Omega-3 Supplementation as a Dietary Intervention to Reduce Aggressive and Antisocial Behavior

Purpose of Review

Although there is an increasing body of literature on the relationship between omega-3 fatty acids and aggressive/antisocial behavior, evidence to date suggests that there are mixed findings on the efficacy of omega-3 supplementation as a dietary intervention to reduce such behaviors. This article describes the current state of the research regarding omega-3 supplementation and aggressive/antisocial behavior from intervention studies, with an emphasis on randomized controlled trials.

Recent Findings

The current evidence base indicates a small effect size (approximately d?=?.20) for the efficacy of increased omega-3 intake in reducing aggressive and antisocial behavior in children and adults. How precisely omega-3 supplementation results in such behavioral improvement is an open question, although upregulation of dysfunctional prefrontal regions is one candidate mediator.

Summary

Directions for further research include understanding the more basic mechanisms that may underlie any intervention effects, delineating dose-response relationships, ascertaining optimal treatment duration and composition, conducting follow-ups post-treatment, and testing the provisional hypothesis that more impulsive, reactive forms of aggression may be particularly amenable to omega-3 supplementation.

     

The cost and analysis of nonuse of cochlear implants.

OBJECTIVE: Analysis of the cost implications and reasons for nonuse of cochlear implants in an established cochlear implant unit. STUDY DESIGN: Clinical data were analyzed retrospectively to construct a table of cochlear implant use over time to identify nonuse and to suggest the reasons for this. SETTING: Yorkshire Cochlear Implant Service is a tertiary referral center. PATIENTS: Three hundred forty consecutively implanted patients from 1990 to 2005. MAIN OUTCOME MEASURES: Life table analysis showed that most children used their implant (p = 0.7 during 11 yr). However, 11 of 155 children and 2 of 185 adults became nonusers during the period of study. The 11 children stopped because of age at implant, educational placement, and family support. Two adults stopped because of psychological issues and inability to adapt to the signal. Surgical and implant costs have initial impact, with subsequent years' costs reflecting programming issues and maintenance. When considering nonuse, there are 2 effects: first, no more costs are incurred, and second, no more years of use are accumulated. Thus, nonuse reduces both costs and years. Costs of gaining a year of use as a function of time showed that there was little financial impact from the 11 children nonusers. As a ratio of "no nonuse" and observed "nonuse" in children, the ratio is 1.07 by 13 years of implantation (7%). The adult group was too few to analyze. CONCLUSION: The nonuse added 7% to the average cost. Retrospective audit identifies that patient selection by a multidisciplinary team is crucial to reducing nonuse.     

Plasma atrial natriuretic factor and graft function in renal transplant recipients

In order to determine the relationships between allograft function and the recipient's plasma concentrations of atrial natriuretic factor (ANF), plasma ANF was measured by radioimmunoassay for 14 days after cadaveric renal transplantation in 9 patients aged 19-64 years. All received immunosuppression with prednisolone, azathioprine, and cyclosporine. No patient was in heart failure. During the study period, six grafts functioned, and three were nonfunctioning--two due to rejection and one to acute tubular necrosis. Plasma ANF concentration at the time of transplantation was 48 +/- 16 pmol/L (mean +/- SEM) range 15-145 pmol/L. In the six patients with functioning grafts, ANF declined in parallel with the fall in serum creatinine (658 +/- 35 to 210 +/- 34 mumol/L). In the three with nonfunctioning grafts, serum creatinine and plasma ANF concentration both increased. There was overall a significant linear relation between serum creatinine and plasma ANF (r = 0.527, P less than 0.001). The changes in plasma ANF after renal transplantation bore no relationship to changes in body weight or blood pressure. However, plasma ANF concentration was related to allograft fractional sodium excretion (r = 0.687, p less than 0.001). We conclude that elevated plasma ANF concentrations in end-stage renal disease are restored to normal by successful renal transplantation, implying that renal function is a determinant of plasma ANF concentration. Circulating plasma ANF may also have a direct effect on allograft sodium excretion.