Ernährungsarmut bei Kindern – Ursachen, Folgen, COVID-19

Zusammenfassung

Die SARS-CoV-2-Pandemie hat zu lang anhaltenden Beschränkungen geführt, die vor allem Kinder in armen Familien besonders betrafen. Nicht nur der psychische Druck, die fehlenden sozialen Kontakte, die immer wieder kommuniziert werden, sondern auch eine unzureichende Ernährung hat Folgen für die Kinder. Letzteres wird aber bisher übersehen, da schwer vorstellbar. Kinder aus armen Verhältnissen sind bereits vor den Schließungen der Schulen und damit auch der Schulmensen in vielen Fällen nicht ausreichend ernährt. Eine gesunde Ernährung, wie sie Kinder vor allem in den Entwicklungsphasen brauchen, kann mit den verfügbaren Mitteln des ALGII nicht finanziert werden. Kommt eine Lockdown-Situation dazu, so wird der finanzielle Rahmen für Lebensmittel noch enger und die ausfallende Schulverpflegung verschärft die Situation einer Mangelernährung bei Kindern aus armen Verhältnissen. In Deutschland sind dies derzeit 21 %, die vorwiegend bei alleinerziehenden Müttern (53 %) leben. Die Folgen sind auch in Deutschland sichtbar, Wachstumsverzögerung und eingeschränkte kognitive Entwicklung. Ursache sind fehlende Mikronährstoffe (Eisen, Zink, Jod, Vitamin D), die für die körperliche und kognitive Entwicklung gebraucht werden. Die Erhöhung des Tagessatzes für Ernährung (4,01 €) auf 5,50 € ist ebenso eine dringend gebotene Maßnahme, wie eine Alternative zur Schulspeisung, wenn die Schulen geschlossen sind.

Abstract

The SARS-CoV2 pandemic has resulted in long-lasting restrictions that have particularly affected children in poor families. Not only the psychological pressure, the lack of social contacts, which are communicated again and again, but also insufficient nutrition has consequences for the children. However, the latter has been overlooked so far, as it is difficult to imagine in a country as wealthy as Germany. Children from poor backgrounds are in many cases not sufficiently nourished even before the closure of schools and thus also of school canteens. A healthy diet, as children require especially in the developmental phases, cannot be financed with the available funds of ALGII. If a lockdown situation is added to this, the financial framework for food becomes even tighter and the failing school meals exacerbate the situation of malnutrition among children from poor backgrounds. In Germany, this is currently 21 %, most of whom live with one-parent households (53 %). The consequences are also visible in Germany, growth retardation and limited cognitive development. The cause is a lack of micronutrients (iron, zinc, iodine, vitamin D) needed for physical and cognitive development. The increase of the daily rate for nutrition for children between 6 and 16 years (4.01€) to 5.50 € is an urgent measure, as well as an alternative to school meals when schools are closed.

Schlüsselwörter

Ernährungsarmut - Kinder - COVID-19 - Mikronährstoffe - Mangelernährung

Keywords

nutrition poverty - children - COVID-19 - micronutrients - malnutrition

Publication History

Article published online:
16 September 2021

• Literatur

• 1 Bertelsmann Stiftung. Kinderarmut: Eine unbearbeitete Großbaustelle. (22.07.2020). Im Internet: Stand 24.06.2021 https://www.bertelsmann-stiftung.de/de/themen/aktuelle-meldungen/2020/juli/kinderarmut-eine-unbearbeitete-grossbaustelle
• 2 Wissenschaftlicher Beirat für Agrarpolitik, Ernährung und gesundheitlichen Verbraucherschutz beim Bundesministerium für Ernährung und Landwirtschaft. Politik für eine nachhaltigere Ernährung – Eine integrierte Ernährungspolitik entwickeln und faire Ernährungsumgebungen gestalten Juni 2020. https://www.bmel.de/SharedDocs/Downloads/DE/_Ministerium/Beiraete/agrarpolitik/wbae-gutachten-nachhaltige-ernaehrung.pdf?__blob=publicationFile&v=3 Stand: 24.06.2021
• 3 Azevedo JP, Hasan A, Goldemberg D. et al. Simulating the Potential Impacts of COVID-19 School Closures on Schooling and Learning Outcomes: A Set of Global Estimates. 2021 Published by Oxford University Press on behalf of the International Bank for Reconstruction and Development
• 4 Borkowski A, Correa JS, Bundy DA. et al. COVID-19: Missing more than a classroom. The impact of school closures on childrens nutrition. Innocenti working paper 2021-01
• 5 Feichtinger E. Armut und Ernährung im Wohlstand: Topographie eines Problems. In: Barlösius E, Feichtinger E, Köhler BM. Hrsg. Ernährung in der Armut – Gesundheitliche, soziale und kulturelle Folgen in der Bundesrepublik Deutschland. Berlin: sigma; 1995: 291-305
• 6 Pfeiffer S, Ritter T, Oestreicher E. Food insecurity in German households: Qualitative and quantitative data on coping, poverty consumerism and alimentary participation. Social Policy & Society 2015; 14: 483-495 DOI: 10.1017/S147474641500010X.
• 7 Pfeiffer S, Ritter T, Oestreicher E. Armutskonsum: Ernährungsarmut, Schulden und digitale Teilhabe. In: Forschungsverbund Sozioökonomische Berichterstattung, Hrsg. Berichterstattung zur sozioökonomischen Entwicklung in Deutschland. Exklusive Teilhabe – ungenutzte Chancen. Dritter Bericht. Bielefeld: W. Bertelsmann Verlag; 2016. DOI: 10.3278/6004498w020
• 8 Lampert T, Hoebel J, Kuntz B. et al. Messung des sozioökonomischen Status und des subjektiven sozialen Status in KiGGS Welle 2. Journal of Health Monitoring 2018; 3: 114-133 DOI: 10.17886/RKI-GBE-2018-016.
• 9 Allen J. Children’s food insecurity increasing during COVID-19 pandemic Harvard Chan Scholl. 2020
• 10 The Food Foundation. More than five million people in households with children have experienced food insecurity since lockdown began (04.05.2020). https://foodfoundation.org.uk/wp-content/uploads/2020/05/New-COVID-19-childrens-food-insecurity-data-FINAL.pdf Stand: 12.06.2021
• 11 Ballard TJ, Kepple AW, Cafiero C. The Food Insecurity Experience Scale: Development of a Global Standard for Monitoring Hunger Worldwide. Rome: FAO; 2013
• 12 Depa J, Gyngell F, Müller A. et al. Prevalence of food insecurity among food bank users in Germany and ist association with population characteristics. Prev Med Rep 2018; DOI: 10.1016/pmedr.2018.01.005.
• 13 Tafel Deutschland e. V.. Die Tafeln während der Corona-Pandemie. https://www.tafel.de/fileadmin/media/2021-05-11_TAFEL_Corona_Grafiken.pdf Stand: 12.06.2021
• 14 Dunn CG, Kenney E, Fleischhacker S. et al. Feeding low income children during the Covid-19 pandemic. NEJM 2021; 382: 18
• 15 Profeta A, Enneking U, Smetana S. et al. Der Einfluss der Corona Pandemie auf den Lebensmittelkonsum der Verbraucher. Berichte über Landwirtschaft. Zschr Agrapolitik und Landwirtschaft; 2021
• 16 Abrams SA, Avalos A, Gray M. et al. High level of food insecurity among families with children seeking routine care at federally qualified health centers during coronavirus disease 2019 pandemic. J PediatrX 2020; 4: 100044
• 17 Litton MM, Beavers AW. The relationship between food security status and fruit and vegetable intake during the COVID-19 pandemic. Nutrients 2021; 13: 712
• 18 Perez-Escamilla R, Vianna RPT. Food insecurity and the behavioral and intellectual development in children: A review of the evidence. J Appl Res Children: Informing policy for children at risk 2020; 3: 9
• 19 De Oliveira KHD, de Almeida GM, Gubert MB. et al. Household food insecurity and early child development: Systematic review and meta analysis. Maternal & Child Nutrition 2020; e12967
• 20 Mertens E, Hoffmann I. Lebensmittelkosten bei verschiedenen Ernährungsweisen. Ern Umschau 2008; 3: 139-148
• 21 Jones NRV, Conklin AI, Suhrcke M. et al. The growing price gap between more and less healthy foods: analysis of a novel longitudinal UK dataset. PLoS ONE 2014; 9: e109343 DOI: 10.1371/journal.pone.0109343.
• 22 Rao M, Afshin A, Singh G. et al. Do healthier foods and diet patterns cost more than less healthy options? A systematic review and meta-analysis. BMJ Open 2013; 3: e004277 DOI: 10.1136/bmjopen-2013-004277.
• 23 Thiele S. A new approach to specify additional social benefit rates for a wholesome diet in Germany. Ern Umschau 2014; 61: 32-37
• 24 Kersting M, Clausen K. Wie teuer ist eine gesunde Ernährung für Kinder und Jugendliche. Ern Umschau 2007; 9: 508-513
• 25 Lampert T, Kroll LE, Kuntz B. et al. Gesundheitliche Ungleichheit in Deutschland und im internationalen Vergleich: Zeitliche Entwicklungen und Trends. Journal of Health Monitoring 2018; 3 (Suppl. 01) 1-26 DOI: 10.17886/RKI-GBE-2018-019.
• 26 Carlson S, Keith-Jennings B. SNAP is linked with Improved Nutritional Outcomes and Lower Health Care Costs (17.01.2018). https://www.cbpp.org/research/food-assistance/snap-is-linked-with-improved-nutritional-outcomes-and-lower-health-care Stand: 22.03.2021
• 27 Holben DH, Marshall MB. Position of the Academy of Nutrition and Dietetics: Food Insecurity in the United States. J Acad Nutr Diet 2017; 117: 1991-2002 DOI: 10.1016/j.jand.2017.09.027.
• 28 Gundersen C, Hake M, Dewey A. et al. Food insecurity status and mortality among adults in Ontario, Canada. Plos one 2018; 13: e0202642
• 29 Food and Nutrition Service. Getting Food on the Table. https://www.fns.usda.gov/coronavirus Stand: 14.06.2021
• 30 Deutscher Bundestag. Antrag der Abgeordneten Amira Mohamed Ali, Dr. Gesine Lötzsch, Doris Achelwilm, Simone Barrientos, Lorenz Gösta Beutin, Matthias W. Birkwald, Heidrun Bluhm-Förster, Dr. Birke Bull-Bischoff, Jörg Cezanne, Anke Domscheit-Berg, Susanne Ferschl, Brigitte Freihold, Sylvia Gabelmann, Nicole Gohlke, Kerstin Kassner, Dr. Achim Kessler, Katja Kipping, Jan Korte, Jutta Krellmann, Caren Lay, Sabine Leidig, Ralph Lenkert, Michael Leutert, Pascal Meiser, Cornelia Möhring, Norbert Müller (Potsdam), Sören Pellmann, Victor Perli, Ingrid Remmers, Dr. Petra Sitte, Dr. Kirsten Tackmann, Jessica Tatti, Andreas Wagner, Harald Weinberg, Katrin Werner, Hubertus Zdebel, Sabine Zimmermann (Zwickau), Pia Zimmermann und der Fraktion DIE LINKE. Gutes Essen für alle in Kita und Schulen – Drucksache 19/25786 (12.01.2021). https://dserver.bundestag.de/btd/19/257/1925786.pdf Stand: 14.06.2021
• 31 Leimbach A. Kein gesundes Essen mit Hartz IV (07.04.2021). https://taz.de/Groko-ignoriert-eigene-Beraterinnen/!5759046/ Stand: 14.06.2021
• 32 Deutscher Bundestag. Antwort der Bundesregierung auf die Kleine Anfrage der Abgeordneten Nicole Bauer, Frank Sitta, Grigorios Aggelidis, weiterer Abgeordneter und der Fraktion der FDP – Drucksache 19/6533 – Gesunde Ernährung in Kitas und Schulen (02.01.2019). https://dserver.bundestag.de/btd/19/068/1906864.pdf Stand: 14.06.2021
• 33 Biesalski HK. Verborgener Hunger – Sattsein ist nicht genug. Heidelberg: Springer; 2013
• 34 Hilbig A, Drossard C, Kersting M. et al. Nutrient adequacy and associated factors in a nationwide sample of German toddlers. Journal of Pediatric Gastroenterology and Nutrition 2015; 61: 130-137 DOI: 10.1097/MPG.0000000000000733.
• 35 Zaragoza-Jordana M, Closa-Monasterolo R, Luque V. et al. Micronutrient intake adequacy in children from birth to 8 years. Data from the childhood obesity project. Clin Nutr 2018; 37: 630-637
• 36 Diethelm K, Huybrechts I, Moreno L. et al. Nutrient intake of European adolescents: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescents) Study. Pub Health Nutr 2013; 17: 486-497
• 37 Kaganov B, Caroli M, Mazur A. et al. Suboptimal micronutrient intake among children in Europe. Nutrients 2015; 7: 3524-3535
• 38 Darmon N, Drewnowski A. Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: a systematic review and analysis. Nutrition Reviews 2015; 73: 643-660
• 39 Drewnowski A. Nutrient density: addressing the challenge of obesity. Br J Nutr 2018; 120 (Suppl. 01) S8-S14 DOI: 10.1017/S0007114517002240.
• 40 Aggarwal A, Monsivais P, Drewnowski A. Nutrient Intakes Linked to Better Health Outcomes Are Associated with Higher Diet Costs in the US. PLoS ONE 2012; 7: e37533 DOI: 10.1371/journal.pone.0037533.
• 41 Leroy JL, Frongillo EA. Perspective: What does stunting really mean? A critical review of the evidence. Adv Nutr 2019; 10: 196-204
• 42 Gates Foundation. Stunting. https://www.gatesfoundation.org/goalkeepers/report/2020-report/progress-indicators/stunting/ Stand: 14.06.2021
• 43 Baten J, Böhm A. Childrens height and parental unemployment. A large-scale anthropometric study on eastern Germany 1994–2006. German economic review 2010; 11: 1-24
• 44 Desmond C, Casale D. Catch up growth in stunted children: Definitions and predictors. PLOSone 2017; 12: e01891135
• 45 Leroy J, Ruel M. Covid-19 and the Irreversible Marks Undernutrition Will Leave in Its Wake. Outlook POSHAN, December 10, 2020
• 46 Frongillo EA, Nguyen HT, Smith MD. et al. Food insecurity is associated with subjective well-being among individuals from 138 countries in the 2014 Gallup world poll. J Nutr 2017; 147: 680-687 DOI: 10.3945/116.243642.
• 47 Piwoz E, Sundberg S, Rooke J. Promoting Healthy Growth: What Are the Priorities for Research and Action?. Adv Nutr 2012; 3: 234-241
• 48 FAO, IFAD and WFP. The State of Food Insecurity in the World 2013. The multiple dimensions of food security. Rome: FAO; 2013
• 49 Lehmkühler SH. Die Gießener Ernährungsstudie über Ernährungsverhalten von Armut Haushalten (GESA) – qualitative Fallstudien. Gießen: Justus-Liebig-Universität Gießen; 2002
• 50 Koletzko B, Holzapfel C, Schneider U. et al. Lifestyle and body weight consequences of the COVID-19 pandemic in children: Increasing disparity. Ann Nutr Metab 2021; 77: 1-3 DOI: 10.1159/000514186.
• 51 Kleiser C, Schaffrath Rosario A. et al. Potential determinants of obesity and adolescents in Germany: results from the cross-sectional KiGGS study. BMC Public Health 2009; 9: 46-60
• 52 Biesalski HK. ed. Hidden Hunger and the transformation of food systems. How to combat the double burden of malnutrition. World Review of Nutrition and Dietetics. Band 121. Basel: Karger; 2020: 1-15
• 53 Pietrobelli A, Pecoraro L, Ferruzzi A. et al. Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity living in Verona Italy: A longitudinal study. Obesity 2020; 28: 1382-1385
• 54 Akter S. The impact of COVID-19 related ‘stay-at-home’ restrictions on food prices in Europe: findings from a preliminary analysis. Food Security 2020; 12: 719-725 DOI: 10.1007/s12571-020-01082-3.
• 55 Skopek J, Giampiero P. Socioeconomic inequality in childrens achievement from infancy to adolescence: The case of Germany. Social Forces 2020; 1-27 DOI: 10.1093/sf/soaa093.
• 56 Biesalski HK, Black R. eds. Hidden Hunger. Malnutrition and the first 1000 days of life: Causes, consequences and solutions. World Review of Nutrition and Dietetics. Band 115. Basel: Karger; 2016: 21-629
• 57 Halle T, Forry N, Hair E. et al. Disparities in Early Learning and Development: Lessons from the Early Childhood Longitudinal Study – Birth Cohort (ECLS-B). Washington, DC: Child Trends; 2017
• 58 von Hippel PT, Workman J, Downey DB. Inequality in Reading and Math Skills Comes Mainly from Early Childhood: A Replication, and Partial Correction, of ‘Are Schools the Great Equalizer?. Sociology of Education 2018; 91: 323-357
• 59 Fernald A, Marchman VA, Weisleder A. SES differences in language processing skill and vocabulary are evident at 18 months. Dev Sci 2013; 16: 234-248
• 60 Johnson SB. et al. State of the art review: Poverty and the developing brain. Pediatrics 2016; 137: e20153075
• 61 Luby J, Belden A, Botteron K. et al. The effects of poverty on childhood brain development: the mediating effects of caregiving and stressful life events. JAMA Pediatr 2013; 167: 1135-1142
• 62 Takeuchi H, Taki Y, Asano K. et al. Childhood socioeconomic status is associated with psychometric intelligence and microstructural brain development. Comm Biol 2021; 4: 470-489
• 63 Biesalski HK. The 1000-day window and cognitive development. In: Biesalski HK, Black R. Hidden Hunger. Malnutrition and the first 1000 days of life: Causes, consequences and solutions. World Review of Nutrition and Dietetics. Band 115. Basel: Karger; 2016: 21-29
• 64 Jednorog K, Altarelli I, Monzalvo K. et al. The influence of socioeconomic status on children’s brain structure. Plos One 2012; 7: 42486
• 65 Hanson JL, Chandra A, Wolfe BL. et al. Association between income and the hippocampus. PLoS ONE 2011; 6: e18712
• 66 Ursache A, Noble KG. Neurocognitive development in socioeconomic context: Multiple mechanisms and implications for measuring socioeconomic status. Psychophysiology 2016; 53: 71-82
• 67 Hurt H, Betancourt LM. Effect of socioeconomic status disparity on child language and neural outcome: how early is early?. Pediatr Res 2015; 79: 148-158
• 68 Conger R, Rand D, Donnellan MB. An Interactionist Perspective on the Socioeconomic Context of Human Development. Annual Review of Psychology 2007; 58: 175-199
• 69 Noble KG, Houston SM, Kan E. et al. Neural correlates of socio-economic status in the developing human brain. Dev Sci 2012; 15: 516-527
• 70 Houston JL, Chandra A, Wolfe B. et al. Association between income and the hippocampus. Plos One 2011; 6: 19712
• 71 Brito NH, Noble KG. Socioeconomic status and brain development. Front Neurosci 2014; 8: 276
• 72 Leonard JA, Mackey AP, Finn AS. et al. Differential effects of socioeconomic status on working and procedural memory systems. Front Hum Neurosci 2015; 9: 554
• 73 Knickmeyer RC, Gouttard S, Kang C. et al. A structural MRI study of human brain development from birth to two years. J Neurosci 2008; 28: 12176-12182
• 74 Lin M, Fwu PT, Buss C. et al. Developmental changes in hippocampal shape among preadolescent children. Int J Devl Neuroscience 2013; 31: 473-481
• 75 Biesalski HK. Mikronährstoffe als Motor der Evolution. Heidelberg: Springer; 2015
• 76 Gomez-Pinilla F. Brain foods: the effect of nutrients on brain function. Nat Rev Neurosci 2008; 9: 568-578
• 77 Perez-Garcia G, Guzman-Quevedo O, Da Silva Arago R. et al. Early malnutrition results in long lasting impairments in pattern-separation for overlapping novel object and novel location memories and reduced hippocampal neurogenesis. Sci Rep 2015; 6: 21275
• 78 Biesalski HK. Hidden Hunger – Consequences for brain development. Bread and Brain, Education and Poverty Pontifical Academy of Sciences. Scripta Varia 2014; 125
• 79 Hair NL, Hanson JL, Wolfe BL. et al. Association of child poverty, brain development, and academic achievement. JAMA Pediatr 2015; 169: 822-829
• 80 Staff RT, Murray AD, Ahearn TS. et al. Childhood socioeconomic status and adult brain size: childhood socioeconomic status influences adult hippocampal size. Ann Neurol 2012; 71: 663-660
• 81 Takeuchi H, Taki Y, Asano K. et al. Childhood socioeconomic status is associated with psychometric intelligence and microstructural brain development. Comm Biol 2021; 4: 470
• 82 Lipina SJ, Posner MI. The impact of poverty on the development of brain networks. Front Human Neurosci 2012; 6: 238
• 83 Elsäßer G. Soziale Ungleichheit und Gesundheit bei Kindern – Ergebnisse und Konsequenzen aus den Brandenburger Einschulungsuntersuchungen. Kinderärztliche Praxis 2002; 73: 248-257
• 84 Elsäßer G, Lüdecke K. Einschulungsuntersuchung 2015. Landesamt für Arbeitsschutz, Verbraucherschutz und Gesundheit;
• 85 Georgieff MK. Nutrition and the developing brain: Nutrient priorities and measurement. Am J Clin Nutr 2007; 85: 614-620
• 86 Fretham SJB, Carlson ES, Georgieff MK. The role of iron in learning and memory. Adv Nutr 2011; 2: 112-221
• 87 Radlowski EC, Johnson RW. Perinatal iron deficiency and neurocognitive development. Front Hum Neurosci 2013; 7: 585 DOI: 10.3389/fnhum.2013.00585.
• 88 Larson LM, Phiri KS, Pasricha SR. Iron and cognitive development: What is the evidence?. Ann Nutr Metab 2017; 71 (Suppl. 03) 25-38
• 89 González HF, Visentin S. Micronutrients and neurodevelopment: An update. Arch Argent Pediatr 2016; 114: 570-575
• 90 McCann S, Amado M, Moore SE. The role of iron in brain development: A systematic review. Nutrients 2020; 12: 2001
• 91 Nyaradi A, Li J, Hickling S. et al. The role of nutrition in children’s neurocognitive development, from pregnancy through childhood. Front Hum Neurosci 2013; 7: 97
• 92 Takeda A, Tamano H. Insight into zinc signaling from dietary zinc deficiency. Brain Res Rev 2009; 62: 33-44
• 93 Kumar V, Kumar A, Singh K. et al. Neurobiology of zinc and ist role in neurogenesis. Eur J Nutr 2021; 60: 55-64
• 94 Levenson CW, Morris D. Zinc and neurogenesis: Making new neurons from development to adulthood. Adv Nutr 2011; 2: 96-200
• 95 Sandstaed HH. Subclinical zinc deficiency impairs human brain function. J Trace El Med Biol 2012; 26: 70-73
• 96 Cusick SE, Georgieff MK. The role of nutrition in brain development: The golden opportunity of the “first 1000 days”. J Pediatr 2016; 175: 16-21
• 97 Bening S, Margawati A, Rosidi A. Zinc deficiency as risk factor for stunting among children aged 2–5 years. Univ Med 2017; 36: 11-18
• 98 Rovet J, Daneman D. A review of current diagnostic and treatment practices in relation to neuropsychologic outcome. Paediatric Drugs  2003; 5: 141-149 DOI: 10.2165/00128072-200305030-0001.
• 99 Valdez-Hernandez M, Wilson KL, Aspray EC. et al. Brain findings associated with iodine deficiency identified by magnetic resonance methods: A systematic review. Open J Radiol 2013; 3: 180-195
• 100 Santiago-Fernandez P, Torres-Barahona R, Muela-Martinez JA. et al. Intelligent quotient and iodine intake: a cross sectional study in children. J Clin Endocrin Metab 2004; 89: 3851-3857
• 101 Bougma K, Aboud FE, Harding KB. et al. Iodine and mental development of children 5 years old and under: A systematic review and meta-analysis. Nutrients 2013; 5: 1384-1416
• 102 Zentrum für internationale Entwicklungs- und Umweltforschung. Repräsentative Markterhebung zur Verwendung von Jodsalz in handwerklich und industriell gefertigten Lebensmitteln. Gießen: Universität Gießen; 2018
• 103 Esche J, Thamm M, Remer T. Contribution of iodized salt to total iodine and total salt intake in Germany. Eur J Nutr 2020; 59: 3163-3169
• 104 Nadimi H, Djazayery A, Javanbakht MH. et al. Effect of vitamin D supplementation on CREB-TrkB-BDNF pathway in the hippocampus of diabetic rats. Iran J Basic Med Sci 2020; 23: 117-123
• 105 Whitehouse AJ, Holt BJ, Serralha M. et al. Maternal vitamin D levels and the autism phenotype among offspring. J Autism Dev Disord 2013; 43: 1495-1504
• 106 Keflie TS, Nölle N, Lambert C. et al. Vitamin D deficiencies among tuberculosis patients in Africa: A systematic review. Nutrition 2015; 31: 1204-1212
• 107 Amrein K, Scherkl M, Hoffmann M. et al. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr 2020; 74: 1498-1513
• 108 Kvestad I, Hysing M, Shrestha M. et al. Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children. Am J Clin Nutr 2017; 105: 1122-1131
• 109 Miller AD. The Methylation, Neurotransmitter, and Antioxidant Connections Between Folate and Depression. Altern Med Rev 2008; 13: 216-226
• 110 Lövblad KO, Ramelli G, Remonda L. et al. Retardation of myelination due to dietary vitamin B12 deficiency: Cranial MRI findings. Pediatr Radiol 1997; 27: 155-158
• 111 Strand TA, Taneja S, Ueland PM. et al. Cobalamin and folate status predicts mental development scores in North Indian children 12–18 mo of age. Am J Clin Nutr 2013; 97: 310-317
• 112 Biesalski HK, Kalhoff H. Kontra vegane Ernährung in kindlichen Wachstumsphasen – ein ernährungsmedizinischer Kommentar. Aktuel Ernahrungsmed 2020; 45: 104-113
• 113 Ibrahim MK, Zambruni M, Melby CL. et al. Impact of childhood malnutrition on host defense and infection. Clin Microbiol Rev 2017; 30: 919-971
• 114 Bourke CD, Berjlkey JA, Prendergast AJ. Immune dysfunction as a cause and consequence of malnutrition. Trends Immunol 2016; 37: 386-398
• 115 Gombart AF, Pierre A, Maggini S. A review of micronutrients and the immune system-working in harmony to reduce the risk of infection. Nutrients 2020; 1: 236
• 116 Mora JM, Iwata M, von Andrian UH. Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol 2008; 8: 685-698
• 117 Farré R, Fiorani M, Rahiman AS. et al. Intestinal Permeability, Inflammation and the Role of Nutrients. Nutrients 2020; 17: 1185
• 118 Dong Y, Mo X, Hu Y. et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China epidemiology of COVID-19 among children in China. Pediatrics 2020; 145: e20200702
• 119 Götzinger F, Santiago-García B, Noguera-Julian A. et al. COVID-19 in children and adolescents in Europe: a multinational, multicenter cohort study. Lancet Child Adolesc Health 2020; 4: 653-661
• 120 Sinha IP, Lee AR, Bennett D. et al. Child poverty, food insecurity, and respiratory health during the COVID-19 pandemic. The Lancet Resp Health 2020; DOI: 10.1016/S2213-2600(20)30280-0.
• 121 Biesalski HK. Vitamin D deficiency and co-morbidities in COVID-19 patients – A fatal relationship?. NFS J 2020; 20: 10-21 DOI: 10.1016/j.nfs.2018.03.001.
• 122 Yilmaz K, Sen V. Is vitamin D deficiency a risk factor for Covid-19 in children. Pediatr Pulmonol 2020; DOI: 10.1002/ppul.25106.
• 123 Weiss G, Ganz T, Goodnough LT. Anemia of inflammation. Blood 2019; 133: 40-50
• 124 Sonnweber T, Boehm A, Sahanic S. et al. Persisting alterations of iron homeostasis in COVID‑19 are associated with non‑resolving lung pathologies and poor patients’ performance: a prospective observational cohort study. Resp Res 2020; 21: 276
• 125 Shahbaznejad L, Navaeifar MR, Abbaskhanian A. et al. Clinical characteristics of 10 children with a pediatric inflammatory multisystem syndrome associated with COVID-19 in Iran. BMC Ped 2020; 20: 513
• 126 Ng KF, Kothari T, Bandi S. et al. COVID-19 multisystem inflammatory syndrome in three teenagers with confirmed SARS-CoV-2 infection. J Med Virol 2020; 92: 2880-2886 DOI: 10.1002/jmv.26206.
• 127 Zughaier SM, Alvarez JA, Sloan JH. et al. The role of vitamin D in regulating the iron-hepcidin-ferroportin-axis in monocytes. J Clin Transl Endocrinol 2014; 1: e19-e25
• 128 Mertens E, Penalvo JL. The burden of malnutrition and fatal COVID-19: A global burden of disease analysis. Front Nutr 2021; 7: 619850
• 129 DGPI. PIMS Survey Update. Kalenderwoche 26. 2021 https://dgpi.de/pims-survey-update Stand: 30.06.2021
• 130 Frisvold DE. Nutrition and cognitive achievement: An evaluation of the school breakfast program. J Public Econ 2015; 124: 91-104
• 131 Borkowski A, Correa JSO, Bundy DAP. et al. COVID-19: Missing more than a classroom. Innocenti Working Paper 201-01 UNICEF Office of research; 2020
• 132 FAO. The State of Food Security and Nutrition in the World. 2019 http://www.fao.org/3/ca5162en/ca5162en.pdf Stand: 30.06.2021
• 133 Watanabe M, Risi R, Tuccinardi D. et al. Obesity and SARS-CoV-2: A population to safeguard. Diabetes Metab Res Rev 2020; 21: e3325 DOI: 10.1002/dmrr.3325.
• 134 Ryu J, Bartfeld JS. Household food insecurity during childhood and subsequent health status: The early childhood longitudinal study – Kindergarten Cohort. Am J Pub Health 2012; 10250-10255
• 135 Mensink GBM, Haftenberger M, Lage Barbosa C. et al. Forschungsbericht. EsKiMo II – die Ernährungsstudie als KiGGS-Modul. Berlin: Robert Koch-Institut; 2020
• 136 Moosburger R, Lehmann F, Haftenberger M. et al. Aufnahme von Lebensmittelgruppen bei Mädchen und Jungen mit unterschiedlicher Inanspruchnahme der Schulverpflegung. Ern Umschau 2021; 5: 86-94
• 137 Alexy U, Clausen K, Kersting M. Die Ernährung gesunder Kinder und Jugendlicher nach dem Konzept der optimierten Mischkost. Ern Umschau 2008; 3: 168-178
• 138 Niles MT, Bertmann F, Belarmino EH. et al. The early food insecurity impacts of COVID-19. Nutrients 2020; 12: 2096
• 139 De Oliveira KHD, de Almeida GM, Gubert MB. et al. Household food insecurity and early child development: Systematic review and meta analysis. Maternal & Child Nutrition 2020; e12967
• 140 FAO, IFAD, UNICEF, WFP and WHO. The State of Food Security and Nutrition in the World 2019. Safeguarding against economic slowdowns and downturns. Rome: FAO; 2019
• 141 Poppik L. The effects of COVID-19 will ripple through food systems. 26.03.2020 https://www.scientificamerican.com/article/the-effects-of-covid-19-will-ripplethrough-food-systems/ Stand: 30.06.2021
• 142 Bauer L. The COVID-19 Crisis Has Already Left Too Many Children Hungry in America. 06.05.2020 https://www.hamiltonproject.org/blog/the_covid_19_crisis_has_already_left_too_many_children_hungry_in_america?referringSource=articleShare Stand: 30.06.2021
• 143 Simon D, McInerney M, Goodell S. The Earned Income Tax Credit, Poverty, and Health. 04.10.2018 https://bit.ly/3phiM5T Stand: 30.06.2021
• 144 Sherman A, Mitchell T. Economic Security Programs Help Low-Income Children Succeed Over Long Term, Many Studies Find. 17.07.2017 https://bit.ly/2WIWE8c Stand: 30.06.2021
• 145 East CN. The Effect of Food Stamps on Children’s Health: Evidence from Immigrants’ Changing Eligibility. Denver: University of Colorado; 2016
• 146 Hoynes HW, Whitmore Schanzenbach D, Almond D. Long-Run Impacts of Childhood Access to the Safety Net. American Economic Review 2016; 106: 903-930
• 147 Morris PA, Gennetian LA, Duncan GJ. Effects of Welfare and Employment Policies on Young Children: New Findings on Policy Experiments Conducted in the Early 1990s. Social Policy Report 2005; 19: 1-20
• 148 US-Department of Agriculture. ERS definitions. http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/measurement.aspx Stand: 30.06.2021
• 149 Anderson PM, Butcher KF. The relationships among SNAP benefits, grocery spending, diet quality, and the adequacy of low-income families resources. 14.06.2016 https://www.cbpp.org/research/food-assistance/the-relationships-among-snap-benefits-grocery-spending-diet-quality-and Stand: 30.06.2021
• 150 Perez-Escamilla R, Cunningham K, Hall Moran V. COVID-19 and maternal and child food and nutrition insecurity. Maternal & Child Nutrition 2020; 16: e13036