Abstract
BackgroundInterventions to better manage aggressive behaviour and reduce recidivism are a primary concern for corrective services. Nutritional interventions to correct prisoner behaviour have been largely overlooked in the literature. Emerging evidence suggests that dietary intake influences aggressive behaviours and that nutritional supplementation with omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) could attenuate both the severity and frequency of aggressive behaviour.MethodsAdult male prisoners who have a history of aggressive behaviour (n = 600) will be recruited from at least 6 Correctional Centres and randomised to receive either n-3 LCPUFA or placebo supplementation for a 16-week duration. Treatment will be with either 1 g/day of n-3 LCPUFA (694 mg DHA and 397 mg EPA) or placebo capsules, which are a corn/soy oil blend and are identical in size and colour.The primary outcome measure is the Inmate Behavioural Observation Scale (IBOS): an objective measure of aggressive behaviour. Secondary outcome measures include questionnaires (including aggression, attention deficit disorder, impulsivity, depression/anxiety/stress scales), engagement in programmes, recidivism and quality of life. Baseline and post-intervention assessments include the IBOS, questionnaires and blood to measure the levels of n-3 LCPUFA.DiscussionTo conclusively test the potential that increasing n-3 LCPUFA intakes can improve rates of prisoner aggression and associated mental health and violence-related social system management costs, we propose an adequately powered multi-centre, double-blind, randomised controlled trial, examining the effects of n-3 LCPUFA supplementation on aggressive behaviour in adult male prisoners. If successful, this study will inform prisoner policy with respect to nutrition and by inference contribute to a broader community approach to preventative mental health practices.Trial registrationAustralian New Zealand Clinical Trial Registry (ANZCTR) ACTRN12618001665224. Registered on 10 October 2018.
Highlights
Background and rationale {6a} While the importance of good nutrition for optimal mental health is increasingly being recognised [1], poor nutrition and low educational attainment are more common in low socio-economic groups and both are defining characteristics of prisoner populations
To conclusively test the potential that increasing n-3 LCPUFA intakes can improve rates of prisoner aggression and associated mental health and violence-related social system management costs, we propose an adequately powered multi-centre, double-blind, randomised controlled trial, examining the effects of n-3 LCPUFA supplementation on aggressive behaviour in adult male prisoners
A vast body of literature has attested to the benefits of dietary supplementation on mental health issues in general [1] and an emerging literature suggests that dietary supplementation may impact upon aggressive behaviour [2, 3]
Summary
Background and rationale {6a} While the importance of good nutrition for optimal mental health is increasingly being recognised [1], poor nutrition and low educational attainment are more common in low socio-economic groups and both are defining characteristics of prisoner populations. Nutrition is rarely supplemented as a strategy for improving prison behavioural outcomes, even as part of existing mental health intervention programmes which tend to focus on acute needs rather than long-term management [4]. Omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) have cardiovascular health benefits [5, 6], and there is emerging evidence for n-3 LCPUFA benefits for mental health benefit, including reducing violent or aggressive behaviour [7]. Emerging evidence suggests that dietary intake influences aggressive behaviours and that nutritional supplementation with omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFA) could attenuate both the severity and frequency of aggressive behaviour
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