Going Hungry in Childhood

Did you ever go to bed hungry as a child?  Rick poses that question in this week's podcast, and reveals that no, he never did.  While we're in true confession mode, I will reveal that I've never had that experience either, and suspect that few of our listeners or readers have. Yet that is not the case for a distressingly sizable, and growing number of children worldwide.

In this issue of Archives of Pediatric and Adolescent Medicine, we learn that the consequences of childhood hunger can be much more far reaching than a night of belly pangs.  Child hunger and long term adverse consquences for health examines these outcomes in almost 6000 children aged 10 to 15 and over 3000 in the 16 to 21 age range.

Surveys spanning a 10 year period were used to assess the issue of not having enough to eat, or so-called 'food insecurity' and a number of health conditions, including asthma, allergies, kidney disease, epilepsy and others.  General health was also rated.  The study found an association between higher rates of food insecurity and poorer health, with repeated episodes of hunger most "toxic," according to the authors.

Data cited in the study indicates that while about 11% of US households experienced food insecurity in 2007, that number in 2008 had risen to 15% and was projected to continue to rise.  Even more appalling, 40% of households headed by women experienced food insecurity.

The societal implications, of course, are damning.  How can we tolerate this level of childhood hunger in a society with as many resources as ours undeniably has?  Rick opines that one place where healthcare providers can help is by asking about food availability, both for patients themselves and their families. Many people are likely reluctant to admit a problem purchasing food and may not consider such an issue within the purview of a medical visit, but this study clearly shows that's not the case.  While we are averse to asking the beleaguered primary care doctor to take up more screening as a responsibility, perhaps screening for food insecurity should be added to the list.

Other topics this week include replacing a heart valve through a skin incision in this issue of Annals of Internal Medicine, the impact of blood lipid levels that are too high early in life in the same issue, and suicide risk and medications used to combat seizures in this week's NEJM.  Until next week, y'all live well.

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