Do Black Lives Matter?

Linoleic acid (LA) is an essential omega 6 polyunsaturated fatty acid that is primarily found in seed oils (also known as vegetable oils). Seed oils have become so ubiquitous that they are in almost every processed food item found on a supermarket shelf as well as in almost every item on the menu in fast food shops, take away shops and restaurants. This has resulted in a huge increase in its consumption, from the 1930s when it accounted for around 1–2% of daily calories, to today, where it now accounts for around 7–8% of daily calories (Taha, 2020). This is particularly problematic for around 80% of blacks who have a gene variant that means that when they consume excess amounts of LA it initiates a chemical response in the body called oxidative stress.

Tiny Bit of Science…

Oxidative stress is an imbalance between free radicals and antioxidants in the body. Free radicals are molecules in the body that have an unpaired electron in their outer orbit making them unstable and generally highly reactive. Electrons however, like to be in pairs, so these free radicals scavenge the body to seek out other electrons, so they can become a pair. This causes disruption and damage to cells, proteins and DNA. The body’s response to this is to produce antioxidants. Antioxidants are molecules in cells that prevent free radicals from taking electrons and causing damage. Antioxidants are able to give an electron to a free radical without becoming destabilized themselves, thus stopping the free radical chain reaction.

Glutathione, The body’s Natural Antioxidant

There is an important antioxidant that the body produces called glutathione (GSH) that is involved in the production of vitamin D (Parsanathan & Jain, 2020), but when there is insufficient GSH to match the amount of free radicals present, vitamin D deficiency occurs which has a cascading effect that results in inflammation. Chronic inflammation is when the body’s immune system that has evolved to provide a protective defence against viruses, bacteria and pathogens acts as if it is constantly under attack. This is hugely resource intensive and undermines the body’s ability to function effectively, as compromises must be made due to having finite energy reserves. This prolonged inflammatory response can eventually start damaging healthy cells, tissues, and organs and lead to the diseases that collectively represent the leading causes of disability and mortality worldwide, such as cardiovascular disease, cancer, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease and autoimmune and neurodegenerative disorders.

So, What Exactly is The Problem? Oxidative Stress

Scientists have suspected for a long time that a diet high in LA from foods containing seed oils that typically come from sunflowers, corn, soybeans, and canola, increase oxidative stress in humans (Turpeinen, Basu, and Mutanen, 1998). Oxidative stress can be initiated by the body converting LA to another polyunsaturated fatty acid called arachidonic acid (AA). But studies in subjects largely of European ancestry had indicated only a small proportion of dietary LA is converted to AA in humans, suggesting that even in the presence of high LA, there was limited capacity for it to be converted to AA and thus LA was not considered problematic. Based on these findings done primarily on people of European ancestry, it was assumed that the low rate of conversion of LA to AA applied to all human populations equally. However, studies later emerged suggesting that there was genetic variability in the rate of conversion of LA to AA, with blacks being significantly more efficient at converting LA to AA and thus far more likely to experience oxidative stress, chronic inflammation and all of the associated diseases (Sergeant et al., 2011; Sergeant et al ., 2012; Mathais et al., 2011).

Quick recap

LA found mostly in seed oils, makes up around 7–8% of total calories consumed for most people eating a standard Western diet, up around 8 fold from one hundred years ago.

Ultra-processed foods (UPF) tend to be high in seed oils. The dietary contribution of UPF was found to be highest among African Americans making up 62.1% of their total energy intake, suggesting that LA may make up even more than 8% of the total calories that they consume (Baraldi et al., 2018).

Why This is a problem

Excess consumption of LA can result in it being converted to AA which is a known inflammatory pathway

Approximately 81% of blacks have a gene that results in them being more efficient at converting LA to AA in comparison to around 43% of whites (Rifkin et al., 2021)

Blacks are significantly more likely to have high AA serum blood levels than whites (Rifkin et al., 2021)

Elevated blood plasma levels of AA is strongly associated with hypertension, inflammation and heart disease (Tsukamoto and Sugawara, 2017: Martinelli et al., 2008)

Studies have consistently shown high blood pressure levels in African Americans and an earlier onset of hypertension (Lackland, 2014).

Elevated blood plasma levels of AA is known to cause leptin resistance, which occurs when leptin, a hormone that regulates hunger and metabolism, no longer responds to signals of satiety in a normal way and can result in obesity and oxidative stress (Cheng et al., 2015: Bouloumie et al., 1999).

High plasma levels of AA are associated with an imbalance between free radicals and antioxidants known as oxidative stress and cancer (Sztolsztener et al., 2020: Nagata et al., 2017)

Being African American is considered an independent risk factor for enhanced oxidative stress and inflammation (Feairheller et al., 2011).

Oxidative stress is believed to induce obesity (Youn et al., 2014)

Over 80% of black women over the age of 20 are overweight or obese in America (Hhs.gov., 2020)

Antioxidants like GSH are produced by the body to regulate free radicals to avoid or limit oxidative stress.

Glutathione can become depleted by long-term oxidative stress

Blood GSH levels are 13% lower in blacks than in whites (Richie et al., 2007: Morris et al., 2012)

GSH is necessary for the production of vitamin D which is an important vitamin for the immune system and overall health (Parsanathan & Jain, 2020)

Obesity is also strongly associated with vitamin D deficiency, with a previous studying showing that 78.4% of female adolescent African Americans who were obese were also vitamin D deficient (Ashraf et al., 2009)

82.1% of African-American adults have vitamin D deficiency the highest prevalence rate of any group (Parva et al., 2018)

How this affects differences in racial outcomes

As should now be abundantly clear, excess LA is potentially very significant in driving the disparities that exist between blacks and whites in health outcomes. However, three other areas in which the pernicious effects of LA may be at play will be considered: birth outcomes; educational outcomes; and violent crime.

Birth Outcomes

The differences in outcomes between blacks and whites start before birth so attempting to close gaps after birth are unlikely to be completely successful. This is because so much development occurs during pregnancy that cannot be augmented or altered later on. So to address racial disparities, prioritising the health and well-being of the mother during the preconception period and throughout the pregnancy is essential. In order for this to be the case, what is done regarding excess linoleic acid is critical.

A recent animal model study has shown the dangerous liaison between vitamin D deficiency and high blood plasma levels of AA which can be induced by consuming a diet high in seed oils containing linoleic acid (Nandi et al., 2019). In this study, mothers with both vitamin D deficiency and high blood plasma levels of AA were shown to be far more likely to give birth to underweight offspring. This mirrors the experience of black mothers in America where a recent study showed that the prevalence of vitamin D insufficiency was 91 % for non-Hispanic black women and 47 % for non-Hispanic white women (Chawla et al., 2019) and 13.3% of births by African American women are of low birth weight, whereas low birth weights make up only 7.1% of births from white women (March of Dimes, 2020).

The serious consequences of vitamin D deficiency are not to be underestimated. As well as low birthweight, first trimester miscarriage, preeclampsia, neonatal hypocalcemia, poor postnatal growth, bone fragility, and increased incidence of autoimmune diseases have all been linked to low vitamin D levels during pregnancy (Mulligan et al., 2009: Andersen et al., 2015).

This needs to be reiterated. Maternal vitamin D level is positively associated with the birth weight of both male and female infants in black mothers (Tian et al., 2015) and it may be the consumption of seed oils that is causing the vitamin D deficiency, by causing oxidative stress, thus lowering GSH which is required to produce vitamin D.

What do you think could be achieved if maternal diets are optimised prior to conception and on throughout the pregnancy? I think there is every reason to believe that the disparities in birth outcomes may be positively impacted.

Educational and cognitive outcomes

Intelligence and education are closely correlated and they appear to have a bidirectional effect on each other. For example, intelligent children spend longer in education; while a longer education, increases intelligence. In a knowledge and skill based society, intelligence and educational attainment are important modifiers of life outcomes. Therefore, any attempt to improve the outcomes for blacks, necessitates addressing the intelligence and educational gaps that exist and to do that the consumption of excess linoleic acid must be considered.

For example, there are clear associations between maternal vitamin D levels during pregnancy and the intelligence of the offspring (Melough et al., 2020).

In a recent article, I wrote about the role that seed oil consumption can play on the fatty acid composition of breast milk and how this can be a strong predictor of cognitive outcomes in the offspring. This is important because smarter kids are more likely to complete school education and thereby enjoy the additive cognitive benefits of education, which has been shown to add approximately 1 to 5 IQ points for each additional year of education completed (Ritchie and Tucker-Drob, 2018). In the 2017–18 school year, 79% of African Americans graduated from high school, in comparison to 89% of white Americans (Ed.gov., 2020).

Another reason for failing to complete school is due to disruptive behaviour, which appears to impact blacks disproportionately. For example in the UK, blacks are 3 times as likely to be permanently excluded from school as white British pupils (Gov.uk, 2020). While nationally in America, 5% of white boys and 2% of white girls receive one or more out-of-school suspensions annually, as compared with 18% of black boys and 10% of black girls (Gopolan & Nelson., 2019)

Interestingly however, omega 3 supplementation in children has shown promise in improving disruptive behaviour (Portnoy et al., 2018). A 2017 review of 16 studies, found that omega-3 fatty acids improved impulsivity, hyperactivity, attention, visual learning, and working/short-term memory (Derbyshire, 2017)

If these extraordinary results could be achieved with short term use of omega 3 supplementation, would it not be possible that a lifetime of consuming excessive amounts of omega 6 could cause oxidative stress and impair executive function and impulse control? What do you think could be achieved if maternal diets were optimised prior to conception and on throughout breastfeeding and then maintained in the child throughout childhood? I think there is every reason to believe that the disparities in educational and intellectual outcomes would be positively impacted.

Violent crime

Discussing the disparities in violent crime is often not pursued as it is considered a sensitive subject. However, failure to do so may mean opportunities are missed to resolve the issues. Also, there is simply no way that inequalities can be eradicated while blacks disproportionately commit violent crimes and as a result end up serving custodial sentences. As you will see, the role of seed oil consumption containing high amounts of LA cannot be ignored in addressing this issue.

It has been shown repeatedly that blacks bear a far higher burden of exposure to environmental pollutants than other groups. For example, blacks are significantly more exposed than other groups to particulate matter air pollution (Erqou et al., 2018).

However, while blacks in general experience higher exposure to pollution, even high income blacks are at a greater risk of death than lower income whites as a result of exposure to air pollution, which would suggest exposure alone is not the sole cause of the differences in outcomes between groups (Lung.org, 2016).

Interestingly, omega 3 supplementation has been shown to provide protection against particulate matter (Tong et al., 2012). In one particular study, dietary intake of the fatty acids omega-3 and omega-6, showed that they may have opposite effects on the severity of exposure to pollution. The study reported that children with higher levels of omega-3 in their diets had less severe symptoms of exposure to high levels of particulate matter pollution. Conversely, those children with higher levels of omega 6 had more severe symptoms in response to high levels of particulate matter pollution (Brighman et al., 2019). As already discussed, when blacks consume seed oils that are high in omega 6 LA, they very efficiently convert this to the omega 6 AA, which in high amounts is known to lead to oxidative stress. This means that their defence system is both preoccupied and impaired and thus less equipped to mount a successful assault against pathogens, viruses, bacteria and pollutants. The result is that blacks fare poorly in these areas. But how does this relate to violent behaviour?

Blacks have higher blood lead levels (BLL) than other groups even in childhood (White, Bonilha and Ellis, 2015) A study in America showed that 15.2% of black children aged 1–5 had high BLLs compared to 7.9% of white children of the same age (Public Health Post, 2019).

This is important because childhood lead exposure is strongly linked to cognitive impairment based on robust long term epidemiological studies (Reuben et al., 2017). In fact high BLLs have been implicated in poor academic outcomes (Aizer et al., 2015) as well as an explanation for racial disparities in academic test scores (Canfield, Jusko, and Kordas, 2005). However, perhaps even more alarmingly, high BLLs are strongly correlated to violent crime. A study looked at the aggregate BLLs in areas in America and found that they were statistically significant predictors of areas with violent crime i.e. areas with higher BLL had higher violent crime (Boutwell et al., 2017).

It should be noted, that these studies are observational and that correlation does not equal causation. However, from the data available African Americans appear to be more susceptible to the effect of pollutants due to an impaired immune system caused by excess LA through the consumption of seed oils. This may offer at least some explanation to why African Americans accounted for 52.4% of all homicide offenders in 2018 while making up 13% of the population (FBI, 2018). While in the UK, in 2010, blacks made up 2.7% of the general population, but made up 13.7% of the prison population (Gov.uk, 2010) and for the three-year period, year ending March 2017 to the year ending March 2019, when looking at the principal suspect of a homicide offence, almost one in five (18%) were black (Elkin, 2020).

I do not claim that high BLLs is the only cause for the disproportionate amount of black offenders of violent crime. However, what the data might show is that a compromised immune system that enables pollutants to impair cognition, could impact executive function and impulse control leading to poor self regulation and violent behaviour. Importantly, studies have shown that omega 3 supplementation was able to significantly decrease the effect of lead-induced brain damage in animal model studies (Singh et al., 2016).

Beyond animal studies, there are a plethora of gold standard double blind randomised controlled trials involving humans that show when violent and criminal offenders are given omega 3 supplements their behaviour changes relative to those given a placebo, resulting in reduced antisocial and aggressive behaviour (Raine et al., 2020: Cortie et al., 2020: Gesch et al., 2018) Interestingly, repeat offenders have been shown to be more likely to have lower omega 3 levels and when given omega 3, they re-offended less than those given a placebo (Miles et al., 2018).

If short term supplementation of omega 3 can alter ingrained violent behaviour of hardcore repeat offenders, how implausible is it that the life long consumption of seed oils containing the omega 6 fatty acid LA which causes oxidative stress and impairs the immune system could make people more susceptible to the ravages of lead contamination? How do you think society would change if children are supported to adopt an optimal diet that protects their brain and their immune system from pollutants? I think there is every reason to believe that the racial disparities in violent crime offences would be positively impacted.

Fat’s All Folks

We have seen how consuming LA is incredibly difficult to avoid as it is so pervasive in the foods that we eat. In fact health agencies have encouraged people to consume around 6% of daily calories from LA primarily from seed oils. It has impacted blacks from every socio-economic background. Even elite NBA basketball players (81.1% of which are black) are known to have vitamin D deficiency (Fishman, Lombardo & Kharrazi, 2016). Incredibly, the only group of black people that I was able to find in my research who have optimal levels of vitamin D, are the Hadza, a hunter gatherer tribe in Tanzania and the Maasai, a tribe of herdsmen in Kenya (Luxwolda et al, 2012). It should come as no surprise that neither of those groups eat seed oils.

So, for black people who do not personally prepare their own food or are unable to have control over what goes in their food (school children, patients in hospital or care homes, prisoners etc) they will find it virtually impossible to limit their consumption of LA and thus prevent oxidative stress from occurring and all of the other maladies that follow. Racial gaps cannot be closed without addressing this.

Blacks appear to be faced with a difficult dilemma: on the one hand they can prepare and make their own food so as to avoid the toxic seed oils, (which of course is entirely impractical for most), or they can enjoy the convenience of prepared food, but experience the decidedly inconvenient effects of toxic seed oils.

Surely, there is a better option available, one where black people are able to enjoy the convenience of prepared food, but not at the expense of their health.

And indeed, there is a simple solution. Alternative fats need to be used in the production of food. Fats that do not disproportionately harm one particular group over another, but one where everyone in society can equally consume them without fear of negative consequences to health. However, that will only happen if enough people think that black lives matter.

References

Aizer, A., Currie, J., Simon, P. and Vivier, P. (2015). Lead Exposure and Racial Disparities in Test Scores. [online] . Available at: https://economics.yale.edu/sites/default/files/aizer_feb_12_2015.pdf [Accessed 4 Feb. 2021].

‌Andersen, L.B., Jorgensen, J.S., Jensen, T.K., Dalgard, C., Barington, T., Nielsen, J., Beck-Nielsen, S.S., Husby, S., Abrahamsen, B., Lamont, R.F. and Christesen, H.T. (2015). Vitamin D insufficiency is associated with increased risk of first-trimester miscarriage in the Odense Child Cohort. American Journal of Clinical Nutrition, [online] 102(3), pp.633–638. Available at: https://pubmed.ncbi.nlm.nih.gov/26178723/ [Accessed 4 Feb. 2021].

Ashraf, A., Alvarez, J., Saenz, K., Gower, B., McCormick, K. and Franklin, F. (2009). Threshold for Effects of Vitamin D Deficiency on Glucose Metabolism in Obese Female African-American Adolescents. The Journal of Clinical Endocrinology & Metabolism, [online] 94(9), pp.3200–3206. Available at: https://pubmed.ncbi.nlm.nih.gov/19549742/ [Accessed 4 Feb. 2021].

Baraldi, L.G., Martinez Steele, E., Canella, D.S. and Monteiro, C.A. (2018). Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study. BMJ Open, [online] 8(3), p.e020574. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855172/ [Accessed 4 Feb. 2021].

Bouloumie A;Marumo T;Lafontan M;Busse R (1999). Leptin induces oxidative stress in human endothelial cells. FASEB journal : official publication of the Federation of American Societies for Experimental Biology, [online] 13(10). Available at: https://pubmed.ncbi.nlm.nih.gov/10385613/ [Accessed 4 Feb. 2021].

Boutwell, B.B., Nelson, E.J., Qian, Z., Vaughn, M.G., Wright, J.P., Beaver, K.M., Barnes, J.C., Petkovsek, M., Lewis, R., Schootman, M. and Rosenfeld, R. (2017). Aggregate-level lead exposure, gun violence, homicide, and rape. PLOS ONE, [online] 12(11), p.e0187953. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703470/ [Accessed 4 Feb. 2021].

‌Brigham, E.P., Woo, H., McCormack, M., Rice, J., Koehler, K., Vulcain, T., Wu, T., Koch, A., Sharma, S., Kolahdooz, F., Bose, S., Hanson, C., Romero, K., Diette, G. and Hansel, N.N. (2019). Omega-3 and Omega-6 Intake Modifies Asthma Severity and Response to Indoor Air Pollution in Children. American Journal of Respiratory and Critical Care Medicine, [online] 199(12), pp.1478–1486. Available at: https://www.atsjournals.org/doi/10.1164/rccm.201808-1474OC [Accessed 4 Feb. 2021].

Canfield, R.L., Jusko, T.A. and Kordas, K. (2005). Environmental lead exposure and children’s cognitive function. Rivista italiana di pediatria = The Italian journal of pediatrics, [online] 31(6), pp.293–300. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675165/ [Accessed 4 Feb. 2021].

‌‌Chawla, D., Daniels, J.L., Benjamin-Neelon, S.E., Fuemmeler, B.F., Hoyo, C. and Buckley, J.P. (2019). Racial and ethnic differences in predictors of vitamin D among pregnant women in south-eastern USA. Journal of Nutritional Science, [online] 8. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6401563/ [Accessed 4 Feb. 2021].

Cheng, L., Yu, Y., Zhang, Q., Szabo, A., Wang, H. & Huang, X. (2015). Arachidonic acid impairs hypothalamic leptin signaling and hepatic energy homeostasis in mice. Molecular and Cellular Endocrinology, 412 12–18. Available at: https://ro.uow.edu.au/cgi/viewcontent.cgi?article=1533&context=ihmri [Accessed 4 Feb. 2021].

Cortie, C.H., Byrne, M.K., Collier, C., Parletta, N., Crawford, D., Winberg, P.C., Webster, D., Chapman, K., Thomas, G., Dally, J., Batterham, M., Martin, A.M., Grant, L. and Meyer, B.J. (2020). The Effect of Dietary Supplementation on Aggressive Behaviour in Australian Adult Male Prisoners: A Feasibility and Pilot Study for a Randomised, Double Blind Placebo Controlled Trial. Nutrients, [online] 12(9), p.2617. Available at: https://pubmed.ncbi.nlm.nih.gov/32867282/ [Accessed 4 Feb. 2021].

‌Derbyshire, E. (2017). Do Omega-3/6 Fatty Acids Have a Therapeutic Role in Children and Young People with ADHD? Journal of Lipids, [online] 2017, pp.1–9. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603098/ [Accessed 4 Feb. 2021].

‌Ed.gov. (2020). The Condition of Education — Preprimary, Elementary, and Secondary Education — High School Completion — Public High School Graduation Rates — Indicator May (2020). [online] Available at: https://nces.ed.gov/programs/coe/indicator_coi.asp [Accessed 4 Feb. 2021].

Elkin, M., 2020). Homicide in England and Wales. [online] Ons.gov.uk. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/articles/homicideinenglandandwales/yearendingmarch2019 [Accessed 4 Feb. 2021].

‌Erqou, S., Clougherty, J.E., Olafiranye, O., Magnani, J.W., Aiyer, A., Tripathy, S., Kinnee, E., Kip, K.E. and Reis, S.E. (2018). Particulate Matter Air Pollution and Racial Differences in Cardiovascular Disease Risk. Arteriosclerosis, Thrombosis, and Vascular Biology, [online] 38(4), pp.935–942. Available at: https://www.ahajournals.org/doi/full/10.1161/atvbaha.117.310305 [Accessed 4 Feb. 2021].

FBI. (2018). Expanded Homicide Data Table 6. [online] Available at: https://ucr.fbi.gov/crime-in-the-u.s/2018/crime-in-the-u.s.-2018/tables/expanded-homicide-data-table-6.xls [Accessed 4 Feb. 2021].

‌‌‌‌Feairheller, D.L., Park, J.-Y., Sturgeon, K.M., Williamson, S.T., Diaz, K.M., Veerabhadrappa, P. and Brown, M.D. (2011). Racial Differences in Oxidative Stress and Inflammation: In Vitro and In Vivo. Clinical and Translational Science, [online] 4(1), pp.32–37. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077905/ [Accessed 8 Jan. 2021].

Fishman MP;Lombardo SJ;Kharrazi FD (2016). Vitamin D Deficiency Among Professional Basketball Players. Orthopaedic journal of sports medicine, [online] 4(7). Available at: https://pubmed.ncbi.nlm.nih.gov/27482529/ [Accessed 4 Feb. 2021].

‌Gesch, C.B., Hammond, S.M., Hampson, S.E., Eves, A. and Crowder, M.J. (2018). Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. British Journal of Psychiatry, [online] 181(1), pp.22–28. Available at: https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/influence-of-supplementary-vitamins-minerals-and-essential-fatty-acids-on-the-antisocial-behaviour-of-young-adult-prisoners/04CAABE56D2DE74F69460D035764A498 [Accessed 4 Feb. 2021].

‌Gopalan, M. and Nelson, A.A. (2019). Understanding the Racial Discipline Gap in Schools. AERA Open, [online] 5(2), p.233285841984461. Available at: https://journals.sagepub.com/doi/10.1177/2332858419844613 [Accessed 4 Feb. 2021].

Gov.uk. (2010). Statistics on women and the criminal justice system: A Home Office publication under Section 95 of the Criminal Justice Act 1991–2004/05. Probation Journal, [online] 54(2), pp.181–181. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/759770/women-criminal-justice-system-2017..pdf.

‌Gov.uk. (2020). Pupil exclusions. [online] Available at: https://www.ethnicity-facts-figures.service.gov.uk/education-skills-and-training/absence-and-exclusions/pupil-exclusions/latest [Accessed 4 Feb. 2021].

‌Hhs.gov. (2020). Obesity and African Americans — The Office of Minority Health. [online] Available at: https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=25 [Accessed 4 Feb. 2021].

‌Lackland, D.T. (2014). Racial Differences in Hypertension: Implications for High Blood Pressure Management. The American Journal of the Medical Sciences, [online] 348(2), pp.135–138. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4108512/#:~:text=These%20racial%20differences%20are%20evidence,matched%20white%20boys%20and%20girls. [Accessed 8 Jan. 2021].

Lung.org. (2016). Disparities in the Impact of Air Pollution. [online] Available at: https://www.lung.org/clean-air/outdoors/who-is-at-risk/disparities [Accessed 4 Feb. 2021].

Luxwolda MF;Kuipers RS;Kema IP;Dijck-Brouwer DA;Muskiet FA (2012). Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l. The British journal of nutrition, [online] 108(9). Available at: https://pubmed.ncbi.nlm.nih.gov/22264449/ [Accessed 4 Feb. 2021].

‌‌Marchofdimes.org. (2020). Peristats | March of Dimes. [online] Available at: https://www.marchofdimes.org/Peristats/ViewSubtopic.aspx?reg=99&top=4&stop=45&lev=1&slev=1&obj=1 [Accessed 4 Feb. 2021].

‌Martinelli, N., Girelli, D., Malerba, G., Guarini, P., Illig, T., Trabetti, E., Sandri, M., Friso, S., Pizzolo, F., Schaeffer, L., Heinrich, J., Pignatti, P.F., Corrocher, R. and Olivieri, O. (2008). FADS genotypes and desaturase activity estimated by the ratio of arachidonic acid to linoleic acid are associated with inflammation and coronary artery disease. The American Journal of Clinical Nutrition, [online] 88(4), pp.941–949. Available at: https://academic.oup.com/ajcn/article/88/4/941/4650024 [Accessed 4 Feb. 2021].

‌‌Mathias, R.A., Sergeant, S., Ruczinski, I., Torgerson, D.G., Hugenschmidt, C.E., Kubala, M., Vaidya, D., Suktitipat, B., Ziegler, J.T., Ivester, P., Case, D., Yanek, L.R., Freedman, B.I., Rudock, M.E., Barnes, K.C., Langefeld, C.D., Becker, L.C., Bowden, D.W., Becker, D.M. and Chilton, F.H. (2011). The impact of FADS genetic variants on ω6 polyunsaturated fatty acid metabolism in African Americans. BMC Genetics, [online] 12(1), p.50. Available at: https://link.springer.com/article/10.1186/1471-2156-12-50 [Accessed 8 Jan. 2021].

Melough, M.M., Murphy, L.E., Graff, J.C., Derefinko, K.J., LeWinn, K.Z., Bush, N.R., Enquobahrie, D.A., Loftus, C.T., Kocak, M., Sathyanarayana, S. and Tylavsky, F.A. (2020). Maternal Plasma 25-Hydroxyvitamin D during Gestation Is Positively Associated with Neurocognitive Development in Offspring at Age 4–6 Years. The Journal of Nutrition, [online] 151(1), pp.132–139. Available at: https://academic.oup.com/jn/article/151/1/132/5951845 [Accessed 4 Feb. 2021].

Miles, L., Simpson, M., Butler, T., G Wood, L., Knight, L., Greenberg, D. and Schofield, P. (2018). Effect of omega-3 fatty acids on offending behavior in repeat violent offenders: A randomized controlled trial feasibility study. Journal of Psychiatry and Behavioral Sciences, 1(1).

‌‌Morris, A.A., Zhao, L., Patel, R.S., Jones, D.P., Ahmed, Y., Stoyanova, N., Gibbons, G.H., Vaccarino, V., Din-Dzietham, R. and Quyyumi, A.A. (2012). Differences in Systemic Oxidative Stress Based on Race and the Metabolic Syndrome: The Morehouse and Emory Team up to Eliminate Health Disparities (META-Health) Study. Metabolic Syndrome and Related Disorders, [online] 10(4), pp.252–259. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3449394/ [Accessed 4 Feb. 2021].

Mulligan, M.L., Felton, S.K., Riek, A.E. and Bernal-Mizrachi, C. (2010). Implications of vitamin D deficiency in pregnancy and lactation. American Journal of Obstetrics and Gynecology, [online] 202(5), pp.429.e1–429.e9. Available at: https://pubmed.ncbi.nlm.nih.gov/19846050/ [Accessed 4 Feb. 2021].

‌‌Nagata, M., Hata, J., Hirakawa, Y., Mukai, N., Yoshida, D., Ohara, T., Kishimoto, H., Kawano, H., Kitazono, T., Kiyohara, Y. and Ninomiya, T. (2017). The ratio of serum eicosapentaenoic acid to arachidonic acid and risk of cancer death in a Japanese community: The Hisayama Study. Journal of Epidemiology, [online] 27(12), pp.578–583. Available at: https://www.sciencedirect.com/science/article/pii/S0917504017301430 [Accessed 4 Feb. 2021].

‌Nandi, A., Wadhwani, N. and Joshi, S.R. (2019). Vitamin D deficiency influences fatty acid metabolism. Prostaglandins, Leukotrienes and Essential Fatty Acids, [online] 140, pp.57–63. Available at: https://pubmed.ncbi.nlm.nih.gov/30553405/#:~:text=Our%20findings%20indicate%20that%20maternal,alters%20maternal%20fatty%20acid%20metabolism [Accessed 4 Feb. 2021].

‌Parsanathan, R. and Jain, S.K. (2019). Glutathione deficiency induces epigenetic alterations of vitamin D metabolism genes in the livers of high-fat diet-fed obese mice. Scientific Reports, [online] 9(1). Available at: https://www.nature.com/articles/s41598-019-51377-5#:~:text=Glutathione%20Stimulates%20Vitamin%20D%20Regulatory,Treat%2025%2DHydroxyvitamin%20D%20Deficiency. [Accessed 4 Feb. 2021].

Parva, N.R., Tadepalli, S., Singh, P., Qian, A., Joshi, R., Kandala, H., Nookala, V.K. and Cheriyath, P. (2018). Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011–2012). Cureus. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6075634/#:~:text=Race%20was%20identified%20as%20a,%25%2D71.7%25)%20%5B3%5D. [Accessed 4 Feb. 2021].

Portnoy, J., Raine, A., Liu, J. and Hibbeln, J.R. (2018). Reductions of intimate partner violence resulting from supplementing children with omega-3 fatty acids: A randomized, double-blind, placebo-controlled, stratified, parallel-group trial. Aggressive Behavior, [online] 44(5), pp.491–500. Available at: https://onlinelibrary.wiley.com/doi/abs/10.1002/ab.21769 [Accessed 4 Feb. 2021].

Public Health Post. (2019). Racial Gaps in Children’s Lead Levels | Public Health Post. [online] Available at: https://www.publichealthpost.org/databyte/racial-gaps-in-childrens-lead-levels/ [Accessed 4 Feb. 2021].

Reuben, A., Caspi, A., Belsky, D.W., Broadbent, J., Harrington, H., Sugden, K., Houts, R.M., Ramrakha, S., Poulton, R. and Moffitt, T.E. (2017). Association of Childhood Blood Lead Levels With Cognitive Function and Socioeconomic Status at Age 38 Years and With IQ Change and Socioeconomic Mobility Between Childhood and Adulthood. JAMA, [online] 317(12), p.1244. Available at: https://jamanetwork.com/journals/jama/fullarticle/2613157 [Accessed 4 Feb. 2021].

‌‌‌‌Richie, J., Muscat, J., Calcagnotto, A., Kleinman, W., Colosimo, S. and Karam El-Bayoumy (2007). Blood selenium and glutathione status in black and white americans. Cancer Research, [online] 67(9 Supplement), pp.2508–2508. Available at: https://cancerres.aacrjournals.org/content/67/9_Supplement/2508#:~:text=Racial%20differences%20in%20blood%20glutathione,r%3D0.08%2C%20NS) [Accessed 4 Feb. 2021].

‌Rifkin, S., Shrubsole, M., Cai, Q., Smalley, W., Ness, R., Swift, L., Milne, G., Zheng, W. and Murff, H. (2021). Differences in erythrocyte phospholipid membrane long-chain polyunsaturated fatty acids and the prevalence of fatty acid desaturase genotype among African Americans and European Americans. Prostaglandins, Leukotrienes and Essential Fatty Acids, [online] 164, p.102216. Available at: https://www.sciencedirect.com/science/article/pii/S0952327820301745 [Accessed 4 Feb. 2021].

Ritchie, S.J. and Tucker-Drob, E.M. (2018). How Much Does Education Improve Intelligence? A Meta-Analysis. Psychological Science, [online] 29(8), pp.1358–1369. Available at: https://journals.sagepub.com/doi/10.1177/0956797618774253 [Accessed 4 Feb. 2021].

Singh, P.K., Nath, R., Ahmad, M.K., Rawat, A., Babu, S. and Dixit, R.K. (2015). Attenuation of lead neurotoxicity by supplementation of polyunsaturated fatty acid in Wistar rats. Nutritional Neuroscience, [online] 19(9), pp.396–405. Available at: https://pubmed.ncbi.nlm.nih.gov/26005885/#:~:text=Discussion%3A%20Omega%2D3%20fatty%20acid,of%20standard%20drug%2C%20vitamin%20E. [Accessed 4 Feb. 2021].

Sztolsztener, K., Chabowski, A., Harasim-Symbor, E., Bielawiec, P. and Konstantynowicz-Nowicka, K. (2020). Arachidonic Acid as an Early Indicator of Inflammation during Non-Alcoholic Fatty Liver Disease Development. Biomolecules, [online] 10(8), p.1133. Available at: https://pubmed.ncbi.nlm.nih.gov/32751983/ [Accessed 4 Feb. 2021].

Raine, A., Leung, C.-C., Singh, M. and Kaur, J. (2020). Omega-3 supplementation in young offenders: a randomized, stratified, double-blind, placebo-controlled, parallel-group trial. Journal of Experimental Criminology, [online] 16(3), pp.389–405. Available at: https://link.springer.com/article/10.1007/s11292-019-09394-x [Accessed 4 Feb. 2021].

‌‌Taha, Y., Ameer. (2020). Linoleic Acid–Good or Bad for the Brain? Npj Science of Food, vol. 4, no. 1, www.nature.com/articles/s41538-019-0061-9#change-history, 10.1038/s41538–019–0061–9. Accessed 4 Feb. 2021.

Tian, Y., Holzman, C., Siega-Riz, A.M., Williams, M.A., Dole, N., Enquobahrie, D.A. and Ferre, C.D. (2015). Maternal Serum 25-Hydroxyvitamin D Concentrations during Pregnancy and Infant Birthweight for Gestational Age: a Three-Cohort Study. Paediatric and Perinatal Epidemiology, [online] 30(2), pp.124–133. Available at: https://pubmed.ncbi.nlm.nih.gov/26575943/ [Accessed 4 Feb. 2021].

Tong, H., Rappold, A.G., Diaz-Sanchez, D., Steck, S.E., Berntsen, J., Cascio, W.E., Devlin, R.B. and Samet, J.M. (2012). Omega-3 Fatty Acid Supplementation Appears to Attenuate Particulate Air Pollution–Induced Cardiac Effects and Lipid Changes in Healthy Middle-Aged Adults. Environmental Health Perspectives, [online] 120(7), pp.952–957. Available at: https://pubmed.ncbi.nlm.nih.gov/22514211/ [Accessed 4 Feb. 2021].

‌‌Tsukamoto, I. and Sugawara, S. (2017). Low levels of linoleic acid and α-linolenic acid and high levels of arachidonic acid in plasma phospholipids are associated with hypertension. Biomedical Reports. [online] Available at: https://www.spandidos-publications.com/10.3892/br.2017.1015 [Accessed 4 Feb. 2021].

‌‌‌Turpeinen, A.M., Basu, S. and Mutanen, M. (1998). A high linoleic acid diet increases oxidative stress in vivo and affects nitric oxide metabolism in humans. Prostaglandins, Leukotrienes and Essential Fatty Acids, [online] 59(3), pp.229–233. Available at: https://pubmed.ncbi.nlm.nih.gov/9844997/ [Accessed 7 Jan. 2021].

White, B.M., Bonilha, H.S. and Ellis, C. (2015). Racial/Ethnic Differences in Childhood Blood Lead Levels Among Children <72 Months of Age in the United States: a Systematic Review of the Literature. Journal of Racial and Ethnic Health Disparities, [online] 3(1), pp.145–153. Available at: https://pubmed.ncbi.nlm.nih.gov/26896114/#:~:text=Blood%20lead%20levels%20were%20most,highest%20mean%20blood%20lead%20level [Accessed 4 Feb. 2021].

‌Youn, J.-Y. ., Siu, K.L., Lob, H.E., Itani, H., Harrison, D.G. and Cai, H. (2014). Role of Vascular Oxidative Stress in Obesity and Metabolic Syndrome. Diabetes, [online] 63(7), pp.2344–2355. Available at: https://diabetes.diabetesjournals.org/content/63/7/2344? [Accessed 4 Feb. 2021].

‌‌