Lack of adequate food is ongoing health risk to US children

The new policy statement, "Promoting Food Security for all Children," will be presented at the AAP's National Conference & Exhibition in Washington, DC, and published in Pediatrics on Friday, Oct. 23. U.S. Department of Agriculture (USDA) Secretary Tom Vilsack will give a plenary address at the Conference on Monday, Oct. 26, "Healthier Kids, Healthier Economy: How nourishing the next generation will help to secure America's future," which will address the new policy in the context of child nutrition reauthorization efforts underway on Capitol Hill.

Despite improvements over the past few years, the latest data show that more than 15 million U.S. children live in households still struggling with hunger. The policy statement identifies the immediate and potentially lifelong health effects of this pervasive problem.

USDA data released in September show that the number of children regularly getting enough food to stay healthy and active last year was its highest since 2007. The slight but significant rise to pre-recession food security levels underscores the effectiveness and ongoing importance of federal nutrition programs such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the Supplemental Nutrition Assistance Program (SNAP) and school lunch and breakfast programs, according to the AAP. In fact, nearly half of all SNAP recipients are children.

"The health effects of hunger on children are pervasive and long-lasting, which is why our new policy urges pediatricians to take action in and outside of the clinic to conquer food insecurity and promote child health," said Sarah Jane Schwarzenberg, MD, FAAP, a lead author of the policy statement and director of pediatric gastroenterology, hepatology and nutrition at the University of Minnesota Masonic Children's Hospital. Health problems linked to hunger described in the AAP policy statement include:

• Children who live in households that are food insecure, even at the lowest levels, get sick more often, recover more slowly from illness, have poorer overall health and are hospitalized more frequently.
• Children and adolescents affected by food insecurity are more likely to be iron deficient, and preadolescent boys dealing with hunger issues have lower bone density. Early childhood malnutrition also is tied to conditions such as diabetes and cardiovascular disease later in life.
• Lack of adequate healthy food can impair a child's ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems from preschool through adolescence.

"As is the case with many childhood health conditions, being malnourished or not getting enough healthy food early in life has effects that can last well into adulthood," Dr. Schwarzenberg said.

Struggles to keep food on the table can affect children in any community, and households with children have substantially higher rates of food insecurity then those without. Low-income working families and families headed by a single parent are at particular risk. Women who experience food insecurity during pregnancy are at increased risk for poorer birth outcomes, including low birth weight babies and toxic stress, which can have lifelong effects on the health and well-being of a child.

"The demographic of food-insecure Americans extends beyond the areas of concentrated urban poverty and into suburbs and rural America, areas often mistakenly thought to be immune to this problem," the authors write. "Like poverty, food insecurity is a dynamic, intensely complex issue," they write, and levels remain near historic highs despite the current economic recovery.

For many families, seemingly small changes to income, expenses, or access to federal or state assistance programs can instantly reduce the ability to buy enough nutritious food, according to the AAP policy statement. In addition, statistics show that more than 30 percent of families who reported food insecurity said they had to choose between paying for food or paying for medicine or medical care.

Every child needs optimal nutrition to grow and stay healthy. "We are in the midst of a nutritional crisis in our country, and when you're in a crisis, you can't keep doing what you've always done," said AAP President Sandra Hassink, MD, FAAP. "That's why pediatricians are taking a comprehensive approach, connecting families to resources and advocating to keep federal nutrition programs like WIC and SNAP strong. It will take all of us--pediatricians, parents, government leaders, educators--partnering together, to do our best to ensure that no child goes hungry in this country."

The report will be presented during the AAP conference session, "Food Insecurity: Starving Our Future," at 2 p.m. Saturday, Oct. 24 in room 206 of the Walter E. Washington Convention Center. Journalists wishing to attend the presentation or Secretary Vilsack's address on Monday, Oct. 26 at 11:50 a.m. must first check in at the press office, room 204A to obtain credentials.

In addition, the AAP will partner with the relief organization Stop Hunger Now for a community service project taking place at the conference center at noon Friday. Attendees will assemble 10,000 non-perishable, nutritious meals for children worldwide who lack adequate access to food.