cookingclassWe all accept that a sedentary lifestyle combined with a processed, nutritionally poor diet can affect bodily health and cause chronic diseases, but what effect does such a diet have on a child’s brain, mood and behaviour? The findings revealed by Dr Alex Richardson in this exclusive extract from the latest edition of JFHC will both enlighten and disturb you:

Everywhere that modern, Western-style eating habits are adopted on this planet, they bring with them a host of chronic, diet-related diseases and conditions. The catalogue of physical health problems now firmly linked with our sugar-high, nutrient-poor food choices is pretty well known: obesity, type 2 diabetes, various immune disorders, even cancers.

In fact, one third of all cancers are attributable to poor diet according to the World Health Organisation. Nutritionally speaking, the modern Western diet is not just evolutionarily novel – it is pathological. So it’s only right that we should be constantly reminded of how vital healthy and unprocessed foods are for the healthy development of our children’s bodies.

And most health care professionals – including health visitors, midwives, community nurses and dieticians – are acutely aware of the need to help parents to develop healthy eating habits in their children from the very start.

Brain health and omega-3s
How often do we recognise the link between good bodily health and healthy brain function? If a nutrionally poor, over-processed diet is catastrophic for the body, what does it do to the brain? In other words, how do our eating choices affect our children’s mood, behaviour, concentration and ability to cope with life?

Recently, our Oxford University research team reported findings from a major study of omega-3 fatty acids in UK school children. It was the first of its kind to investigate blood concentrations of omega-3 in children from mainstream schools.

Omega-3 fats – particularly DHA and EPA, found in fish and seafood – are critical not only for heart and immune system health, but also for the normal structure and functioning of our brains and eyes. However, like vitamins, they must be derived from the diet.

DOLAB study
Our DHA Oxford Learning and Behaviour (DOLAB) study involved almost 500 Oxfordshire children aged seven to nine years, who matched the national average socially and academically. We first tested the children’s blood levels of DHA and EPA (known as the omega-3 index). The optimum for health is over 8%, but these children were averaging only 2.46%. In adults, an omega-3 index below 4% puts you at high risk of heart disease and stroke. It’s therefore shocking that our children are so deficient in these vital nutrients, particularly as they also make up so much of brain tissue.

Unsurprisingly, we found that children with higher reported fish consumption had higher blood omega-3 levels. But nearly nine in 10 of the children didn’t meet current official dietary guidelines for fish consumption (two portions a week, one of which should be oily). We also showed that lower blood DHA in these children was significantly linked with poorer reading, poorer working memory, poorer parent-rated behaviour, and more sleep problems.

What’s more, in a controlled treatment trial involving 362 children who were behind in their reading, we showed that dietary supplementation with 600mg/day of omega-3 DHA led to significant improvements in these children’s behaviour, reading progress and sleep.

Growing body of evidence
Ours is not the only research showing links between children’s behaviour and omega-3 intakes. Research published last month in the Journal of Child Psychology and Psychiatry found a 41.6% reduction in parent-rated externalised behaviour problems in children aged eight to 16 who took high-dose omega 3 supplements for six months. Another highly respected study, carried out 10 years ago among prison inmates, showed that giving omega-3 and omega-6 fatty acids and recommended daily intakes of vitamins and minerals significantly reduced disruptive and antisocial behaviour. And in children with ADHD-type symptoms (inattention, hyperactivity and impulsivity), a ‘meta-analysis’ of 10 controlled trials confirmed that supplementation with long-chain omega-3 (EPA/DHA) is beneficial.

Link between diet and behaviour
Many other studies also show that an impoverished diet is one factor behind the rise in cases of ADHD, dyspraxia, dyslexia, autism and other behavioural and learning difficulties. These conditions are not as easy to diagnose as physical illnesses; they are complex and overlapping, and so many other factors need to be considered. More fundamentally, these diagnoses are descriptions, not explanations. But they are clearly on the rise.

In the UK, one in five children attending mainstream schools has some form of special educational need. Many features associated with ADHD, dyslexia, dyspraxia and autistic spectrum disorders are consistent with deficiencies or imbalances in fatty acids. These include the excess of males affected, slightly increased tendencies for pregnancy and birth complications (including prematurity) and an increased frequency of atopic or other immune system disorders in affected individuals and their relatives.

But at the moment, the role of nutrition in these conditions is almost universally ignored. What we eat plays no part either in either the assessment or the management of these conditions. This makes no sense; we need the right nutrients to build our bodies and brains, and to fuel, maintain and repair every cell and connection. We know that vitamins, minerals, essential amino acids (the building blocks of protein) and two very special types of fat, omega-3 and omega-6, are essential nutrients. So by definition, without optimal levels of these in our diets, our physical and mental health will suffer. Of course, individuals differ, so a recommended amount of a given nutrient might be more than enough to meet one individual’s needs but not nearly enough for another. 

With respect to omega-3, very few people achieve the intake that research shows is needed for a healthy heart, immune system and brain; and abundant evidence now shows that omega 3-deficiencies are linked with a range of childhood learning and behavioural difficulties like ADHD, ASD, dyspraxia and dyslexia – as well as with depression and related conditions in adults. Nutrition research is thus increasingly proving its value in psychology, psychiatry and related areas – including education and social services.

How can we improve matters?
So how do we link all these things together and try to reverse the catastrophic health effects of a poor diet? Health service providers of all kinds need to monitor this connection between growing cognitive disorders and poor diets, and keep this on their radar.

Of course, health care practitioners who are already dealing first hand with everyday health problems in the community can’t be expected to turn around a nation’s eating habits single-handed. But they are well placed to encourage good practice, particularly given the unique relationships that midwives and health visitors, for example, form with their patients.

The food industry argues that people should be free to choose to eat what they wish. But it’s not a proper choice if you are not armed with the facts in the first place. To redress the epidemic of physical and mental problems linked to Western diets, we all need to do whatever we can to make healthy choices the norm, not the exception.

In the last century, dietary advice focused mainly on physical growth, especially for babies and children. This meant that height and weight were often taken as sufficient indicators of healthy development. But human development is actually more about the growth of the brain than the body – and the brain is 60% fat.

The fact that most people still innocently think that ‘low-fat’ foods and diets are ‘healthy’ therefore needs challenging. And health professionals can do their bit by explaining to parents and children how essential the omega-3 fats are for brains as well as bodies – and how to increase their intake. We really must look again at how we feed that body in order to reach the brain and properly nourish it.

Further information
● The research involving giving children high doses of omega-3 was led by Professor Adrian Raine, of the Richard Perry University Departments of Criminology, Psychiatry and Psychology in Philadelphia. For more details of this and earlier research, see http://www.fabresearch.org/viewItem.php?id=9199  
● Details of the DOLAB Studies can be found at http://www.spi.ox.ac.uk/centre-for-evidence-basedintervention/projects/the-dolab-studies.html  
● The next FAB event held on Nutrition and mental resilience in children and adults: feeding better health, wellbeing and performance is at the Royal College of Surgeon, London on 29 October. Book your place via www.fabresearch.org

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