What exactly is starvation? Or malnutrition? We see numerous videos of starving children from all over the world. Close your eyes and you can clearly see their thin arms and legs, their terrified eyes. Just as clearly everyone can understand, this is starvation. There are methods to determine the extent of starvation which helps with treatment. Starvation is the end effect of malnutrition. Measurements for malnutrition exist but “seeing” malnutrition is harder. Children can be malnourished and not be visibly “starving”.
Americans tend to think that malnourished children only exist in faraway countries. Did you know that about 19% of U.S. children (13.4 million children) lacked reliable access to adequate food in 2022? This access to food can vary from having to skip a meal or not eat for a day occasionally to multiple days in a month.
So if it isn’t starvation why should a parent or teacher or senator be concerned about a little malnourishment? Decades of research reported in the journal Pediatrics describe a number of negative health outcomes and even lifelong consequences. Children in food insecure homes are more likely to have poor overall health, reduced immune system functioning, more infectious diseases, asthma, anxiety and depression. Alarmingly they have more learning problems.
Children that are in food insecure homes have more trouble concentrating, poorer memories, more irritable moods and decreased motor skills. Children who eat breakfast at school scored 17.5% higher on standardized math tests.
Another way that children can be impacted by malnutrition is if their grandmother was malnourished during her pregnancy. Malnourishment can cause changes in gene expression. Gene expression is the process by which the formation encoded in a gene is used to create a functional product. Genes are like recipes placed in the DNA which is the cookbook. When a cell needs to use a recipe (gene), it first makes a copy of it, called mRNA, which is like photocopying the recipe. Then the mRNA copy travels to the protein-making factory (ribosome) where it is used to make the protein or other RNA molecules.
These changes in gene expression can be passed down to future generations potentially changing the health and development of grandchildren. These changes may increase the risk of certain diseases or health issues in the future. Studies have shown that famine during pregnancy leads to increased risks of diabetes, obesity and other health problems in offspring and grandchildren.
A study from Tulane University found that a protein-deficient diet in one generation created related health risks- lower birth-weights, smaller kidneys- in offspring that lasted four generations.
Parents and community leaders need to work to remove barriers to the 13.4 million American children and their pregnant mothers to adequate food to prevent malnutrition. There are well documented large racial and ethnic disparities in economic and food hardship. In response to the almost 1 in 5 children who are malnourished there are programs like the Supplemental Nutrition Assistance Program (SNAP) and other food assistance programs which should be protected and increased.
by Sally Robinson, MD Clinical Professor
Keeping Kids Healthy
Published March 2025