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BBC – Future – Why food poverty is a health-related time bomb

Kerry Wright was not hungry. Not as you expect. Her belly growled, yes, she could hear it. She just could not feel it. She called it "hunger mode". Wright, mother of three children living in Aberdeen, had reached a low point. But she had to take care of her children, who were just getting into adolescence.

When faced with the prospect of watching her own children go out, she had not come into contact with her parents and the rest of her parents. She wanted a fresh start Apart from the fact that at this time in 2013 a restart was quite far away. Her partner had left, and her services were declining. Every now and then she took on paid housework, but never made enough money. Desperately, she scanned her cupboards, hoping there would be enough soup or cans of beans to at least get the next lunch together.

Since there was always so little to do, it did not take long for her to start bopping meals. The effects soon came. She was tired all the time ̵

1; and yet she could not sleep. She was hungry, but she did not want to eat, and when she did, she was sometimes sick. 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 tiredness, and it was also dizzy.

But it was not her own well-being that she was most worried about. It was her children's. Try it that way, she could not hide it from her that she was not feeling well. They asked her questions: Why was she dizzy the whole time? Why did she take these tablets from the doctor?

And one day she came home to find 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. "Children should not worry about their parents."

Today her biggest concern is not that her physical health was hit, but her children's mental health. What psychological scars were left over when they watched their mother starve to death?

What happened to Wright and his family is much more common to wealthy households than some think. Food insecurity, also known as food poverty, is on the increase in the UK, the ninth-richest country in the world. The exact scope is unknown. But many other countries are struggling with this problem. For example, there are millions of families in Europe, the US and Canada currently facing food insecurity.

Food banks distributing food to the needy free of charge are becoming more prevalent in places where food insecurity has become a permanent problem. (The Trussell Trust, which operates food banks in the UK, recently reported a 19% increase in the number of outsourced food parcels in Great Britain – to a total of 1.6 million.) But also groups like the Trussell Trust is unanimous that food banks are not long term Can be solution. The offered foods vary in quantity and quality – often they are only limited nutritional. Systemic reform, say charitable organizations, is needed to prevent families from starving themselves.

Scientists have shown that hunger is not just temporary. Hunger in childhood can have a ripple effect that we are just starting to understand. The long-term physical and psychological consequences of hunger are serious and have an impact on the health of society. Food insecurity may be a time bomb for today's hungry generations – how dangerous is it?

It was a charity that helped the locals find a job when someone mentioned Wright the term "food bank". But she jumped at the idea. "No way," she thought. She was afraid that the social services would take her children with her if she was looking for help with a food bank. It was a reflexive reaction she had from childhood. Her own parents mistrusted outside agencies and told their children that if someone came in, "shut up".

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 kind of like a trade."

As a volunteer, she might get some support, that weird bit of food. It was worth a try. For the first few days she felt awkward and out of place. Then Kelly Donaldson, one of the workers, took her under her wing. She soon learned what Wright was going through, and now and then Donaldson assembled a small pack of groceries for her new friend at the end of the day. "This is your dinner for tonight," she said encouragingly to Wright, handing over the bag.

This food bank was in the center of Aberdeen, which is operated by the Community Food Initiatives North East – known as CFine. In addition to the food bank, CFine offers cooking classes and subsidized fruits and vegetables. And it's in CFines HQ that I'm meeting Wright in person for the first time. I arrive on a busy Wednesday as people queue for three-day food parcels. Helpers pass certain items while a small snake forms at the door.

The food parcels are presented as nondescript white tote bags with milk, several cans of food, cereal, rice or pasta and gravy. Within about 20 minutes, two rows of sacks stacked on shelves disappear. It will not be long before they are replenished. I was told that a few weeks ago CFine had spent 179 of these bags on a single day, the highest number ever recorded by a charity.

Dependence on food banks in Aberdeen is high. There are 20 such services in the city – more than any other city in Scotland, including the more populous cities of Glasgow and Edinburgh. Food banks are becoming more generalized in many places, such as rural US communities, Canadian cities, and affluent European countries. Scotland is by no means an outlier.

Before we can meet, I see Wright shoot into an interview room to give advice to a young man. He has long hair, camouflage pants. His dog came along. Wright is now part of the Financial Fitness team. It is their job to help people manage their finances. The role is to support them with benefit claims – the kind of hoop she had to leap through to feed her family.

Wright tells me she's still worried about what her kids have been through. 19659002] "My children's health was not physically endangered, but I would say that it relates to their psychological wellbeing," she explains. "They were worried and worried about their mother. They were afraid to go to school because they were not sure what was wrong with my health.

Evidence that more and more children in rich countries are starving and their negative effects. Just over a week before my visit to Scotland, 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."

The situation is not better across the Atlantic. Every fifth child in the United States goes to school hungry. Canada had its own visit by a UN Special Rapporteur in 2012. He also noted that food insecurity is a growing problem.

Where hunger increases, the consequences are bad. 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 the experience of Kerry Wright and her concerns about her children's psychological well-being.

"The woman is obviously very ingenious," says Tarasuk. "That's why we have to worry about these children."

Tarasuk is a professor of nutrition science and an expert on the relationship between food insecurity and health. She and her colleagues have analyzed national data from tens of thousands of Canadians to show that the harder a person is to struggle with food insecurity, the more likely they are to seek help from health services. However, it is also pursuing research that looks into 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 only a handful of times associated with poorer physical and mental health. It also means that children are less likely to finish school.

In a six-year study, McIntyre and colleagues found that young people who were hungry had a significantly higher risk of developing depressive symptoms. Another big analysis showed that children who are starving may also have a certain health problem in the next 10 years. Researchers wrote that hunger had a "toxic" effect: "Adolescents who had multiple starvation episodes experienced a higher likelihood of chronic disease and asthma compared to those who were never hungry."

These findings even kept upright other things that could affect the health were included in the factor – hunger actually seems to play a crucial role.

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

The team initially focuses on young people who have one of four "tracer states" – eczema, constipation, asthma, and epilepsy.

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 knowledge of the relationship between food insecurity and health, albeit in quite localized contexts.

Great research is currently underway in King's College London in two large districts south of the capital. Lambeth and Southwark. It is run by Ingrid Wolfe, who is also a pediatric consultant. She says it was part of the motivation to see more children being 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 (CYPHP, ironically pronounced "chip") is Wolfe and her colleagues' efforts to biopsychosocial context for young people health care providers. In other words, it's an attempt to understand what might have affected the things in a young person's life that brought him to the doctor.

The team initially focuses on young people who are under one of the four indicator states. There are now around 1,000 CYPHP participants, and the program will add more in the coming years.

Wolfe says that participants fill out a detailed online questionnaire about their domestic life. Issues include questions about the stability of the home environment, food and social life of young people.

There is already evidence that food insecurity is a bigger factor in the health of young people than previously known. For example, in 90% of obese users, food insecurity turned out to be worrying.

Ultimately, CYPHP seeks to improve children's health by finding out which factors can influence well-being so they can be addressed – rather than waiting for children to seek medical treatment. Until then, it might be harder to solve the problem.

The fact that food insecurity can be so damaging to a child's long-term health in a rich country is worrying. Even more disturbing is the recognition that while Canada and the US have made efforts to address population insecurity in the population, in the UK there is no equivalent measurement. However, this will soon change: the Department of Labor and Pensions will include questions on food insecurity in its annual Household Survey on Living Standards. The first data will be available in 2021.

Conditions related to food insecurity are already very visible to doctors. One who regularly sees the consequences of starvation in children is Ronny Cheung, a general pediatrician in London. He sends me data showing that there has been a marked increase in rickets cases in England over the last 20 years, requiring hospitalization. There are now more children's hospitals for rickets than ever before in the last five decades. Rickets can not always be linked to the diet, because the vitamin D deficiency can also be caused by sunlight deficiency. However, "nutritional cravings" are diagnosable if it turns out that a child's food intake is below average.

When I met him in a tiny office in a central London hospital, Cheung recalls the case of an 18-month-old patient. old boy whom he has treated recently. The boy's mother had taken him to the family doctor because he had difficulty learning how to walk. When Cheung brought him to a closer examination, it became clear why. He had severe arch legs, a characteristic symptom of rickets. Not only that, but the boy had developed bony gems at the top of his ribs, known as the Rachitic rosary.

"That's really rare," says Cheung. "This is like textbook stuff that nobody sees, and that kid had it because the flaw was so severe."

After discussing his diet with the boy's mother, it became clear that it was a case of rickets. After a series of supplements, followed by an improved diet regimen, the boy's rickets reversed. At such a young age, children grow so fast that their bones can correct themselves – as long as the body gets the right nutrients.

If we see rare diseases, it means that there is a problem We do not test or do not know about it – Ronny Cheung

Cheung thinks we should not consider such cases anomalies. "When we see tips of rare diseases, it tells us there's a whole problem underneath that we do not test or know about. This is a beacon, right? That's what it is. "

We know that poor nutrition can affect children's health. But what happens here in the body? Apart from a lower vitamin D level, the nutritional intake of a malnourished child may still be different.

Tipping the Scales

In a home where parents or guardians rely on cheaper food, children consume sugary foods and fatty foods will normally increase. Diets can become unbalanced and micronutrient intake will decrease. Some of the first deficiencies could be an iron deficiency, as occurred with Kerry Wright, along with a vitamin A and iodine deficiency.

Iodine, which is abundant in white fish and dairy products, is particularly important for the development of the brain. The British Medical Association says iodine deficiency is "the leading cause of preventable mental retardation and brain damage that has the most devastating effects on the developing fetus and young child's brain in their early years".

And let's not forget the obesity. People sometimes hear the word "malnutrition" and mean that this results in a lack of food that causes someone to become weaker and emaciated. While malnutrition is one form of malnutrition, obesity is another. It's just the other end of the scale.

The Royal College of Paediatrics and Child Health says that obesity is related to withdrawal. "In England, it appears that overweight and obesity decline over time among the least favored but not the most disadvantaged."

Unfortunately, a poor diet can never provoke a response from doctors if these issues do not get serious. Kelly Donaldson, Wright's friend at CFine, says she and her three children have become obese because of their reliance on cheap, easy-to-cook meals. "It was easy enough to get like a bag of chips and a bag of sausage instead of buying healthier things," she explains. "The doctor says they are healthy kids, just a bit 'dumpy', I think it was the word he used."

When Donaldson learned how transformative a healthy diet can be while working at CFine, she changed her cooking habits at home. She has already noticed a weight loss in her youngest boy.

Improving nutrition can not be done only by food banks. Even the organizations that operate them say so. But there is another way – a so-called "person-centered approach".

This is currently taking place across the UK, though not in hospitals or doctors' offices. It is the work of charities.

Care in the kitchen

"I like talking to people," says Sheena Boyd with a big smile. "You'll understand that at the end of the day." She laughs heartily. She is the project leader of a charity named Centrestage, located in the town of Kilmarnock in southwest Glasgow. Their job is to manage two programs: one that provides fresh food to people in deprived areas and one that conducts community cooking classes.

Before working here, Boyd was employed by a bank. Then she guided her friend, who worked for Centrestage, on a tour of the charity's activities. She was overwhelmed. Her friend announced that there was a job – it would be Boyd if she wanted it. She did not have to think twice before accepting it.

"I have just seen the help that is there for these people that I could not do in the bank," she explains. The spark had ignited in her head: "I can help these people."

When Centrestage was founded 13 years ago, the founders did not intend to feed the humans. They wanted to offer a theater group for locals. The idea was to stage big shows with a bit more buzz and pizzazz than, for example, school drama departments. In addition, everyone could participate, 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 – in fact, it could even be a barrier to people taking part in something like a theater project. When you are hungry, you can not be expected to work hundreds of hundreds or work hours.

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

"That's our motto," says Boyd. "Everything is fun, everything makes people feel relaxed, they feel welcome, they do not feel intimidated, they do not feel judged."

She herself saw how a lack of food can take its toll Young people. Children can be fatigued by hunger – but they can also have the opposite effect. For example, in children with ADHD, hunger can trigger hyperactivity. At a cooking class, Boyd's effort to start the lesson was hampered by a boy running around the room. She distributed sandwiches. "After he had eaten, he calmed down," she says.

The "On the Road" project by Centrestage is a biplane bus that drives around and rinses food. Boyd would like to show me the bus that is today in an area called Shortlees in the south of Kilmarnock, where a shocking 37% of children live in poverty. But before I see the bus, I have to witness the kitchen, where thousands of prepared meals are prepared every week, says Boyd.

We drive to a large gray warehouse on an industrial estate. The sky is gray too. However, when the door beeps as we enter the unit of Centrestage, the smell of cooking suddenly causes color. Cooks hurry around in black and comfortable hiking boots, with jugs of various blends or huge bowls for the ovens.

The food portions cooked here are distributed to Centrestage locations. You can also buy them for just a pound in the café. 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.

As the bus driver, Ian Maconochie, reports, food banks often ask for coupons before distributing goods. "Nae chitties here," he says, "nae chitties."

Volunteers will be happy to hand over food for free, though they're wondering if people can try to budget something each week and make a small donation, like a pound or two pounds. In any case, says Maconochie, nobody is turned away. The number of people using the Centrestage bus and other food distribution points is mind-boggling. Between July and September 2018, adults were given nearly 6000 meals and children about 2,200 occasions.

The other part of Boyd's role is to help people cook so they can better take care of themselves. Centrestage has acquired an old school in Kilmarnock, which will be converted into the charity's headquarters in the next few years. The old cafeteria becomes a café serving inexpensive meals. The auditorium is being converted into its flagship theater space. Classrooms are rented to local initiatives designed to teach people skills such as hairdressing.

Boyd organizes cooking classes in the old housekeeping department. The first time she saw the rows of sinks and hobs, she was overwhelmed. "I just have to cry," she recalls.

Boyd and her co-workers, along with many volunteers, seek to consciously and holistically fight poverty. 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. The woman who brought her daughter on the bus was right: this is not a food bank. It's much more than that. Boyd says, "We can say," What's going on? We can help you in other ways. "

Kerry Wright and her colleagues at CFine in Aberdeen also provide a wide range of support to the locals. Charities like these aim to get something much bigger under your skin: the loss of poverty. Maybe food is the first thing to get someone out the door.

Dave Simmers, Chief Executive of CFine, wants his organization to focus on helping people to help themselves. But the extent of the crisis in which he sees people means also leading the food bank.

"We do not like food banks," he says, as the workers spread the food parcels just a few yards away from his office door. "They are not helpful, they undermine dignity, they create dependency and change nothing."

"But basically, people are hungry."

Wright's life might have been saved by CFines Food Bank, even though she had come seemingly more likely to be a volunteer than a user. And yet, Simmers' position that food banks are of little help makes sense in the broader context of a hungry nation. Improving the fairness of the benefit system and monitoring and safeguarding child nutrition would be the first steps that could lead families to no longer rely on food banks.

Changing Life

For Wright, a charity that really got them back started working without access to free food. Today she expresses a real zeal for her work. She now works at CFine for 29 hours a week. It finally has a steady income stream. This year she will be debt-free for the first time in a long time. She is very careful though. If it is a bit chilly, she will try not to put an extra 10 pounds in the gas meter in case she gets too little food the following week.

However, 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 have the feeling that Wright, like her friend Kelly Donaldson, has found a role that not only helps her in the here and now – she is it she can build on.

"I have a loyalty here," she says. "Because they really help people to change their circumstances. This affects the physical health, the mental health and the life situation.

Donaldson whistles and shows 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 on Mosaic by Wellcome and is re-released here under a Creative Commons license.

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