An estimated 7.9 million kids in the U.S. live in "food-insecure" households. This means there's not always enough to eat at home.

But when these kids go to the doctor for a checkup, or a well-child visit, the signs of malnutrition are not always apparent. So pediatricians say it's time to start asking about it.

Kids and parents often shy away from talking about their struggles. "They're embarrassed, or they don't think the doctor will care," says pediatrician Sarah Jane Schwarzenberg of the University of Minnesota Masonic Children's Hospital.

To get families talking, the American Academy of Pediatrics is now recommending that pediatricians screen all children for food insecurity by asking questions like this:

Within the past 12 months, the food we bought didn't last, and we didn't have money to get more. Yes or No?

As we've reported, America's wealth gap manifests on our dinner plates. Families who rely on SNAP — the federal Supplemental Nutrition Assistance Program, also known as food stamps — tend to eat about the same number of calories as higher-income Americans. But when it comes to nutrient-dense foods, such as fruits and vegetables, SNAP recipients eat less.

"Some families do rely on starchy, filling foods that may not provide all the vitamins and minerals they need," says Schwarzenberg, who co-authored the AAP's new policy.

There are myriad health problems linked to poor nutrition. "Hunger, malnutrition and food insecurity are tied to adult cardiovascular disease, obesity and diabetes," Schwarzenberg says.

And that's not all. According to the AAP policy statement:

  • Children who live in households that are food insecure, even at the lowest levels, get sick more often, recover more slowly from illness, have poorer overall health and are hospitalized more frequently.
  • Children and adolescents affected by food insecurity are more likely to be iron deficient, and preadolescent boys dealing with hunger issues have lower bone density. Early childhood malnutrition also is tied to conditions such as diabetes and cardiovascular disease later in life.
  • Lack of adequate healthy food can impair a child's ability to concentrate and perform well in school and is linked to higher levels of behavioral and emotional problems from preschool through adolescence.

The new AAP policy statement, which is published in the journal Pediatrics, also recommends that pediatricians keep on hand a list of community resources, such as food banks.

"Pediatricians can have this information at their fingertips" to share with their patients in need, Schwarzenberg says.

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

RENEE MONTAGNE, HOST:

Kids all know that an apple a day keeps the doctor away. But plenty are just not eating those fresh apples, which is why America's leading pediatric group is recommending for the first time that pediatricians take time during checkups to screen all of their young patients to see if they are eating right and enough. NPR's Allison Aubrey reports.

ALLISON AUBREY, BYLINE: About 8 million kids in the U.S. live in homes where there's not always enough food in the house. But when these kids go for checkups, the signs of malnutrition are not always apparent. Pediatrician Sarah Jane Schwarzenberg, who co-authored the American Academy of Pediatrics' new policy, says families often shy away from talking about their struggles.

SARAH JANE SCHWARZENBERG: They're embarrassed, or they don't think the doctor would care.

AUBREY: It's not just about calories. Some kids may even be overweight but not getting all of the nutrients they need.

SCHWARZENBERG: Many families do rely on starchy, filling foods that may not provide all the vitamins and minerals they need.

AUBREY: With pediatricians asking more about food during checkups, the idea is to flag kids who need help. Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.

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