Diagnosing and Treating Hunger in Kids

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Diagnosing and Treating Hunger in Kids

• Deborah A. Frank MD
• Professor of Child Health and Well-Being, Boston
  University School of Medicine
• Founder and Principal Investigator, Childrens
  HealthWatch
• Founder and Director, Grow Clinic for Children,
  Boston Medical Center 1/24/14

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FOOD INSECURITY IS A PEDIATRIC DISEASE

• Households with children 2X as likely to be
  food insecure
• 15.9 million children (1/5) in 2012
• Younger the child the higher the risk

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FOOD INSECURITY LINKED TO MUTIPLE HARDSHIPS

• Which all disproportionately
• Impact families with young children

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Economic Hardship
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Young Children Often Invisible Except to Families
and Health Providers
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The First 1000 Days are Critical for Brain Growth
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WHATS THE PRESCRIPTION?FOOD IS THE CHEAPEST
MEDICINE
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70 of Benefits Go to Household with Children
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SNAP Dose Too Low Even Before ARRA Roll back
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What are the Maternal Child Health Impacts of
Food Insecurity ?

• Does SNAP Help?

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Food Insecurity Associated with Pregnancy
Complications
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FOOD INSECURITY IN PREGNANCY (Carmichael 2007)

• Is associated with anencephaly and other neural
  tube defects

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Food Insecurity in Pregnancy Linked to Low Birth
Weight (Borders,2007)
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SNAP DECREASES LOW BIRTHWEIGHT
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Low Birth Weight Increases Developmental Risk and
Lifetime Health Costs Including Metabolic
Syndromes
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SNAP In Early Life Less Metabolic Syndrome
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Post-natal Child Health Impacts of Food
Insecurity

• Food Insecure children suffer 2-4 times as many
  health problems as other children within same
  income level
• Stomach aches, head aches, colds, ear infections
• Higher hospitalization rates
• Iron-deficiency anemia
• Decreased bone mineral density
• More susceptible to lead poisoning
• Poor oral health

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Why Hospitalizations?
Infection
Cycle
Malnutrition
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Post-natal Child Health Impacts of Food
Insecurity

• Food Insecure children suffer 2-4 times as many
  health problems as other children within same
  income level
• Stomach aches, head aches, colds, ear infections
• Higher hospitalization rates
• Iron-deficiency anemia
• Decreased bone mineral density
• More susceptible to lead poisoning
• Poor oral health

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What are the Child Developmental Impacts of Food
Insecurity?
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Brain

• Brain structure most vulnerable to nutritional
  insults early in development
• Brain function is sensitive to quality and
  quantity of foods consumed throughout live span
• Requires high energy consumption and cant store
  energy

(Lyle et al, 1984)
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Developmental RiskRose-Jacob, 2008
Young children in food insecure households are
40 more likely to score at developmental
/behavioral risk than other low income children

• /

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Congressional Food Stamp Challenge

• My focus and co-ordination are not sharp. I have
  one thought at a time and I am getting very
  confused not to mention crabby.

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Developmental Functions Remain at Risk Following
Early Undernutrition

• Language
• Short Term Memory
• Audio Visual Equivalence
• Attention
• Modulation of Activity and Affect
• Locomotor Skills

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SNAP ASSOCIATED WITH BETTER ACADEMIC ACHIEVEMENT
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Food Insecurity and SNAP Myths
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Hunger isnt the Problem Obesity is the Problem
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Puzzle of Poverty and Obesity

• Cyclical food deprivation/overeating
• Need to minimize per calorie cost
• Lack of access to fruits and vegetables in low
  income neighborhoods
• Lack of opportunity for safe exercise in low
  income neighborhoods
• Obesogenic practices in feeding children
• Stress hormones

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Real Cost of a Healthy Diet
Can parents afford to purchase healthy food?
0.79
2.59
Stop and Shop Price Check March 2010
880 calories
880 calories
How do you feed them without giving them harmful
things ? Witnesses to Hunger Mother
Drewnowski 2004
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Arent People Just Ignorant?
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Breastmilk is Best Milk but Does NotPrevent
Child Food Insecurity

• Pizza crust and Breastmilk

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SNAP Not Linked to More Child Obesity Some
Studies Find Less Obesity
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Myth Cutting SNAP will Save Money!

• Excess Health Care Costs for Adults and Children
  Calculated to Exceed SNAP savings

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Myth Private Charity Can Make Up the Shortfall
Would be More than 2X what Second Harvest Can do
Now
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Can We Fix It?
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Rx Policy Choices

• DX Our Childrens Brains and Bodies Suffering
  From Hunger and Hardship

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WIC supports childrens health

• Young children who receive WIC more likely
• Good/excellent health
• Food secure
• Healthy height/weight for age
• Lower risk developmental delays
• WIC can be located in hospitals and community
  health centers that serve obstetric and pediatric
  patients

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Could Health ProvidersPrescribe Healthful Food?
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Could We Help People Apply for SNAP and Health
Insurance at Same Time?
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Good Medicine for the Economy Too

• If all eligible participated additional
• 261 million would flow into
• San Mateo/Santa Clara Counties

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WHY BOTHER?
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We are Talking Real Children!
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• There is no finer investment for any community
  than putting milk into babies.
• - Winston Churchill

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Boston, MA 02118 tel [phone]
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