30 Oct 2023 Guest blog: Undernourishment Under the Spotlight
In this blog, we hear from Shona Goudie, Policy and Advocacy Manager at The Food Foundation, about the worrying rise in underweight children in England, and the long-term health impacts of malnutrition.
In October, new NHS data was released providing our annual insight into the state of children’s weight in England. This year, a worrying new finding has emerged: we are now witnessing the highest level of underweight in Year 6 children since the measurement programme began. While a small change, it suggests a concerning increase in children going hungry. Not getting sufficient calories to maintain weight and not getting the nutrients they need to grow up healthily puts children at risk of long term health conditions, hindering their ability to reach their full potential.
Sadly, this is not altogether surprising when we consider that food insecurity levels doubled over the course of 2022 and there has been a lack of sufficient government action to support struggling families afford food through the cost of living crisis. Eating healthily is simply unaffordable for many families across the UK right now. In fact, the poorest fifth of the population need to spend an unrealistic 50% of their disposable income on food to afford the Government recommended Eatwell Guide diet which would meet their nutritional requirements. This compares to just 11% for the richest fifth.
This financial barrier is also a major contributor to vast and persistent inequalities in obesity levels, with this latest data showing children in the most deprived groups are still twice as likely to have obesity as their least deprived peers. A lack of sufficient income is likely to result in a reliance on less healthy, highly processed foods due to their relative affordability compared with healthier options. These foods tend to be calorie dense and lacking in essential vitamins, minerals and other nutrients, resulting in an increased risk of being overweight and yet undernourished.
GPs are also reporting a rise in undernutrition, including seeing an increase in diseases of micronutrient deficiencies such as rickets (calcium deficiency) and scurvy (vitamin C deficiency), and there were a shocking 700 cases of children being admitted to hospital with malnutrition, scurvy and rickets last year. Such conditions are entirely preventable in a high income country like the UK.
This echoes another indicator of how significantly undernutrition is impacting UK children, particularly the most deprived children, explored in The Food Foundation’s annual Broken Plate report. We found that on average White British boys and girls in the most deprived tenth of the population are 1.3cm and 0.6cm shorter respectively than their counterparts in the least deprived tenth in their last year of primary school. Although diet is often overlooked as a determinant of the height of children in the UK, height-for-age is a commonly used indicator around the world to assess nutritional status. Comparatively, the UK is not performing well compared to other similarly high income countries. Data from the Non-Communicable Diseases Risk Factor Collaboration shows that by age 5 children in the UK are shorter than in nearly all other high income countries. In fact, this difference is as much as 7cm on average compared with the Netherlands, and the situation has since deteriorated. The UK has fallen down the national rankings in recent years (In 1985, the UK was ranked 68th out of 200 countries; in 2019 we were ranked 102nd for boys and 96th for girls). Although genetic factors play a role in height, these tend to play more of a role in later childhood and at age 5 height is very indicative of environmental factors including nutrition, stress and illness.
It’s unmistakable from these findings that undernourishment is impacting children in England, and is distinctly socioeconomically patterned. As a first step to tackling childhood obesity, underweight and co-existing micronutrient deficiencies, the Government must invest more in nutritional safety net schemes that provide vital nourishment for low income children. This includes taking urgent action to strengthen and improve Free School Meals and Healthy Start to ensure that they are fit for purpose and expand eligibility to reach all children who need them. No child should be denied their right to grow up healthy and reach their full potential.
Shona is a Registered Associate Nutritionist working as the Policy and Advocacy Manager at the Food Foundation. She joined The Food Foundation as a Project Officer in 2019 and has worked on research, policy and advocacy across a range of projects over that time including leading on the organisation’s food insecurity surveys and flagship annual Broken Plate reports. She now works across The Food Foundation’s policy portfolio including our children’s food campaigns and work on food insecurity and food environments.