Resource paper on malnutrition as a risk factor for violence such as anxiety, depression, antisocial behavior

1. At Malnutrition as a Risk Factor for Violence
(Anxiety, depression, antisocial behavior, etc.)
[April 21, 2006]
James M. DeCarli, MPH, MPA, CHES
Research Analyst III. Behavioral Sciences
Injury & Violence Prevention Program
(213) 351-7846
jdecarli@ph.lacounty.gov
Iron deficiency impacts brain function by affecting dopamine and serotonin neurotransmitters. In addition to Iron
deficiency, other forms of malnutrition have been found to be associated with an increased risk of violence
(anxiety, depression, antisocial behavior, etc.). This is demonstrated in the research below. While malnutrition
is found to predispose children to neurocognitive deficits that in turn predisposes them to persistent
externalizing behavior problems throughout childhood and adolescence, by reducing early malnutrition
may help to reduce later antisocial and aggressive behavior.1
Iron deficiency is the most common form of malnutrition in the U.S. In early brain development it can result
in anxiety, depression, social and attention problems, and cognitive and motor delays later in adolescence. 2
Iron deficiency is common among U.S. women of reproductive age, due to blood loss during heavy
menstruation. An estimated 15-18% of women among this group are iron deficient, between 8-10 million in
the U.S.3
Additionally protein4, zinc, and B vitamin deficiency has also been shown to result in impulsive and
antisocial behavior in adolescence.5
Iron Deficiency among adolescent males has been shown to be associated with aggressive behavior6
Iron, copper, manganese, and zinc deficiency found to be associated with mental impairment leading to
violence.7
Iodine deficiency or imbalance has been found to be associated with mood disorders8-9
Experimental and observational studies have shown an association between iodine and depression10-11,
anxiety12, aggression13, schizophrenia14-15, and bipolar disorder16-17-18
Vitamin and mineral tests have shown to be an indicator of violent behavior.19
Iron deficiency in the U.S. is seen in 7% of toddlers with 9-16% in adolescent females.20
Among African American and Mexican American females iron deficiency is between 19-22% (unfortunately
no other comparison groups have been identified in the literature)
In a review on malnutrition the author suggests that body chemistry and calorie malnutrition plays a role in
abnormal behavior and is linked to violence and crime.21
An earlier study suggesting a link between iron deficiency and abnormal behavior.22
Malnutrition among children suggests increase of fatigue and irritability.23
After adjusting for population density, the incidence of homicide, suicide and rape were significantly higher
in areas where the drinking water contained little or no lithium. Results of this study suggest that low level
doses of lithium have a beneficial effect on human behavior.24
Evaluated blood lead levels of young children scored the highest in Total Problem Behavior Score
checklists.25
Research spanning a period of 20 years found abnormal trace metal concentrations in violence prone young
males 3-20 years of age.26
Biochemical evidence of thiamine deficiency related to junk food diets, the adolescents especially were found
to be impulsive, irritable, aggressive, and angered easily.27
Nutrient dense diets in 813 state facilities resulted in significantly improved conduct. The distribution of
vitamin and mineral supplements was a significant factor in promoting less violent behavior.28
Numerous studies conducted in juvenile correctional institutions have reported that violence and serious
antisocial behavior have been dramatically reduced after implementing nutrient dense diets.29
The results of an intensive study of former drug users, violent offenders or those with a history of domestic
violence assert that lithium supplementation has a mood improving and stabilizing effect. Authors suggest
that a nutritional lithium supplement may be a valuable drug in violence and suicide prevention programs.30

2. 1
Jianghong Liu, Ph.D., Adrian Raine, D.Phil., Peter H. Venables, Ph.D., D.Sc. and Sarnoff A. Mednick, Ph.D.,
D.Med, Malnutrition at Age 3 Years and Externalizing Behavior Problems at Ages 8, 11, and 17 Years, Am J
Psychiatry 161:2005-2013, November 2004
2 Shonkoff, J.P. & Phillips, D.A. (2000). From neurons to neighborhoods: The science of early childhood
development. Washington, D.C.: National Academy Press
3 John Beard, Experimental Biology 2004 meeting, Washington DC
4 Pollitt, E. & Gorman, K.S. (1994). Nutritional deficiencies as developmental risk factors. In Nelson, C.A. (Ed.)
Threats to optimal development: Integrating biological, psychological, and social risk factors. Hillsdale, NJ:
Lawrence Erlbaum Associates, Publishers. 121-144v
5 Liu, Jianghong, Rain Adrian. Early nutrient deficiency may increase adolescent violence. American Journal of
Psychiatry, 161:2005-2013.
6 Werbach, Melvyn: Nutritional influences on aggressive behavior. J Ortho Med 1995; v.7, no. 1v
7 Sanstead H: A brief history of the influence of trace elements on brain function. J Clin Nutrit 1986; 43:293-98
8
Benvenga S, Lapa D, Trimarchi F. Don't forget the thyroid in the etiology of psychoses.
Am J Med. 2003 Aug 1; 115(2): 159-60
9
Yang SJ, Wang SY, Chen CC. Acute psychotic state due to hyperthyroidism following excision of a mandible bone
tumor: a case report. Kaohsiung J Med Sci. 2003 Jan; 19(1): 29-32
10
Maes M, Van de Vyvere J, Vandoolaeghe E, Bril T, Demedts P, Wauters A, Neels
H. Alterations in iron metabolism and the erythron in major depression: further evidence for a chronic
inflammatory process. J Affect Disord. 1996 Sep 9;40(1-2):23-33
11
Patterson AJ, Brown WJ, Roberts DC. Dietary and supplement treatment of iron deficiency results in
improvements in general health and fatigue in Australian women of childbearing age. J Am Coll Nutr. 2001
Aug;20(4):337-42
12
Lee IT, Sheu WH, Liau YJ, Lin SY, Lee WJ, Lin CC. Relationship of stressful life events, anxiety and depression to
hyperthyroidism in an asian population. Horm Res. 2003; 60(5): 247-51
13
Stalenheim EG. Long-term validity of biological markers of psychopathy and criminal recidivism: follow-up 6-8
years after forensic psychiatric investigation. Psychiatry Res. 2004 Jan 1; 121(3): 281-91
14
Kuloglu M, Atmaca M, Ustundag B, Canatan H, Gecici O, Tezcan E. Serum iron levels in schizophrenic patients
with or without akathisia. Eur Neuropsychopharmacol. 2003 Mar;13(2):67-71
15
Kimura A, Yoshino H, Yuasa T. A case of cerebellar degeneration with schizophrenia-like psychosis, severe iron
deficiency, hypoceruloplasminemia and abnormal electroretinography: a new syndrome? Rinsho Shinkeigaku. 2001
Aug;41(8):507-11
16
Bauer M, London ED, Silverman DH, Rasgon N, Kirchheiner J, Whybrow PC. Thyroid, brain and mood
modulation in affective disorder: insights from molecular research and functional brain imaging.
Pharmacopsychiatry. 2003 Dec; 36 Suppl 3: 215-21
17
Arnold LM. Gender differences in bipolar disorder. Psychiatr Clin North Am. 2003 Sep; 26(3): 595-620
18
Davis JD, Stern RA, Flashman LA. Cognitive and neuropsychiatric aspects of subclinical hypothyroidism:
significance in the elderly. Curr Psychiatry Rep. 2003 Oct; 5(5): 384-90
19 Schoenthaler S: Vitamins Against Crime: supplementation and antisocial behavior in institutions. Medical
Nutrition 1990; 34-37
20 Liu, Jianghong, Early nutrient deficiency may increase adolescent violence. American Journal of Psychiatry,
161:2005-2013.
21 Lonsdale D, et al: J of Advancement of Medicine 1994; 7(3):171-180
22 Rosen GM, et al.:Iron deficiency among incarcerated juvenile delinquents. J Adolesc Health Care 1985;6:419-
423.
23
Center on Hunger, Poverty and Nutrition Policy. Statement on the Link Between Nutrition and Cognitive
Development in Children 1995. 2nd ed. Medford, Mass: Tufts University School of Nutrition:1995
24 Schrauzer GN, Shrestha KP: Lithium in drinking water and the incidences of crimes, suicides and arrests related
to drug addictions. Biol Trace E.em Res 1990;25(2):105-113
25 Lead Exposure and Child Behavior. American Journal of Public Health 1992; 82(10):1356-1359
26 Walsh W, et al.:Elevated blood copper/zinc ratios in assaultive young males. Physiol Behav 1997;49(1):327-329
27 Lonsdale D, Schamberger R. Red cell transketolase as an indicator of nutritional deficiency. Am J Clin Nutr
1980;33(2):205-211
28
Schoenthaler S: Applied nutrition and behavior. J Applied Nutr 1991;43(1):31-39
29
Schoenthaler, SJ, Bier ID:The effect of vitamin-mineral supplementation on juvenile delinquency among
American schoolchildren:a randomized, double-blind placebo-controlled trial. J Altern Complement Med 2000;
6(1):7-17
30
Schrauzer G, Vroey E: Effects of nutritional lithium supplementation on mood. Biological Trace Element Res
1994; 40:89-101