The effects of diet on levels of physical activity during winter in forensic inpatients – A randomized controlled trial

  • Anita L. Hansen
  • Gina Ambroziak
  • David Thornton
  • Lisbeth Dahl
  • Bjørn Grung
Keywords: Fatty fish consumption, meat consumption, physical exercise, mental health problems


Background: Fish consumption has been shown to have beneficial effects on biological and subjective measures of health and well-being. However, little is known about the effects of fish consumption at the behavioral level.

Objective: The primary aim of this study was to investigate the influence of diet on behavior such as physical activity during winter in forensic inpatients. The secondary aim was to investigate the relationship between vitamin D status and physical activity.

Design: Eighty-one male forensic inpatients participated in this study. Participants were randomized into two different diet groups: a Fish group receiving fatty fish three times per week and a Control group receiving an alternative meal (e.g. chicken, pork, and beef); while the Fish group received their fish, the Control group received an alternate meal, but with the same nutritional value as their habitual diet. The duration of the food intervention was 6 months.

Results: The results revealed that the Fish group had a regular pattern of physical activity throughout the intervention period. The participants in the Control group showed a more irregular pattern of physical activity in addition to a significant reduction in physical activity over time.

Conclusion: Behavior such as physical activity during winter seemed to be influenced by the diet.


Download data is not yet available.


  1. Hansen AL, Dahl L, Olson G, Thornton D, Graff IE, Frøyland L, et al. Fish consumption, sleep, daily functioning and heart rate variability. J Clin Sleep Med 2014; 10(5): 567–75. doi: 10.5664/jcsm.3714

  2. Hansen AL, Olson G, Dahl L, Thornton D, Grung B, Graff IE, et al. Reduced anxiety in forensic inpatients after a long-term intervention with Atlantic salmon. Nutrients 2014; 6(12): 5392–404. doi: 10.3390/nu6125405

  3. Reul JMHM, Collins A, Saliba R, Mifsud KR, Carter SD, Gutierrez-Mecinas M, et al. Glucorticoids, epigenetic control and stress resilience. Neurobiol Stress 2015; 1(1): 44–59. doi: 10.1016/j.ynstr.2014.10.001

  4. Hansen AL, Johnsen BH, Sollers JJ, Stenvik K, Thayer JF. Heart rate variability and its relation to prefrontal cognitive function: the effects of training and detraining. Eur J Appl Physiol 2004; 93(3): 263–72. doi: 10.1007/s00421-004-1208-0

  5. Kwon O, Park S, Kim Y-J, Min S-Y, Kim YR, Nam G-B, et al. The exercise heart rate profile in master athletes compared to healthy controls. Clin Physiol Funct Imaging 2016; 36(4): 286–92. doi: 10.1111/cpf.12226

  6. Aune D, Sen A, ó’Hartaigh B, Janszky I, Romundstad PR, Tonstad S, et al. Resting heart rate and the risk of cardiovascular disease, total cancer, and all- cause mortality – A systematic review and dose – response meta-analysis of prospective studies. Nutr Metab Cardiovas 2017; 27(6): 504–17. doi: 10.1016/j.numecd.2017.04.004

  7. Thayer JF, Lane RD. (2000). A model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord 2000; 61(3): 201–16. doi: 10.1016/S0165-0327(00)00338-4

  8. Pivarnik JM, Reeves MJ, Rafferty AP. Seasonal variation in adult leisure-time physical activity. Med Sci Sport Exer 2003; 35(6): 1004–8. doi: 10.1249/01.MSS.0000069747.55950.B1

  9. Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, for the Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012; 380(9838): 219–29. doi: 10.1016/S0140-6736(12)61031-9

  10. Harvey SB, Hotopf M, Øverland S, Mykletun A. Physical activity and common mental disorders. Brit J Psychiat 2010; 197(5): 357–64. doi: 10.1192/bjp.bp.109.075176.

  11. Grant WB, Bhattoa HP, Boucher BJ. Seasonal variation of U.S. mortality rates: roles of solar ultraviolet-B doses, vitamin D, gene expression, and infections. J Steroid Biochem 2017; 173(October): 5–12. doi: 10.1016/j.jsbmb.2017.01.003

  12. Lansdowne ATG, Provost SC. Vitamin D3 enhances mood in healthy subjects during winter. Psychopharmacology 1998; 135(4): 319–23. doi: 10.1007/s002130050517

  13. Tyrer AE, Levitan RD, Houle S, Wilson AA, Nobrega JN, Meyer JH. Increased seasonal variation in serotonin transporter binding in seasonal affective disorder. Neuropsychopharmacol 2016; 41(10): 2447–54. doi: 10.1038/npp.2016.54

  14. Hansen AL, Dahl L, Olson G, Thornton D, Grung B, Thayer JF. A long-term fatty fish intervention improved executive function in inpatients with antisocial traits and a history of alcohol and drug abuse. Scand J Psychol 2015; 56(5): 467–74. doi: 10.1111/sjop.12229

  15. Thayer JF, Hansen AL, Saus ER., Johnsen BH. Heart rate variability, prefrontal neural function, and cognitive performance: The Neurovisceral Integration Perspective. Ann Behav Med 2009; 37(2): 141–53. doi: 10.1007/s12160-009-9101-z

  16. Hansen AL, Ambroziak G, Thornton DM, Dahl L, Molde H, Grung B. Fatty fish intervention and psychophysiological responses to mental workload in forensic inpatients: a randomized control trial. J Psychophysiol 2018;34(1): 10–8. doi: 10.1027/0269-8803/a000231

  17. Thayer JF, Lane RD. The role of vagal function in the risk for cardiovascular disease and mortality. Biol Psychol 2007; 74(2): 224–42. doi: 10.1016/j.biopsycho.2005.11.013

  18. Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96(7): 1911–30. doi: 10.1210/jc.2011-0385

  19. Holick MF. Environmental factors that influence the cutaneous production of vitamin D. A J Clin Nutr 1995; 61(3): 638S–645S doi: 10.1093/ajcn/61.3.638S.

  20. Christensen MH, Lien EA, Hustad S, Almås B. Seasonal and age-related differences in serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D and parathyroid hormone in patients from Western Norway. Scand J Clin Lab Inv 2010; 70(4): 281–86. doi: 10.3109/00365511003797172

  21. VKM 2014. Benefit-risk assessment of fish and fish products in the Norwegian diet – an update. Scientific Opinion of the Scientific Steering Committee. VKM Report 15, ISBN: 978-82-8259-159-1, Oslo, Norway; 2014. Available online:

  22. Grung B, Hansen AL, Berg M, Møen-Knudseth MP, Olson G, Thornton D, Dahl L, Thayer JF. Exploratory multivariate analysis of the effect of fatty fish consumption and medicinal use on heart rate and heart rate variability data. Front. Psychol 2015; 6: 135. doi: 10.3389/fpsyg.2015.00135

  23. Wechsler D. Wechsler Adult Intelligence Scale. Fourth Edition. San Antonio, TX: Pearson; 2008.

  24. Hare RD. The Hare Psychopathy Checklist-Revised. Toronto: Multi-Health Systems; 1991.

  25. Alshurafa M, Briel M, Akl M, Haines T, Moayyedi P, Gentles SJ, et al. Inconsistent definitions for intention-to-treat in relation to missing outcome data: systematic review of the methods literature. PLOS One 2012; 7(11): e49163. doi: 10.1371/journal.pone.0049163

  26. Hansen AL, Ambroziak G, Thornton D, Dahl L, Grung B. (2018). Age and IQ explained working memory performance in a RCT with fatty fish in a group of forensic inpatients. J Nutr Health Aging 2018; 22(4): 513–518. doi: 10.1007/s12603-018-0998-4

  27. Jackson AS, Blair SN, Mahar MT, Weir LT, Ross RM, Stuteville JE. Prediction of functional aerobic capacity without exercise testing. Med Sci Sport Exer 1990; 22(6): 863–870. doi: 10.1249/00005768-199012000-0021

  28. Schembre SM, Riebe DA. Non-exercise estimation of VO2max using the International Physical Activity Questionnaire. Meas Phys Educ Exerc Sci 2011; 15(3): 168–81. doi: 10.1080/1091367X.2011.568369

  29. Kelly G, Kelly KS. Gender differences in the aerobic fitness levels of young African-American adults. J Natl Med Assoc 1999; 91(7): 384–8. PMCID: PMC2608467.

  30. Cohen J. A power primer. Psychol Bull 1992; 112(1): 155–9. doi: 10.1037/0033-2909.112.1.155

  31. Bach-Faig A, Berry EM, Lairon D, Reguant J, Trichopoulou A, Dernini S, et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr 2011; 14(12A): 2274–84. doi: 10.1017/S1368980011002515

  32. Malakou E, Linardakis M, Armstrong MEG, Zannidi D, Foster C, Johnson L, et al. The combined effect of promoting the Mediterranean diet and physical activity on metabolic risk factors in adults: a systematic review and meta-analysis of randomized controlled trials. Nutrients 2018; 10(11): 1577. doi: 10.3390/nu10111577

  33. Best JR, Miller PH, Jones LL. Executive functions after age 5: changes and correlates. Dev Rev 2009; 29(3): 180–200. doi: 10.1016/j.dr.2009.05.002

  34. Allom V, Mullan B. Individual differences in executive function predict distinct eating behaviours. Appetite 2014; 80(September): 123–30. doi:10.1016/j.appet.2014.05.007

  35. Sullivan GM, Feinn, R. Using effect size—or why the P value is not enough. J Grad Med Educ. 2012; 4(3): 279–82. doi: 10.4300/JGME-D-12-00156.1

  36. Mandolesi L, Polverino A, Montuori S, Foti F, Ferraioli G, Sorrentino P, et al. Effects of physical exercise on cognitive functioning and wellbeing: biological and psychological benefits. Front Psychol 2018; 9: 509. doi: 10.3389/fpsyg-2018.00509

  37. World Health Organization. Global Recommendations on Physical Activity for Health. Geneva: WHO Press; 2010.

  38. Uhe AM, Collier GR, O’Dea K. A comparison of the effects of beef, chicken and fish protein on satiety and amino acid profiles in lean male subjects. J Nutr 1992; 122(3): 467–72. doi: 10.1093/jn/122.3.467

  39. Praschak-Rieder N, Willeit M, Wilson AA, Houle S, Meyer JH. Seasonal variation in human brain serotonin transporter binding. Arch Gen Psychiatry 2008; 65(9): 1072–8. doi: 10.1001/archpsyc.65.9.1072

  40. Stumpf WE, Privette TH. Light, vitamin D and psychiatry: role of 1,25-dihydroxyvitamin D3 (soltriol) in etiology and therapy of seasonal affective disorder and other mental processes. Psychopharmacology 1989; 97(3): 285–94. doi: 10.1007/BF00439440

  41. Plasqui G, Westerterp KR. Physical activity assessment with accelerometers: an evaluation against doubly labeled water. Obesity 2007; 15(19): 2371–9. doi: 10.1038/oby.2007.281

  42. Gidlow C, Johnston L H, Crone D, Ellis N, James D. A systematic review of the relationship between socio-economic position and physical activity. Health Educ J 2006; 65(4): 338–67. doi: 10.1177/0017896906069378

How to Cite
Hansen AL, Ambroziak G, Thornton D, Dahl L, Grung B. The effects of diet on levels of physical activity during winter in forensic inpatients – A randomized controlled trial. fnr [Internet]. 2020Feb.21 [cited 2020Mar.28];64. Available from:
Original Articles

Most read articles by the same author(s)