Volunteers load cabbage into bags during a San Antonio Food Bank distribution in December. Credit: Stephanie Marquez for the San Antonio Report

In 2018 it was estimated that 11 million children were living in households with food insecurity. Because of COVID-19, this number is projected to increase to 18 million – a number that is even more concerning knowing that food insecurity is tied to serious health issues in children. 

Food insecurity means that at times during the year, household access to adequate (healthy) food is limited due to lack of income. Forty-nine percent of parents in a study conducted by the University of Texas Rio Grande Valley and the Social & Health Research Center in San Antonio reported that they ran out of food before the end of the month. And this was before the pandemic.

Our study, which measured the social and health risk factors of children 4 years of age from 28 preschools located along the Texas-Mexico border found that where there is poverty there is obesity, hypertension, and diabetes. This is nothing new.

A finding that concerned us was the coexistence of food insecurity and obesity. Although nearly half of the children in our study did not have enough food to eat, they were still heavier than U.S. children of the same age on average (obesity prevalence: 18 percent and 11 percent, respectively). The coexistence of food insecurity and obesity is not just a problem of Texas-Mexico border children, it is also a problem of San Antonio children. An earlier study showed similar findings among San Antonio children from poor families.

These children were obese not because they ate too much, but because they ate too little. They weren’t consuming enough fruits, vegetables, whole grains, and milk loaded with the minerals and vitamins they need. Iron is needed to make blood cells, calcium to breakdown body fat, magnesium to regulate blood glucose, phosphorus for muscles to work, and potassium to learn. Vitamins, like minerals, help to resist infections, keep your nerves healthy, and give your body energy. So, you can imagine the consequences if these are missing in a child’s diet. 

Specifically, the link between food insecurity and obesity is calcium. Several studies of children have shown the association between a low calcium diet and high body fat. Calcium found in fruits, vegetables and dairy products suppresses the production of fat cells and stimulates breakdown of lipids. 

School-provided meals are often a child’s chance to fill in gaps of a diet lacking certain nutrients due to food insecurity. However, our study found that children threw away most fruits and vegetables served to them at school.

One of the barriers to healthy eating for families in poverty is the lack of health education. When children throw away the fruits and vegetables served to them at school, they are showing unhealthy behaviors that they’ve brought from home. Yes, humans have an innate preference for fat and sugar, but parents can put their thumb on the scale to balance their child’s intake of fat, sugar, minerals, and vitamins. 

But food insecurity is not just a parent problem. During a national disaster, like what we are experiencing with COVID-19, we, as a society, need to jump in to secure children’s health. However, over the last seven years, federal expenditures for USDA’s food and nutrition assistance programs (WIC, SNAP, SLP) decreased from $118 billion to $92 billion. This is a 22 percent decrease in food assistance programs that are meant to help families in need at a time when more and more people need that assistance.

Organizations like the San Antonio Food Bank are stepping up to help families. Annually, the food bank distributes 77 million meals and 63 million pounds of food. During the pandemic, it is serving 58,000 individuals a week. For those of us who are able, donating to the food bank is one way we can help.

But in the long term, health education must be prioritized. The economic effects of the pandemic will be felt long after it’s over. Addressing food insecurity must include health education in order to not only ensure that children are getting enough to eat, but to make sure they’re getting enough of the food that will nourish their bodies and minds. You may not be able to change the environment around you, but you can change yourself with knowledge. Children spend 1,100 hours a year and have two meals a day at school. School health education that coordinates instruction through health class, physical education, food service, and home environments have a wider reach and can help children and parents build healthy habits starting now.

Dr. Roberto P. Treviño founded the South Alamo Medical Group in 1986 for the practice of primary care medicine in poor and underserved areas. He is the executive director of the Social Health & Research...