not particularly great.

The U.S. national debt, topping $8 trillion, is a troubling illustration of the fact that the United States is squandering its future. "From time immemorial the last thing a government does is drive the country to bankruptcy," Enriquez observes. "You cannot spend five to six percent more than the country earns every year without serious consequences. It is not inconceivable that the U.S. will be running out of money."

It can be said that the U.S.'s per capita debt level, at around $27,500, is acceptable relative to that of other leading industrial nations in the Organization for Economic Cooperation and Development (OECD). But the U.S. appears far different than other Western OECD nations when you look at other economic and social statistics. Enriquez mentions a few: The minimum wage has fallen by 37 percent since 1968 in terms of real dollars; 11 percent of Americans don't have enough to eat; in 2000 the federal government spent $2,106 on each American child while spending $21,120 on each person over age 65. Enriquez cites research indicating that if the U.S. government maintains its current policies, nearly half the budget will be spent on senior citizens by 2016. Hence his question: Do you invest in the future or in the past?

Within two generations, 40 percent of the American population will be comprised of African-Americans and Hispanics. Both groups continue to lag far behind whites and Asian-Americans in the educational system. Few graduate from college and even fewer get advanced degrees or become scientists. Countries like Finland, Iceland, Japan, Sweden, Denmark, Norway and Singapore are already surpassing the U.S. when it comes to scientific research. This causes Enriquez to say that without making significant investments in education for African-Americans and Hispanics, who will make up almost half the population by mid-century, America cannot maintain its current prominence in the sciences.

Not only is the U.S. failing to make vital national investments, it is allowing the national debt to increase as the Bush administration believes it can lower taxes at the same time as spending $200 million a day on the wars in Iraq and in Afghanistan. Enriquez warns: "They spend everything trying to protect what they have today."

Enriquez is also seriously concerned about the conceit that characterizes current American politics. A lot of what the government does, he says, speaks of its conviction that "our way is the only way." This attitude goes hand in hand with an unhealthy blending of science and religion. "Religious beliefs are being manipulated to win elections," he observes.

A sound balance between science, religion and ethics forms an essential foundation for the healthy development of any society, Enriquez believes. And he is convinced that within this balance, attention to science determines a country's future level of wealth. He mentions that the British discovered DNA back in the 1950s and that British scientists laid the foundation for cloning. "But they failed to translate that science into business. They considered it inappropriate, unethical, to earn money on science. Just look where British science is now. Societies that make their football stars rich and their scientists poor are doomed."

A lot of large companies have broken into smaller units since the 1960s because they could no longer prove to their shareholders that the whole was worth more than the independent parts. Juan Enriquez predicts minorities will soon be asking nations the same questions. What is the benefit of this structure? Does this country represent our interests in the best way? "And those are questions that are hard to answer."

Borders are extremely abstract. You can't see them from space. Only islands have clear geographical boundaries. Countries are not natural structures and they are therefore kept together by flags and national anthems. Or -- in Enriquez's view -- by "myths." And the power of those myths goes as far as the next generation wants to believe in them. In other words: If the American dream comes true for ever-fewer Americans, the unity of the United States will come under increasing pressure. This is the point at which questions will naturally arise about whether there are other possible configurations that would give citizens a better shot at fulfilling their dreams.

But isn't America a stable country? Wasn't it founded based on one language and a clear set of principles? Enriquez delicately points out that the same was true for the United Kingdom, which is increasingly devolving into the separate nations of England, Scotland and Wales; and for Spain, where Basques and Catalans are hacking away at national unity. And, pointing to the history of the United States, he adds: "If the parents can split, the kids can split."

The early signs of American disintegration are already apparent, according to Enriquez. In the state of Vermont there is a small but serious separatist movement and a declaration of independence is being drawn up. States in the northeastern U.S. have formed an alliance to carry out the Kyoto climate agreement, which the Bush administration refuses to sign. And guess what's been the motto on Texas license plates since 2004? "It's like a whole other country." Texas earlier announced that all the state's schoolchildren would not only be saying their pledge of allegiance to the American flag, but to the flag of Texas. Finally, in an opinion poll, 42 percent of Texans came out in favour of more political autonomy for Texas as long as it could be arranged within the confederation of the United States.

Then there's California, the seventh-largest economy in the world, where a large part of the population -- including many Republican supporters of Governor Arnold Schwarzenegger -- are extremely displeased with Washington's current conservative politics. California's independence is the subject of frequent jokes at parties and gatherings of the intelligentsia.

Native Americans are also stepping up demands for attention to the historical injustice that caused them to lose their land. Several current court cases are ongoing, for example, involving native peoples' claim to one-third of the land in the state of New York. Over the past 20 years, Australia, New Zealand and Canada have seen discussions about returning seized lands to native peoples as well as adjustments of the Terra nullius principle (that European pioneers appropriated no man's land). It's hard to imagine the United States will be spared a revisit of its history regarding Indian peoples. During his presidency, Bill Clinton already made excuses for the "illegal occupation" of Hawaii.

Enriquez adds another ticking time bomb in a P.S. to his book: "If slaves performed $40 million worth of unpaid labour between 1790 and 1860, reparations would be around $1.4 trillion."

In support of his thesis about American disintegration, Enriquez points to the example of the European Union. The economic umbrella of the EU makes it much easier for smaller entities to be independent. Broader trends of globalization also offer small countries advantages they didn't have. Despite their diminutive sizes, Singapore and Hong Kong, as well as Luxembourg and Switzerland, have been able to develop into extremely successful economic entities.

After making this sharp -- and when it comes to the United States, gloomy -- analysis, it is remarkable that Juan Enriquez writes at the end of his book that he doesn't want to be a preacher of doom. "My desire is simply that citizens ... realize what they have, what they are doing and what they might do differently if they wish to avoid what so many have already gone through," he writes.

Throughout "The Untied States of America," Enriquez offers suggestions for policy reforms which continually emphasize focusing on science and education for minorities as well as special-needs groups. Why should the Netherlands, for instance, be a leading global flower grower and trader when the climate is more suitable in other parts of the world? Dutch success stems from knowledge -- from specific, constant attention to science, and research and development. Enriquez points to Finland, which grew to become a digital superpower in the space of a single generation. And Iceland, which has expanded into a leading technological power thanks to massive investments in education. "You can build a great country when you change education and surf the waves of technology. You can make and unmake countries in months."

His most creative -- and most politically unfeasible -- solution for the United States involves a change in voting rights. In order to rectify the imbalance between the older and younger generations, Enriquez suggests giving parents voting rights on behalf of their underage children. This would mean that a family with four children and two adults would have six votes. The change would put an end to current policies that appropriate the most money to older people because they have the most votes. "If the votes of underage children counted, it would lead to investments in their interests. In good schools. The question is how much support there would be for going to war when the children would be sent off as soldiers."

That last suggestion embodies the bold message of "The Untied States of America." The future success of a country begins by paying attention to how we fulfill the long-term wishes and interests of its citizens today. These citizens of today determine the economic power of tomorrow. Economic power lies at the roots of the current superpower status of the U.S. Juan Enriquez points out that this economic superiority is swiftly being consumed with a policy of arrogant international politics and decadent consumerism. Such a policy has destroyed superpowers throughout history, Enriquez warns as the proverbial voice crying in the wilderness. But the information and ideas he outlines here do offer a pragmatic alternative to the Disunited States of the future.

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