Household food insecurity (FI) (without reliable access to a sufficient quantity of affordable, nutritious food, even for a temporary period), is associated with children's behavioral, academic and emotional problems beginning as early as infancy.

These findings, based on a review of previously published research, appear in the Journal of Developmental & Behavioral Pediatrics.

FI occurs in 21 percent of families with children and adolescents in the United States, but the potential developmental and behavioral implications of this prevalent social determinant of health have not been completely understood.

Researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) studied 23 peer-reviewed articles on the associations between FI and adverse childhood developmental-behavioral outcomes including early cognitive development, academic performance, inattention, externalizing behaviors and depression in four groups -- infants and toddlers, preschoolers, school age and adolescent.

Among their findings:

Articles that examined infants and toddlers suggest that FI poses a developmental risk, impairs child attachment, mental proficiency and cognitive assessment scores.

In preschool years, studies have found an association between FI, externalizing and internalizing behaviors and mental health symptoms, and less optimal self-control and interpersonal skills.

In school-aged children, an association was found between FI and impaired academic performance, increased hyperactivity, inattention, aggressive behavior, missing school, emotional problems, less adaptive interpersonal relations, self-control and approaches to learning, more internalizing and externalizing behaviors and greater likelihood of having seen a psychologist.

Finally, studies involving adolescents indicate associations between FI and anxiety, depression and suicidal ideation, attempted suicide, dysthymia, seeing a counselor, suspension from school, difficulty getting along with others and substance use disorders.

According to the researchers physicians don't usually think of child nutrition programs like WIC, school meals and SNAP (food stamps) as prevention or intervention for the "new morbidity" -- developmental and behavioral/emotional problems which afflict a substantial proportion of America's children. "Our findings suggest that these programs, which are known to decrease food insecurity, may enhance the potential of our children to learn, pay attention, and experience better emotional health," explained corresponding author Deborah Frank, MD, Professor in Child Health and Well-Being, (Pediatrics) at BUSM and director of the Grow Clinic for Children at BMC.

The researchers hope this systematic review will provide evidence of the impact that temporary and even marginal food insecurity can have on the development and behavior of children, such that it will inspire greater awareness amongst healthcare providers, and ultimately, increase political action.