Invisible Malnutrition and America's Future

By David K. Shipler

Senators from both parties are congratulating themselves for passing the agriculture bill yesterday as a model of bipartisan responsibility and healthy compromise—a model of just what legislators should do. But the result is not an example of what legislators should do. It cuts $4.5 billion from the $80-billion annual food stamp program, which helps keep 45 million Americans—most of them children—from the throes of malnutrition.

Responsible legislators would look ahead to the future of a country where millions of children get inadequate nutrients during critical periods of brain development. We know what that means—“we” being our society, which includes the neurologists and pediatricians and nutritionists and psychologists who have studied the lifelong impacts of early malnutrition. Their expertise never seems to penetrate the walls surrounding Capitol Hill.

A raft of research has found that the timing of nutritional deficiency during the most sensitive periods of brain growth can determine which mental capabilities are damaged. During the second trimester of pregnancy, the creation of neurons can be affected. During the third trimester, neuron maturation and the production of branched cells called glia, can be inhibited. From birth until about age two, food scarcity can assault the rapidly developing brain enough to lower I.Q. And even if good nutrition is restored later, there is no full recovery. Early deprivation creates lifetime cognitive impairment.


You might think that Republicans who zealously protect fetuses from abortion would be concerned about the fetuses’ brain development. But just wait until this agriculture bill gets to the House, where Republicans are sharpening their knives to cut food assistance even more—by $134 billion over ten years under Rep. Paul Ryan’s budget proposal, which would also convert the program into block grants to states. Mr. Ryan and his colleagues should read From Neurons to Neighborhoods, an excellent compendium by the National Academy of Sciences of studies, written in layman’s language. One would like to assume that they would be moved.

Lobbyists on behalf of food aid say that Republicans are driven by a few attitudes and beliefs. They want to force more of the poor into food banks, where healthy staples are distributed for free and the temptations of junk food are nonexistent. (Food stamps—now in the form of debit cards, are not supposed to be used for junk food, but it’s a rule not always observed by struggling corner stores in poor neighborhoods.)

Obesity, partly from eating unhealthy food, is seen as evidence of indulgence, but its epidemic scope among the low-income can also mask malnutrition. Overweight people are often getting the wrong kind of food, lacking key nutrients. So malnutrition rarely presents itself in America as vividly as in Somalia. Unless you hang out in malnutrition clinics in Baltimore, Boston, Philadelphia, and elsewhere, you’re not likely to see emaciated children like the ones on TV. If malnutrition in America were photogenic, even Republicans might hesitate to cut benefits.

Food banks are not the answer, however, because they are struggling both from lack of funds and a lack of surplus food from grocery stores whose computer systems now track purchasing and ordering so efficiently that there’s not much excess to give away.

Then there is the Republican contempt for the poor. As we heard during the presidential primary, an ugly current of distaste for those who need food assistance runs through the rightwing of America. Obama is the “food-stamp president.” People should work instead of depending on government handouts. Recipients are somehow immoral. Fraud and corruption are rampant—not true, by the way, since officials put the level at around 1 percent, far lower than practically any other government program, especially the Defense Department.

It’s too bad we use the word “hungry” to describe both the transitory discomfort of a busy Congressman who has to miss lunch, and the durable condition of deprivation that has longterm consequences for both the individual and the nation. I would love to put Ryan and his colleagues through the Navy survival course I took years ago, when we were put out in the woods for five days without food. Your horizon of interest closes in on you. You do not think about poetry or music; you even stop being interested in the other five guys in your unit, except in what they can help find to eat. Food  becomes an obsession. A Congressman might even stop thinking about fundraising. I had a flashback to this experience when I was told by Deborah Frank, a pediatrician who heads a malnutrition clinic in Boston, that learning is a discretionary activity. It can happen only when you are well fed.

If you sit in the backs of classrooms, you can watch students tuning out of the lessons they can’t follow. If you ask kids in poor neighborhoods what percentage of the time they don’t understand what a teacher is saying, you get startling figures: 30, 40, 50 percent or more. If I had to sit in rooms not knowing what was going on half the time, would I continue to show up only to feel stupid?

There are many reasons for the high dropout rate from high schools, including the complex wages of poverty’s stress, violence, and hopelessness. But cognitive disabilities are surely among them. And while there are various reasons for mental impairment, there is no doubt that malnutrition is among them.

That means that food stamps, now called Supplement Nutrition Assistance Program, should be expanded, not contracted, especially as higher skills, not lower, are required for economic success.

Oh, and by the way, in case anybody cares, without food stamps the poverty rate would jump by 2.5 percent, the Census Bureau calculates—from 15.2 to 17.7 percent.