June 23rd 2020

BY ANNAH HERBERT-GRAHAM, Magic Breakfast's Nutrition Advisor

Feeding hungry children during the school holidays has hit the headlines this month and, thanks to months of campaigning from the school food sector, and the influence of a young footballer, the Government will now be providing vouchers for Free School Meals during the summer holidays.

It isn’t usual for the Government to provide Free School Meals in the holidays but these are far from normal times and childhood hunger has certainly been exacerbated by the Covid-19 crisis.

We know that there are many more families struggling to feed their children, many of whom are not eligible for Free School Meals.

Magic Breakfast will be continuing breakfast provision through the summer holidays.

There are many factors which contribute to holiday hunger, and many more side effects as a result of it.

What happens in your body when you eat a meal?

In a nutshell, the food we eat is the raw material for the fuel our bodies need to function and carry out our daily activities, as well as providing the building blocks for continued growth and repair.

From the moment you take a bite of something and chew, your food has entered the digestive system and goes on an exciting journey through your body, passing through ten different organs (including the stomach, liver, pancreas, gallbladder and intestines), over a distance the size of a tennis court, and taking approximately 40 hours. It is gradually broken down into smaller and smaller particles by muscular movement, digestive juices and enzymes until the nutrients can be absorbed into the bloodstream and transported to cells around the body to be used for energy, growth and repair.

We need to consume a range of food groups throughout the day in order to achieve a balance of energy sources, as recommended in the Eatwell guide.^[1]

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Carbohydrates are converted into glucose, a form of sugar that can enter our cells ready to be used for energy. It is this energy that powers our muscles to move and our brains to make new connections through learning and experience. Complex carbohydrates containing a good amount of fibre offer sustained energy as well as helping the digestive system to work efficiently. Whole grain cereals and breads (barley, rye, oats and whole wheat), brown rice, pasta, starchy vegetables (such as sweet potatoes, squash and pumpkin), lentils and beans are all great sources of energy.

Proteins break down into amino acids (which the body cannot make on its own so must obtain from food), essential for the continuous renewal of cells needed for growth and repair. Eggs, soy, dairy products, beans and peas are good sources of protein.

Fats (which come in many different forms, some of which are vital for our survival) are dissolved into fatty acids and glycerol by bile released from the gall bladder then transported around the body via the lymphatic system to provide energy, encourage cell repair and to help fight infection. Beneficial fats can be found in oily fish, lean meats, whole milk, eggs, nuts and seeds.

Micronutrients (vitamins and minerals) are found most abundantly in fresh fruit and vegetables. They are the essential workers in our body which help support the immune system (fighting off infection), nervous system (brain development and reflexes), hormonal balance, muscles, bones and skin health.

As you can see, digestion is a complex process that involves many organs and body systems and ultimately allows us as humans to survive and thrive.

 

What happens when you skip a meal or eat irregularly?

We need a constant, regular supply of fuel - just like our cars - to make sure we can keep on going about our daily activities, without stalling due to lack of energy. This applies equally to active young learners who are continually growing and developing - physically, cognitively, socially and emotionally. On average, a primary-school aged child requires 1700 calories a day (as energy from food), which increases to 2000 calories a day for secondary school pupils^[2]. NHS recommendations for balancing out energy intake throughout the day (in the form of calories) follow a 400 kcal : 600 kcal : 600 kcal ratio, meaning breakfast should provide approximately 400 kcal, with lunch and dinner providing 600 kcal each, leaving some leeway for snacks throughout the day^[3]. As an example, a breakfast consisting of a 90g bagel + 200g beans would provide these energy requirements to keep children going until lunch.

It is important that children keep their energy levels balanced by eating breakfast, lunch and dinner daily, including all the food groups and plenty of fresh water for hydration, as any change in eating patterns can upset the energy available and result in a cascade of hormonal, physical and cognitive changes. Most notable is the change in blood glucose levels (often referred to as ‘blood sugar balancing’).

Once glucose has reached the bloodstream, signals are sent to the brain to tell the pancreas to release the hormone insulin; insulin carries glucose into cells to be used for energy. If blood glucose levels are low, another hormone called glucagon is activated, telling the liver to release stored glucose into the blood stream. Therefore, a careful balance of these two hormones - insulin and glucagon - keep blood sugar levels balanced and energy levels consistent between meals.

However, without the raw materials - regular, healthy food intake - this balance cannot be maintained. The result of low glucose levels is as you might expect - low energy, low mood and an inability to concentrate or carry out tasks effectively. Glucose is vital to brain function, which is why we find it difficult to focus when we are hungry. Imagine how challenging it would be for a child who has not eaten since the previous evening to focus throughout morning lessons while running on ‘empty’!

On the other hand, when blood glucose levels rapidly increase - as a result of eating simple carbohydrates or sugary snacks - this results in an energy spike, which lasts as long as it takes for the hormone balance to be restored. Continued disturbances in blood glucose levels, over a period of time, can lead to insulin resistance (the pancreas stops producing insulin), metabolic disease and Type 2 diabetes, as well as having a negative effect on mental health.^[4]

With regard to hunger of any kind - whether intermittent or prolonged - the effects on children’s overall health are gradually becoming clearer. Although there is certainly scope for more detailed clinical studies and reviews, research so far has shown that children living in food insecure households, who are at higher risk of hunger, are more prone to reduced learning outcomes.^[5] Lack of access to nutritious foods can lead to nutrient deficiencies; iron deficiency is a particular concern among many families experiencing food poverty as it has been linked to delays in cognitive, motor, neurological, and social-emotional development in children.^[6]

With vitamins and minerals so important in maintaining a healthy, functioning body, we must emphasise the importance of access to fresh fruit and vegetables for children.

A small-scale study conducted by Northumbria University has highlighted a worrying trend in fresh produce consumption since lockdown began in March 2020. Out of the children who took part in the study (all were entitled to Free School Meals), half were eating little to no fresh fruit and vegetables, while intake of sugary drinks and snacks high in fat and sugar has risen by 400% during the pandemic.^[7]

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For families living in areas of deprivation, a reliance on cheap, easy to access foods high in fat and sugar and low in essential nutrients not only increases the risk of deficiencies but also childhood obesity, as reported by the Royal College of Paediatrics and Child Health.^[8]

Furthermore, we must seriously consider the effect hunger has on psychological health. The uncertainty that food insecurity brings takes its toll on the whole family; not knowing where the next meal will come from, parents living in poverty will often skip meals so their children can eat. When this happens frequently, the decline in the parent’s health will surely be noticed by children. As children perceive a threat to their caregivers and their family, in turn, their own mental health can suffer. Studies into the mental health of adolescents who experienced hunger as children suggest a higher incidence of depression among this group, despite other factors that may affect mental health status.^[9]

Indeed, as the long-term consequences of hunger on children’s health and wellbeing are still under investigation, what is clear is that our society as a whole will be affected if millions of our young learners (citizens of the future) continue to go to school hungry, or learn from home hungry, unable to fulfil their potential due to an empty stomach and the worry of when they will next get a decent meal.

 

What can we do to ensure young people are getting the constant fuel they need to learn, grow and enjoy their holiday time as well as key time in school?

There is no magic solution to such a complex and widespread issue, however, many organisations are stepping in to plug the gap and provide much needed support in the form of food parcels delivered to families on low incomes over school holidays and during Covid-19.

Magic Breakfast provided breakfasts over the Easter and May school holidays, while children were under lockdown, and we will continue with holiday provision from now on. We know hunger doesn’t take a holiday. 

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^[1] https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/
^[2] Based on females aged 7 - 10 years and 11 - 14 years respectively. The figures are slightly higher for males, and lower for infant aged children. Ref. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/618167/government_dietary_recommendations.pdf.
^[3] https://www.nhs.uk/live-well/eat-well/healthy-breakfast-cereals/
^[4] Knüppel A, Shipley MJ, Llewellyn CH, Brunner EJ. Sugar intake from sweet food and beverages, common mental disorder and depression: prospective findings from the Whitehall II study. Sci Rep. 2017;7(1):6287. Published 2017 Jul 27. doi:10.1038/s41598-017-05649-7
^[5] Food insecurity and hunger: A review of the effects on children’s health and behaviour
Janice Ke, MSc and Elizabeth Lee Ford-Jones, MD https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4373582/#

^[6] Black M. Integrated strategies needed to prevent iron deficiency to promote early childhood development. J Trace Elem Med Biol. 2012;26:120–3. [PMC free article] [PubMed] [Google Scholar]

^[7] https://www.northumbria.ac.uk/about-us/news-events/news/massive-decrease-in-fruit-and-vegetable-intake/

^[8] https://www.rcpch.ac.uk/key-topics/nutrition-obesity/about-childhood-obesity

^[9] McIntyre L, Williams JVA, Lavorato DH, Patten S. Depression and suicide ideation in late adolescence and early adulthood are an outcome of child hunger. J Affect Disord. 2013;150:123–9. [PubMed] [Google Scholar]