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Food insecurity: a risk in children and adolescents

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75% of the socially vulnerable children and adolescents analysed, experience some form of food insecurity, meaning they encounter difficulties accessing nutritionally adequate food for their growth, health, and well-being. The reason is that a large proportion of the child and adolescent population does not meet the consumption recommendations of the Spanish Society of Community Nutrition (SENC), adopting dietary habits that, once learned and maintained during childhood and adolescence, are difficult to change in adulthood.

This is one of the conclusions of the pilot study 'Social Vulnerability as a Predictor of Hidden Hunger and Nutritional Adequacy in Child and Adolescent Populations in Metropolitan Areas of Spain'. This was presented this morning by the CEU Institute of Food and Society (IUAyS-CEU) and MAPFRE Foundation during a roundtable discussion moderated by Daniel Restrepo, Director of Social Action at MAPFRE Foundation, at the Montepríncipe Campus of the University.

The aim of this study, conducted on 175 minors in situations of social vulnerability in metropolitan areas of Spain, is to investigate the relationship between the possibility of maintaining a nutritious and adequate diet with purchasing power, the level of inequality or discrimination, and social status.


3 out of 10 surveyed children and adolescents in vulnerable situations present food insecurity

According to the study, of the total sample, 29% experience severe food insecurity. When specifically analysing the population experiencing some form of food insecurity, 1 in 4 (27%) admits to having at some point gone to bed hungry due to lack of food.

On this matter Gregorio Varela Moreiras, Director of the CEU Institute of Food and Society, stated this morning that food insecurity encompasses not only the lack of economic resources to obtain nutritionally adequate foods but also the inability to access them due to not knowing which ones have higher nutritional quality. "The prevalence of food security among participating volunteers indicates that more than half of the study population is at some risk of food insecurity. The quality of the diet of the children and adolescents who have participated needs urgent changes, as there is frequent consumption of low or moderate nutritional quality foods, displacing the consumption of vegetables, fruits, fish, and seafood, among others, which have high nutritional quality and are essential for our bodies," explains Varela.

Likewise, the report reveals that over half (54%) of these children and adolescents in situations of vulnerability and experiencing food insecurity have been worried about the lack of some foods in their homes in the last month. Specifically, 47% state that both themselves and some household members had to eat foods they didn't really want due to lack of resources. Moreover, 23% indicated having fewer meals in a day because there wasn't enough food, and 11% claimed to have gone a whole day and night without eating anything due to insufficient food.


The percentage of obese children doubles in households with lower incomes compared to those with higher incomes 

The difficulty of accessing food results in nutritional deficiencies being observed at increasingly younger ages, even in developed countries, with an increase in forms of malnutrition such as overweight or obesity. In Spain, one of the European Union countries with a high correlation between the rate of child poverty risk and obesity, the percentage of obese children doubles in households with lower incomes (23.7%), compared to those with higher incomes (10.5%).

Rosaura Leis, President of the Spanish Nutrition Foundation (FEN), emphasised the relationship between the high rates of overweight and/or obesity in Spanish children and adolescents with the loss of adherence to our traditional diets, Mediterranean and Atlantic, in favour of other diets rich in energy but of little nutritional value. "Nutrition in the first 1,000 days of life and during childhood and adolescence is crucial for disease prevention and health promotion in the short, medium, and long term. One of the priority strategies to combat this 'hidden hunger' could be the promotion of consumption of our traditional diet and gastronomy, starting from childhood. For this, school and family, especially caregivers such as grandparents, must play a fundamental role," Leis points out.


Low adherence to the Mediterranean diet

Although the Mediterranean diet is one of the healthiest dietary models currently available, only 15% of the total analysed child and adolescent population shows high adherence to it, with 57% of them showing moderate adherence and 28% showing low adherence. In fact, there is scientific evidence confirming that the higher the level of education and socioeconomic status, the higher the adherence to the Mediterranean diet. 

Among the factors related to low adherence to the Mediterranean diet in childhood and adolescence are individual factors (preferences and aversions, lack of knowledge about nutrition or biology), group factors (economic and social), sedentary lifestyle (video games and television), or low rates of physical activity.

Added to this is the fact that the consumption of Mediterranean foods, such as vegetables, fruits, or fish, has been displaced by excessive consumption of foods such as red meats, processed meats, sugary products, pre-cooked meals, or salty snacks.

"It is important to consider the serious social repercussions of not ensuring the right to a healthy and balanced diet. Repercussions that are immediate in the most vulnerable population groups, such as babies, children, and adolescents, and pregnant and lactating mothers. If a healthy diet is necessary for the entire population, during these stages, a nutritional deficit can condition not only physical but also cognitive and psychological growth. Therefore, we must advocate for messages that promote better practices and social protection that provides people with fewer resources access to nutritious foods and protects them from rising prices. And do so with sensitivity, with integrative proposals rather than marginal ones," concludes Carmen García Cuestas, Head of the Childhood, Adolescence, and Family programme, and member of the inclusion team and social action area of CÁRITAS Spain.

Lack of calcium and excessive consumption of fats and ultra-processed foods 

Changes in dietary patterns are occurring worldwide, and a common characteristic is the replacement of minimally processed foods with moderately, highly, or ultra-processed foods.

In fact, according to this preliminary study, none of the children and adolescents analysed follow a healthy diet pattern: 70% have a diet that needs significant changes and the remaining 30% have a somewhat unhealthy one, a fact that aligns with low adherence to the Mediterranean diet.

In this regard, of the total analysed population, half do not consume fruit daily, a figure that rises to 71% in the case of vegetables, only 57% consume olive oil at home as the main culinary fat, key in the Mediterranean diet but costly, 63% do not consume more than two servings of dairy daily, and 51% do not even consume one. The recommended intake of fish and seafood is also not met, with 90% of respondents not including it in their daily menu. 

Additionally, carbohydrate and fat consumption exceeds the stipulated amounts, and intakes of vitamins B5, B8, B9, D, and E, as well as calcium, magnesium, iron, iodine, and zinc, are insufficient. These deficiencies in essential micronutrients during the growth stage are very concerning, as they are closely related to the possible development of cardiovascular diseases, diabetes, or osteoporosis. It is striking and worrying that, out of a total of 26 intake indicators analysed, recommendations are not met in 13 of them.

Regarding less healthy habits, it stands out that 33% go to fast food restaurants once or more than once a week, and 25% consume sweets or candy several times a day. As for the intake of snacks and salty snacks, it can be observed that more than half of the analysed population exceeds recommendations: 35% consume these products 1 or 2 times a week; 21% 3 or more times a week, and 13% daily.

From this non-representative pilot study, it is clear that there is a need for more research focused on vulnerable groups, once we have understood the extent of food insecurity in the sample population analysed. Surveys and analyses carried out from this work provide valuable information to establish new hypotheses that serve as a guide for developing new plans.

Palabras clave Food insecurity Social vulnerability Food Society Adolescents Children