Tuesday, June 25, 2019
Home Health The "indelible mark" that leaves exposure to hunger in children

The "indelible mark" that leaves exposure to hunger in children

Since there was always so little to do, it did not take long for her to skip meals. She was tired all the time – and yet she could not sleep. She was hungry but did not want to eat, and sometimes she was ill when she did. Her head was stunned. It was hard to hold together a series of thoughts.

Wright was exhausted, but did not want to reveal to her children the extent of her fatigue. So she went with one hand on the furniture through the house and held on tight. A severe iron deficiency, she learned eventually, was responsible for the terrible fatigue. This lasted about two years.

But it was not her own well-being that she was most worried about. It was their children. They asked her questions: Why was she dizzy the whole time? Why did she take these pills from the doctor?

And one day she came home and found a glass of milk on the table. Her son, worried about her, had poured it. He let her drink while he watched – to make sure she had everything.

"It should not be that way," she says now, remembering. "Children should not worry about their parents."

Today her biggest worry is not that her physical health suffered a stroke, but that her children were mentally healthy. What psychological scars were left when they saw their mother starve herself?

At a charity that helped the locals get a job, Wright first mentioned the term "food bank." More and more food banks are providing food to those in need for free. But she jumped at the idea. She was afraid that the social services would take her children with her if she was looking for help with a food bank.

So Wright had a plan. She applied instead to become a volunteer at the Food Bank. "It felt a little better," she says, "so it's a bit of a trade."

For the first few days she felt awkward and out of place. Then Kelly Donaldson, one of the workers, took her under her wing. Now and then, at the end of the day, Donaldson put together a small pack of groceries for her new girlfriend. "This is your dinner for tonight," she told Wright encouragingly and handed the bag.

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There are signs that more and more children in rich countries are hungry and have negative effects. Recently, the United Nations Special Rapporteur on extreme poverty and human rights criticized the British Government for the scenes of poverty he had seen on a trip to Britain. The extent of child poverty in Britain is "not only a shame, but a social calamity and an economic catastrophe, all in one".

"Children come to school on an empty stomach and schools collect food on an ad hoc basis and send them home because teachers know their students will go hungry," he said.

All the workers I talk to at British food banks say they have seen a sharp increase in demand over the past year. The reason given is changes and cuts in benefits, notably the new universal loan scheme, which can lead to gaps between payments that make people unable to pay for the essentials.

The Royal College of Paediatrics and Child Health and the Trussell Trust are concerned about how food insecurity can affect children's health. But what would these effects be?

In a phone call to Valerie Tarasuk at the University of Toronto, I mention Kerry Wright's worries about her children's mental health.

"That's what we have to worry about," says Tarasuk.

Tarasuk is a professor of nutrition science and an expert in the relationship between food insecurity and health. It is also conducting research to study the long-term effects on children living in food-insecure homes.

Studies by a team from the University of Calgary, including Sharon Kirkpatrick and Lynn McIntyre, have shown that hunger is associated with poorer physical and mental health only a handful of times. This also means that children are less likely to finish school.

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In a six-year study, McIntyre and colleagues found that hungry young people had a significantly higher risk of developing depressive symptoms. The hunger, the researchers wrote, had a "toxic" effect: "Adolescents who had multiple starvation episodes were more likely to experience chronic illness and asthma than those who were never hungry."

These findings persisted, although other factors that could affect health were taken into account – hunger actually seems to play a crucial role.

"The exposure that children have makes an indelible impression," says Tarasuk. "It's really a bad idea to scold so many in this situation."

In the UK, long-term data such as the data used by Tarasuk and her colleagues is hard to come by. However, there are efforts to expand our understanding of how food insecurity is related to health.

At present, two major districts in the south of the capital, Lambeth and Southwark, are carrying out significant research work at King's College London. It is run by Ingrid Wolfe, who is also a pediatric consultant. She says that part of her own motivation to participate in the study was that more children were brought to the emergency department whose seizures were caused by vitamin deficiencies. "Very, very acutely significant malnutrition," she says.

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The Child and Youth Health Partnership is Wolfe's and her colleagues' effort to understand what is going on in a young person's life, which may affect the condition that leads them to the doctor.

The team initially focuses on young people suffering from one of four "tracer" conditions – eczema, constipation, asthma and epilepsy. Among the first 1,000 participants with one of the four indicator states, food insecurity turned out to be worrying in 90 percent of the cases.

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In a home where parents or guardians rely on cheaper food, the diet may be less well-balanced and micronutrient intake may decrease. Some of the first deficiencies could be an iron deficiency, as occurred with Kerry Wright, along with vitamin A and iodine deficiency. Iodine – abundant in whitefish and dairy products – is especially important for the development of the brain.

A sugar-rich diet can also lead to dental problems. Between 2013 and 2018, extractions of multiple teeth among 18-year-olds in England increased by 18 percent. This is also related to food insecurity: dental caries occurs more often in deprived areas.

And let's not forget the obesity. The Royal College of Paediatrics and Child Health says obesity is related to withdrawal. "In England, it appears that overweight and obesity decrease over time when they are the least disadvantaged but not among the most disadvantaged."

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Diets can not only be improved by food banks. But there is another way – which is called a "person-centered approach".

"I like talking to people," says Sheena Boyd with a big smile. "You will understand that at the end of the day." She laughs heartily. She is the project leader of a charity named Centrestage in southwest Glasgow.

When Centrestage was founded 13 years ago, the founders wanted to offer a theater group for the locals. The idea was to stage big shows with a bit more buzz and pizzazz than, for example, school drama departments. In addition, anyone can join, regardless of age and background.

Only when those in charge worked more closely with local communities did they realize that food insecurity was such a problem. When you're hungry, you can not expect to work in front of hundreds or work hours backstage.

Centrestage continues to host community shows, but stuffing bellies is now an important goal. The slogan of the group is "fun, food, people".

The On The Road project by Centrestage is a bus that drives around and fills up food. But before I see the bus, I have to witness the kitchen, where thousands of prepared meals are cooked every week, says Boyd.

We move to a big gray warehouse in an industrial area. If the door beeps as we enter the unit of Centrestage, the smell of cooking suddenly gives off color. Cooks hurry around, all in black and comfortable hiking boots, with jugs of various blends or huge bowls for the ovens.

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The cooked portions of food are distributed to Centrestage locations. I'll try later – sprinkle pasta with roasted vegetables, a delicious sauce and some cheese over it. A really nice meal. Also on this day was Paneer curry with rice and pots of red pepper soup.

It is a short drive from the kitchens to the bus. The double-decker bus is off and even on a cool November day locals gather, sit outside and eat something or just enjoy a conversation.

On the upper level of the bus there is a soft-play area where parents can bring their children. Here I meet two mothers, each with a young daughter who eagerly uses the playground. One of the women explains that she has osteoarthritis in her wrist so cooking at home is not always easy. Nevertheless, she never wanted to use a food bank.

"I did not really want to take anything off the bus," she says. "Then I heard it's not a food bank."

As the bus driver says, food banks often ask for coupons – or "chitties" – before distributing the supplies. "Nae chitties here," he says. Volunteers like to give food for free, although they ask if people can try to make a small donation.

Either way, no one is rejected. Between July and September 2018, adults received nearly 6,000 occasions and children about 2,200 occasions.

The well-being of people can be very quickly affected by hunger, but that's never the whole story. In addition to cheap meals and cooking workshops, Centrestage employees and volunteers want to help with service forms, housing applications or employment issues. Boyd puts it this way: "We can say," What's going on? We can help you in other ways. "

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For Wright, it worked for a charity that really got them going again. No access to free food. Today she expresses a real zeal for her work. She now works 29 hours a week at the CFINE food bank in central Aberdeen. It finally has a steady income stream. This year she will be debt-free for the first time in a long time. The physical health of their children is good. They have become more active. Now they play sports and one goes to cadets.

And when I met her at CFINE, I feel like Wright, like her friend Kelly Donaldson, has found a role that not only helps her in the here and now – she can build on that.

Donaldson points out that Wright is now much happier. She gets up every day. Decorate her makeup. Go to work. That makes a big difference – for the whole household.

"That's right," says Wright. "It affects your children."

This article was first published by Wellcome on Mosaic. It will be re-published here under a Creative Commons license. Sign up for the newsletter at mosaicscience.com/newsletter. Wellcome, the publisher of Mosaic, is funding research into poverty and food aid at the London School of Hygiene and Tropical Medicine.

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