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10.1192/bjp.bp.108.061820 Access the most recent version at DOI: 2009, 195:366-367. BJP  Simon C. Moore, Lisa M. Carter and Stephanie van Goozen Confectionery consumption in childhood and adult violence References http://bjp.rcpsych.org/content/195/4/366#BIBL This article cites 0 articles, 0 of which you can access for free at: permissions Reprints/ [email protected] write to To obtain reprints or permission to reproduce material from this paper, please to this article at You can respond http://bjp.rcpsych.org/cgi/eletter-submit/195/4/366 from Downloaded The Royal College of Psychiatrists Published by on October 29, 2012 http://bjp.rcpsych.org/ http://bjp.rcpsych.org/site/subscriptions/ go to: The British Journal of Psychiatry To subscribe to Childhood factors that influence the expression of violence in adulthood are numerous and include economic, ecological and individual factors (such as personality traits). 1Diet has been causally associated with population mortality rates, neurocognitive deficits, disruptive behaviour, antisocial and aggressive behaviour, and offending behaviour in a prison population. 2–5 Furthermore, decision biases, such that rewards are subjectively overweighted and punishment underweighted, are associated with delinquency. 6 Confectionery (sweets/chocolates), often used as a quick reward for children, has also received attention, 3,7 although studies have mostly focused on the short-term effects of diet on behaviour: the long-term effects have yet to be determined. The objective of our study was to extend what is currently known about childhood risk factors for violence by also considering the role of confectionery. We hypothesise that excessive confectionery consumption increases the likelihood of violence in adulthood. Method Our analysis included data on the births and families of babies (respondents, hereafter) born in the UK in one particular week (n= 17 415) derived from the British Cohort Study which began in 1970. Information was requested on all babies born (alive or dead) after the 24th week of gestation from 00:01 on Sunday 5th April to 24:00 on Saturday 11th April 1970. It is estimated that not more than 5% and not less than 2% of all births were missed. Since 1970 there have been seven data collections designed to monitor respondents’ health, education, social and economic circumstances. These additional waves took place when respondents were aged 5, 10, 16, 26, 30, 34 and 42 years. We used data from the age 10 wave when respondents were asked how frequently they consumed confectionery, and the age 34 wave, when self-report violent offending data and additional information on socio- economic status were collected. Additional data were taken from the age 5 wave that characterised respondents’ early development, including parenting style. Respondents were coded positive for perpetration of violence (violence, hereafter) if the most recent offence, between the age 30 and age 34 surveys, for which they were found guilty involved violence. Violence data were collected using a reliable self-report computer-assisted interview methodology. 8 Confectionery consumption was reduced to a binary variable (every day = 1, less often or never = 0) owing to small numbers in the violence variable. To check the robustness of estimates we regressed confectionery consumption onto violence and then incrementally added control variables. With no substantial changein either the sign or significance of the effect of eating confectionery, we then sought the most parsimonious model by removing control variables that yielded no significant association. Numerous control variables were entered into initial models, including information on: the child’s behaviour at home at age 5 years and maternal circumstances based on the Rutter A Scale of behavioural deviance (completed by a parent, usually the mother, and designed to measure behaviour-adjustment problems) and the Malaise Inventory (a 24-item self-completion scale designed to assess psychiatric morbidity); 9aggression and impulsivity at age 10 years, assessed by the child’s class teacher; mental ability at age 5 years, derived from figure drawing and vocabulary tests, reduced to a single mental ability score using a procedure described by Batty 10 and validated against a health visitor’s subjective assessment of ability. Forty-three questions were used to assess parental attitudes in the age 5 wave and iterated principal factor analysis with an oblique rotation method 11 (Kaiser–Meyer–Olkin measure of sampling adequacy 0.88) yielded three factors: an authoritarian attitude to parenting, mothers’ perceptions of their rights, and a parenting style that is more liberal and affords children greater freedom. Across all models the association between eating confectionery daily remained statistically significant. As the binary outcome variable, violence, is a rare event (0.47%) and the statistical analysis of rare events (55%) presents problems, particularly for logistic models, 12 a rare event logistic model 12with cluster correction on government office region was the preferred analytic strategy. Results Overall, 69% of respondents who were violent by the age of 34 years reported that they ate confectionery nearly every day during childhood, compared with 42% who were non-violent. Table 1 presents statistics from the final regression model. Tests for collinearity in independent variables yielded variance inflation factors less than 1.05. Spearman correlation coefficients suggested weak (r50.1 andP50.001 for each comparison) positive associations between being male and not having educational qualifications after the age of 16; eating confectionery daily and being male; access to motorised transport at the age of 34 and being male; parents’ attitudes towards parenting and eating confectionery daily; access to motorised transport at 34 years; and living in a rural area at age 34 years. Weak negative associations between living in a rural area at age 34 years and eating confectionery daily (r=70.06), and parents’ attitudes towards parenting and access to motorised transport at age 34 366 Confectionery consumption in childhood and adult violence Simon C. Moore, Lisa M. Carter and Stephanie H. M. van Goozen Summary Diet has been associated with behavioural problems, including aggression, but the long-term effects of childhood diet on adult violence have not been studied. We tested the hypothesis that excessive consumption of confectionery at age 10 years predicts convictions for violence in adulthood (age 34 years). Data from age 5, 10 and 34 years were used. Children who ate confectionery daily at age 10 years weresignificantly more likely to have been convicted for violence at age 34 years, a relationship that was robust when controlling for ecological and individual factors. Declaration of interest None. The British Journal of Psychiatry(2009) 195, 366–367. doi: 10.1192/bjp.bp.108.061820 Short report years (r=70.03) were also observed. Marginally more substantial associations were observed between not having educational qualifications after the age of 16 and eating confectionery daily (r= 0.11), and parents’ attitudes towards parenting and not having educational qualifications after the age of 16 (r= 0.12). The rare events logistic regression model (Table 1) yielded a significant relationship between eating confectionery at age 10 years and violence at age 34 years. This association was consistent across all models where ecological, childhood and other controls were included. Other significant relationships between control variables and violence included a child’s gender and parents’ attitudes towards parenting. Health visitor screening during childhood protected against adult violence. Having access to motorised transport at age 34 years protected against adult violence, whereas living in a rural area at age 34 years increased the risk of violence. Attrition and non-response bias mean that the data available for analysis may not be characteristic of the larger population, which might affect our conclusions. Discussion Analysis of the British Cohort Study has the advantage of a large sample size and the opportunity to control for numerous potential confounds. However, as a general population cohort study it was not designed to specifically examine the nature of diet and how it might be related to behaviour in the long-term. Exogeneity, whereby a third unmeasured variable promotes both dietary choice and violence across the lifespan (e.g. a genetic factor), is unlikely because dietary choices for 10-year-olds are primarily governed by their immediate circumstances, in particular their parents and primary carers, and these factors are already accounted for in the model presented here. Moreover, self-report data provide an accurate source of behavioural information 8and having controlled for numerous control variables suggest that the relationship between confectionery consumption and violence is both novel and robust. Candidate mechanisms linking confectionery consumption to adult violence must account for enduring changes into adulthood. One plausible mechanism is that persistently using confectionery to control childhood behaviour might prevent children from learning to defer gratification, in turn biasing decision processes towards more impulsive behaviour, biases that are strongly asso- ciated with delinquency. 6Furthermore, childhood confectionery consumption may nurture a taste that is maintained into adult- hood, exposing adults to the effects of additives often found in sweetened food, 3the consumption of which may also contribute towards adult aggression. Moreover, although parental attitudes were associated with adult violence, the effect of diet was robust having controlled for these attitudinal variables. Irrespective of the causal mechanism, which warrants further attention, targetingresources at improving childhood diet may improve health and reduce aggression. Simon C. Moore, PhD, Violence and Society Research Group, Applied Clinical Research and Public Health, School of Dentistry, Cardiff University;Lisa M. Carter, School of Medicine, Cardiff University;Stephanie van Goozen, PhD, School of Psychology, Cardiff University, UK CorrespondenceSimon C. Moore, Violence and Society Research Group, Applied Clinical Research and Public Health, School of Dentistry, University of Cardiff, Cardiff CF14 4XY, UK. Email: [email protected] First received 13 Nov 2008, final revision 30 Apr 2009, accepted 1 Jun 2009 Funding The research was supported by a grant from the Economic and Social Research Council (ES/D000483/1). References 1Farrington DP. Early predictors of adolescent aggression and adult violence. Violence Vict1989;4: 79–100. 2Gesch CB, Hammond SM, Hampson SE, Eves A, Crowder MJ. Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Randomized placebo-controlled trial. Br J Psychiatry2002;181: 22–8. 3McCann D, Barrett A, Cooper A, Crumpler D, Dalen L, Grimshaw K, et al. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial.Lancet2007;370: 1560–7. 4Hibbeln JR, Nieminen LRG, Lands WEM. Increasing homicide rates and linoleic acid consumption among five western countries, 1961–2000.Lipids2004;39: 1207–13. 5Liu J, Raine A, Venables A, Sarnoff AM. Malnutrition at age 3 years and externalizing behavior problems at ages 8, 11, and 17 years.Am J Psychiatry 2004;161: 2005–13. 6Fairchild G, Goozen SH, Stollery SJ, Aitken MR, Savage J, Moore SC, et al. Decision-making and executive function in male adolescents with early-onset or adolescence-onset conduct disorder and control subjects.Biol Psychiatry 2009;66: 162–8. 7Benton D. The impact of diet on anti-social, violent and criminal behaviour. Neurosci Biobehav Rev2007;31: 752–74. 8Turner CF, Ku L, Rogers SM, Lindberg LD, Pleck JH, Sonenstein FL. Adolescent sexual behavior, drug use, and violence: increased reporting with computer survey technology.Science1998;280: 867–73. 9Rutter M, Whitmore K, Tizard J.Education, Health and Behaviour. Longmans, 1970. 10Batty GD, Deary IJ, Schoon I, Gale CR. Mental ability across childhood in relation to risk factors for premature mortality in adult life: the 1970 British Cohort Study.J Epidemiol Community Health2007;61: 997–1003. 11Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research.Psychol Methods1999; 4: 272–99. 12King G, Zeng L. Logistic regression in rare events data.Polit Anal2001;9: 137–63. 367 Confectionery consumption in childhood and adult violence Table 1Results from a rare events logistic multiple regressionmodel indicating a significant association between daily confectionery consumption at age 10 years and conviction for violence by 34 years a Variable Wave Odds ratio 95% CIP Daily confectionery consumption 10 years 3.182 1.374–7.369 0.007 Male 5 years 8.927 2.526–31.549 0.001 Late birth 5 years 3.648 1.531–8.692 0.003 Health visitor screening 5 years 0.294 0.096–0.9 0.032 Child-oriented parenting 5 years 1.874 1.319–2.66150.001 Access to a motor car 34 years 0.224 0.11–0.45650.001 Rural area 34 years 1.801 0.977–3.321 0.059 Constant0.003 0–0.02250.001 a. Observationsn= 6942.
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H4 Correlation& Regression Answer every question in the blue boxes provided below each question prompt. Read the two versions of the article posted on Canvas linking childhood candy consumption to adult violence (Modules, Chapter 8, candy & violence, parts 1 and 2). Answer the following questions (5 points): What claim is being made? (a sentence) Answer: Describe two plausible explanations of the association between candy consumption and adult violence other than the impact of ingesting sugar. (two to four sentences) Answer: Why not conduct an experiment on the effects of childhood candy consumption on adult violence? (a couple of explanatory sentences) Answer: Dr. Carefree placed unobtrusive video recording devices in the living rooms of 20 children. Later, coders (Matt, Mark, and Peter) viewed tapes of the living areas and coded how many minutes each child spent playing video games. Dr. Carefree wants to use the two most reliable coders. Whom should she pick and why? (1 point) Answers: Coders: Why: What is the best estimate for the correlation that summarizes each of the four following scatterplots (1 point each)? Use one these values for your best guess for each graph: -.75, -.15, 0, .15, .75 Answers: Scatterplot Value Dr. Miller walks into a bar. He asks a random sample of patrons how confident they feel (their chances of picking up a member of the opposite sex, measured by subjective probability), and also how many beers they have drunk this evening. His results are shown in the following graph: In his study, what is the independent variable? The dependent variable? How are the two variables related in his data? (3 points) IV: DV: How are they related?: If the average person has drunk 2.5 beers, approximately what does the average person think their chances are of picking up somebody in the bar in this study? (1 point) Answer: The regression equation shows a significant beta weight for beer of .41. What is the best interpretation of this estimate? (1 point) Answer: Research suggests a relationship between beers consumed and number of snapchats, finding that more beer consumption is associated with more snapchats sent on average. Dr. Miller wants to know if differences in extraversion might offer an alternative explanation of why some people send more snapchats than others. Perhaps more extraverted people send more snapchats and also drink more beer. Miller combines the data, that is, average extraversion ratings and number of beers consumed, in a multiple regression equation. His findings are presented in the table below: DV: Snapchats Variable Beta Significance ( p) # Beers consumed .45 .02 Extraversion .30 .02 What should Dr. Miller conclude? (2 points for each variable). Do his results suggest that he can rule out extraversion as a third variable explanation of the effects of beer? (1 point). Answers: What should Dr. Miller Conclude? Extraversion: Beer: Do his results suggest that he can rule out extraversion as a third variable explanation?
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Sugar Rush… to Prison? Study Says Lots of Candy Could Lead to Violence LONDON (AP) Willy Wonka would be horrified. Children who eat too much candy may be more likely to be arrested for violent behavior as adults, new research suggests.British experts studied more than 17,000 children born in 1970 for about four decades. Of the children who ate candies or chocolates daily at age 10, 69 percent were later arrested for a violent offense by the age of 34. Of those who didn’t have any violent clashes, 42 percent ate sweets daily.The study was published in the October issue of the British Journal of Psychiatry. It was paid for by Britain’s Economic and Social Research Council.The researchers said the results were interesting, but that more studies were needed to confirm the link. “It’s not that the sweets themselves are bad, it’s more about interpreting how kids make decisions,” said Simon Moore of the University of Cardiff, one of the paper’s authors.Moore said parents who consistently bribe their children into good behavior with candies and chocolates could be doing harm. That might prevent kids from learning how to defer gratification, leading to impulsive behavior and violence.Even after Moore and colleagues controlled for other variables like different parenting skills and varying social and economic backgrounds, they found a significant link between childhood consumption of sweets and violent behavior in adulthood.Previous studies have found better nutrition leads to better behavior, in both children and adults.Moore said his results were not strong enough to recommend parents stop giving their children candies and chocolates. “This is an incredibly complex area,” he said. “It’s not fair to blame it on the candy.” ANOTHER TAKE ON THIS… Can sweets turn you sour? Sweet enough already? “Lots of sweets makes kids thuggish adults,” said The Mirror today. The newspaper reports that research has found that more than two in three people (69%) with a violent record by the age of 34 had “scoffed confectionery every” day when they were 10 years old. The newspaper quoted experts who think that this aggression comes from not learning patience in childhood. The research, involving 17,500 people, is the first to look at adult violence in relation to childhood diet. However, there are other possible explanations for this link including the fact that difficult children might be given more sweets. It should be noted there was a high proportion of people who ate sweets every day in both the violent and non-violent groups. Also, it appears that less than 0.5% of children (about 81) in this study became violent offenders. Overall, this study on its own does not provide strong enough evidence to support media explanations for the supposed link, which would need more study through dedicated research. Regardless, common sense tells us that eating too many sweets is not good for children’s health.   Where did the story come from? Dr Simon Moore and colleagues from Cardiff University carried out this research. The study was funded by a grant from the Economic and Social Research Council, and published in the peer-reviewed British Journal of Psychiatry.   What kind of scientific study was this? This was a retrospective analysis of data from a prospective cohort study, the British Cohort Study. This research collected data on newborns at regular intervals from 1970 onwards. It followed 17,415 babies born in the UK in one particular week in April that year, and also collected data on their families. The researchers estimate that 95-98% of all births in that week were included. The researchers explain that diet has been associated with behavioural problems, including aggression, but that the long-term effects of childhood diet on adult violence have not been studied. Using the previously collected data they attempted to see if eating sweets and chocolates at 10 years of age was a predictor of convictions for violence in adulthood, up to 34 years of age. Since 1970, there have been seven periods of data collection that used questionnaires to ask about health, education, social and economic circumstances. These took place when the study participants were aged 5, 10, 16, 26, 30, 34 and 42. The researchers only used the data from 5, 10 and 34 years of age. At 10 years old, participants were asked how often they ate sweets, and at 34 years, they self-reported violent offending data and additional information on socioeconomic status. A computerised system was used to ask the questions about violent offending. Some additional questions from the data collection at five years old were used to classify children’s early development and their parents’ style of parenting. Responses to the questions about eating confectionary at the age of 10 were converted into two possible answers: every day or less often/never. The results were analysed using a rare event logistical model, which takes into account that only 0.47% (possibly about 81 children) became violent offenders.   What were the results of the study? Overall, 69% of respondents who were violent by the age of 34 years reported that they ate sweets nearly every day during childhood. Sweets were eaten this regularly by 42% of those who were non-violent. The researchers say that children who ate confectionery daily at age 10 were significantly more likely to have been convicted for violence at age 34, a relationship that was robust when controlling for ecological and individual factors.   What interpretations did the researchers draw from these results? The researchers say that children who ate confectionery daily at age 10 were significantly more likely to have been convicted for violence at age 34 years and that this link remained significant even after controlling for a number of other environmental and the individual’s life factors.   What does the NHS Knowledge Service make of this study? This analysis of the British Cohort Study has the advantage of a large sample size. As it is designed prospectively, it also avoids the chance of reverse causation, i.e. the possibility that in some way violent offending might determine dietary habit. However, there are limitations to this study, some of which are mentioned by the authors: As a general population cohort study it was not designed to specifically examine the nature of diet and how it might be related to behaviour in the long-term. This increases the chance that the original study did not include questions about aspects that later became important. For example, the study does not appear to have asked about family income. The researchers collapsed the responses about how much confectionery was consumed into two categories, known as a binary variable (every day or less often/never). Analyses using this method means that important links between the amount or type of confectionary eaten may have been lost. The approach increased the chance of finding a statistical link for the rare event, (e.g. offending), but at the expense of useful information. The absolute number of children who became violent offenders is not reported in this publication and this also makes it difficult to be sure that the difference in eating habits between a small number of violent offenders and a large number of normal adults is statistically significant. The detail of questions asked by the self-reported computer-assisted interview are not reported and the context of how such sensitive information is collected should be considered when assessing how reliable the responses might be. The accuracy of information provided could have been checked against other records or by face-to-face interview. The number of people choosing not to respond to these questions was not published. Overall, this study on its own does not provide strong enough evidence to guide childhood dietary advice, although common sense says that eating too many sweets is probably not good for children. Before the newspapers’ explanation for a link can be believed there must be studies specifically designed to investigate the issue from the outset.