Thursday, 11 February 2016

Children and Food Insecurity – a crisis for Ireland’s future

Dr Mary Flynn: The devastating economic crash in Ireland during 2008 threw the personal finances of large numbers of people into crisis.  Work opportunities all but vanished, businesses closed, people lost their jobs and many lost their homes; relationships suffered. Food poverty became a real issue for many families. Ireland is recovering from the economic crash but it will take time for this to reach all families.  Children don’t have time. From the moment of birth, they grow and develop relentlessly every day until they are roughly 18 years of age.

Good nutrition and physical activity help ensure children reach their full potential. Diets that provide a poor mix of protein and energy limit children’s chances of reaching their full height potential (growth stunting in the most serious cases).  Height is a marker for better life-long health outcomes, which reflects the critical importance of good nutrition during childhood growth.  It’s not just the ‘big’ nutrients that are important - even a lack of trace elements or vitamins can have long term consequences.  For example, vitamin D deficiency causes growing bones to become weak and ‘bendy’- leading to permanent deformities especially of the weight-bearing bones in the legs.  These are just a few of the more obvious signs of the impact of inadequate nutrition during the crucial growing years.

Usually children’s growth is gradual and consistent.  However at times such as infancy and puberty it is an explosive spurt of development that transforms them.  Good nutrition during these times can improve life-long health considerably. The other side of this is that these periods also represent stages where children are critically vulnerable because poor diet can have lasting detrimental effects.

Unborn babies, infants and young children (up to 3 years) - critical stages
Infants come in all shapes and sizes but babies who are ‘smaller’ or ‘larger’ than expected (for gestational age) are at higher risk of poor health during adulthood.  Size at birth reflects growth and development in the womb which can be nutrition related. For example, iron deficiency during pregnancy can lead to lower birth weights, while maternal obesity and excessive weight gain can result in heavier birth weights. Both iron deficiency and obesity are more common among women from disadvantaged backgrounds in Ireland.

Infancy itself is a truly amazing phase of development. During the first 12 months of life babies treble their birth weight and double their surface area – a feat of rapid growth and development never repeated during the human life cycle.  Good nutrition during this first year of life and on up to 2 years of age can have powerful positive effects.  It can even reverse the long-term risks of being born ‘smaller’ or ‘larger’ than expected.  For the first 6 months of life there is nothing that comes close to exclusive breastfeeding in terms of protecting babies from illness during their infancy, childhood and adult life.  While very few babies in Ireland are breastfed, rates are lowest for those born into disadvantaged families - this is a real missed opportunity for Ireland’s future.

Toddlers and pre-school children can be ‘picky eaters’, yet they have high needs for nutrients and a relatively small capacity for food. Parents worry that toddlers are ‘eating nothing’ and all-too-often this is the start of a vicious cycle of giving toddlers high-fat, high-sugar, or salty foods. These foods cannot meet the complex nutritional needs of toddlers and so problems such as iron deficiency (which delays physical and cognitive development) and obesity are created. Highly processed foods at this stage also hamper how children naturally explore food to develop ‘a taste’ for what they will always need for a healthy diet.

Adolescence – the 5-8 year transformation of child to adult
The ‘almost adult’ look of older children going through adolescence makes it easy to miss their vulnerability. During this last eight years of childhood, adolescents grow half of their adult weight and adult bone mass, along with one-fifth of their adult height. Good nutrition and physical activity levels during this unique growth phase gives children the best chance of healthy futures. But for families on low incomes, this is the most expensive time for providing the right amounts of foods for children. Research in Ireland shows important foods for this age group - such as fruit, vegetables, meat and fish, are the most expensive and almost ‘out of reach’ of families dependent on social welfare.  Studies also show how poverty affects teenage children – in that boys are less likely to be involved in sports and iron deficiency is a problem for girls.  These factors seriously hinder physical development, but iron deficiency compromises mental work capacity at a time when girls are competing for educational opportunities.

Ireland can do better- but it’s up to all of us
Over 46 years ago Brother Kevin Crowley founded the Capuchin Day Centre to help people in need. Over the past five years the numbers of people coming to him for help have tripled – but it’s witnessing children growing up in this situation that he finds most distressing.

The causes of food poverty are complex.  Sinead Keenan, project manager with Healthy Food for All explains that when the rent goes up, or mortgage arrears threaten homelessness, food becomes the flexible item where there is less to spend. Added to this are the practical realities of:

- Affordability (food costs are high),
- Access (people without cars are limited to expensive outlets),
- Availability (unavailability of healthy food options locally) and
- Awareness (limited budgets do not allow for experimenting – if kids don’t like it they go hungry).

While lots of things we are doing to create healthier food environments are making a difference – it is happening too slowly for children caught up in the crisis.  We can’t freeze them until the new houses are built, rents are sorted, jobs become their reality….. We have a reputation in Ireland for coming up with innovative solutions and this issue calls for our collective imagination and determination.
‘What will I be when I grow up?’ is not just a child’s dream – it is Ireland’s future.

Dr Mary Flynn is a Member of the Healthy Ireland Council. She is Visiting Professor, Faculty of Life and Health Sciences, University of Ulster.

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