Dietary supplements for aggressive behavior: studies in people with intellectual disability

Het doel van de dissertatie van David Gast is: het onderzoeken in hoeverre voedingssupplementen (vitaminen, mineralen en omega-3 vetzuren) in de praktijk gebruikt kunnen worden als interventie voor het verminderen van agressief gedrag bij mensen met een verstandelijke beperking (Chapter 1). Daartoe zijn verschillende studies verricht, te beginnen met een onderzoek naar de kwaliteit van voedingspatroon(Chapter 2). De tweede studie is een focusgroep onderzoek, waarin wordt onderzocht in hoeverre professionals en cliënten in de gehandicaptenzorg een interventie met voedingssupplementen accepteren als interventie voor moeilijk verstaanbaar gedrag (Chapter 3). De derde en vierde studies zijn RCT’s waarin het effect van voedingssupplementen wordt onderzocht op agressief gedrag bij respectievelijk gedetineerden (Chapter 4), en mensen met een verstandelijke beperking (Chapter 5). Het laatste onderzoek (Chapter 6) is een meta-analyse van de door ons gevonden studies naar het effect van een interventie met multivitaminen- mineralen op agressief gedrag. Om toekomstig onderzoek met voedingssupplementen in een kwetsbare populatie te faciliteren hebben we de door ons geleerde lessen geordend en van kanttekeningen voorzien (Chapter 7). Tot slot volgt een samenvatting en algemene discussie over de inhoud van de dissertatie (Chapter 8).LUMC / Geneeskund

Dietary supplements for aggressive behaviour in people with intellectual disabilities: a randomised controlled crossover trial

BackgroundAggressive incidents are common in people with intellectual disabilities. Therefore, we aimed to assess whether supplementation of multivitamins, minerals, and omega-3 fatty acids (FA) reduces aggressive incidents.MethodsWe conducted a randomised, triple blind, placebo controlled, single crossover intervention trial. People with intellectual disabilities or borderline intellectual functioning, between 12 and 40 years of age, and showing aggressive behaviour were included. Participants received either a daily dose of dietary supplements, or placebo. Primary outcome was the number of aggressive incidents, measured using the Modified Overt Aggression Scale (MOAS).Resultsthere were 113 participants (placebo, n = 56), of whom 24 (placebo, n = 10) participated in the crossover phase of the trial. All 137 trajectories were included in the analyses. There was no significant difference in mean number of aggressive incidents per day between those assigned to supplements and those who received placebo (rate ratio = 0.93: 95% Confidence Interval [CI] = 0.59–1.45).ConclusionIn this pragmatic trial, we did not find significant differences in the outcomes between the supplement and placebo arms. The COVID-19 pandemic started midway through our trial, this may have affected the results.</div

Diet quality among people with intellectual disabilities and borderline intellectual functioning

Background We sought to assess diet quality among people with intellectual disabilities or borderline intellectual functioning, living in residential facilities or receiving day care. Methods We measured diet quality using the Dutch Healthy Diet Food Frequency Questionnaire (DHD) and compared this between participants with (n = 151) and controls without intellectual disabilities (n = 169). Potential correlates of diet quality were explored. Results We found lower mean diet quality among people with intellectual disabilities (M = 80.9) compared to controls (M = 111.2; mean adjusted difference -28.4; 95% CI [-32.3, -24.5]; p < .001). Participants with borderline intellectual functioning and mild intellectual disabilities had lower diet quality and higher body mass index than individuals with severe to profound intellectual disabilities. Being female was a predictor of better diet quality. Conclusions Overall, we found that diet quality was low in the sample of people with intellectual disabilities or borderline intellectual functioning.Stress-related psychiatric disorders across the life spa

Reducing aggressive behavior in people with intellectual disability with dietary supplements

Abstracts of the Proceedings of the 6th IASSIDD Europe Congress: Value Diversit

Lessons learned from two clinical trials on nutritional supplements to reduce aggressive behaviour

Background Setting up and conducting a randomised controlled trial (RCT) has many challenges-particularly trials that include vulnerable individuals with behavioural problems or who reside in facilities that focus on care as opposed to research. These populations are underrepresented in RCTs. Approach In our paper, we describe the challenges and practical lessons learned from two RCTs in two care settings involving long-stay psychiatric inpatients and people with intellectual disabilities. We describe five main difficulties and how these were overcome: (1) multisite setting, (2) inclusion of vulnerable participants, (3) nutritional supplements and placebos, (4) assessment of behavioural outcomes, and (5) collecting bio samples. Conclusions By sharing these practical experiences, we hope to inform other researchers how to optimally design their trials, while avoiding and minimising the difficulties that we encountered, and to facilitate the implementation of a trial. Both trials were registered in the Clinical Trials Register (RCT A: NCT02498106; RCT B: NCT03212092).Stress-related psychiatric disorders across the life spa

Diet quality among people with intellectual disabilities and borderline intellectual functioning

Background: We sought to assess diet quality among people with intellectual disabilities or borderline intellectual functioning, living in residential facilities or receiving day care. Methods: We measured diet quality using the Dutch Healthy Diet Food Frequency Questionnaire (DHD) and compared this between participants with (n = 151) and controls without intellectual disabilities (n = 169). Potential correlates of diet quality were explored. Results: We found lower mean diet quality among people with intellectual disabilities (M = 80.9) compared to controls (M = 111.2; mean adjusted difference -28.4; 95% CI [-32.3, -24.5]; p < .001). Participants with borderline intellectual functioning and mild intellectual disabilities had lower diet quality and higher body mass index than individuals with severe to profound intellectual disabilities. Being female was a predictor of better diet quality. Conclusions: Overall, we found that diet quality was low in the sample of people with intellectual disabilities or borderline intellectual functioning