Supplements show promise for management of childhood aggression: Meta-analysis

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Dietary supplements like vitamins, minerals, and omega-3 fatty acids may help reducing excessive aggression in children and youth, says a new meta-analysis of 22 studies, including 16 were randomized controlled trials.

Data published in Aggression and Violent Behavior indicated that the strongest support was for studies with vitamins and minerals, while the data from studies using essential fatty acids were mixed.

On the other hand, vitamin D and L-tryptophan supplementation did not produce any significant effects, reported scientists from Waypoint Research Institute, the University of Toronto, and McGill University in Canada.

“Nutritional supplements are cheaper on the system level than conventional mental health treatment and more affordable for individuals than most psychological interventions; further, they are also more widely accepted by parents and have a more positive side effect profile than most psychotropic medications,” they wrote.

“This systematic review concluded that while the data are still inconsistent regarding the benefits of essential fatty acid supplementation and insufficient regarding most other supplements investigated to date, findings in relation to broad-range vitamin and mineral supplements point into the direction that such products may have a role in the management of aggression.

“Their consideration seems warranted especially when bearing in mind the wide range of other (mental) health benefits broad-range micronutrient supplements could provide beyond the regulation of violent behavior, with very minor side effects.”

Meta-analysis

The Canada-based scientists reviewed the literature and identified 22 studies that fit their inclusion criteria for their meta-analysis. Sixteen of these investigated multi-nutrient supplementation, while the remaining six were single nutrients. The average duration of supplementation was 14.8 weeks. The studies included children and young people with disruptive, impulse control and conduct disorders or with neurodevelopmental (including ADHD or autism).

Pooling the data revealed that all four studies of multivitamin and minerals showed a benefit, but when combined with essential fatty acids (one study), the results were mixed. For essential fatty acids alone, one study showed benefits, four showed mixed results, and a further six found no benefits. Mixed results were also observed for a study using carnitine supplementation.

One study using magnesium plus vitamin B6 had benefits, while the data for vitamin D and L-tryptophan found no benefits.

“The findings, favoring multinutrients in relation to their effectiveness to reduce aggression in children and youth, are in line with outcomes found in other areas on nutritional psychiatry, where complex formulas of vitamins and minerals proved to be effective in supporting different areas of mental health such as mood, posttraumatic stress, or non-aggression-related ADHD symptoms,” wrote the researchers.

“The fact that broad-range micronutrient formulas seem to enhance not just one but multiple aspects of mental health without significant side effects make them a reasonable treatment alternative, especially for clients refusing conventional psychiatric medications or who have difficulties tolerating their side effects.”

The researchers called for more “high-quality, appropriately powered trials are definitely needed to provide further support to the above recommendation”.

Source: Aggression and Violent Behavior

July–August 2023, Volume 71, 101841, doi: 10.1016/j.avb.2023.101841

“Nutritional supplementation in the management of childhood/youth aggression: A systematic review”

Authors: R. Qamar et al.