Worldwide, half of the pre-schoolers and two out of three women of reproductive age suffer from “hidden hunger”, malnutrition due to the lack of micronutrients and vitamins—those contained in animal-source foods.

Worldwide, half of the pre-schoolers and two out of three women of reproductive age suffer from “hidden hunger“. What is it? It is a form of malnutrition due to lacking micronutrients and vitamins, such as iron, iodine, zinc, folate and vitamin A. This is revealed by a study published in The Lancet Global Health.

Deficiencies are many due to insufficient intake or low absorption levels that adversely affect the body’s health and physical and cognitive functions. In particular, they impair the proper functioning of the immune system, hinder the normal growth and development of children and affect human potential worldwide.

Among the most serious negative effects are poor growth, limited cognitive development, anaemia, night blindness, osteoporosis, cardiovascular diseases, and cancer. These consequences can initially be subtle, then become increasingly significant and even irreversible. Especially in children, adolescents and pregnant women, where the needs are higher, there is a necessity for a nutritionally dense diet.

The authors of the study provided for the first time an update on the status of micronutrient deficiencies in the population globally, as previous estimates dated back 30 years ago and were based exclusively on anaemia. In this new joint analysis, researchers again analysed individual micronutrient status data from 24 nationally representative surveys between 2003 and 2019.

The results estimate that, overall, 56% of preschool children (6-59 months) and 69% of non-pregnant women of reproductive age (15-49 years) are deficient in at least one micronutrient. This equates to about 372 million pre-schoolers and 1.2 billion non-pregnant women of childbearing age lacking in one of the key micronutrients, which are iron, zinc and vitamin A in pre-schoolers, and iron, zinc and folate in women of reproductive age.

These dramatic estimates affect mainly developing countries that do not have access to high-nutritional density foods, such as meat and animal-source foods. As Ty Beal, among the authors of the study and research consultant at the Global Alliance for Improved Nutrition (GAIN), comments: “Women of reproductive age have an increased need for iron, and folate deficiency during this period may increase the risk of neural tube defects in the foetus, affecting its development. Pregnant and lactating women, infants and children between 6 and 23 months are potentially more affected due to the substantial increase in nutrient requirements at these stages”.

“Diets that do not provide the right levels of vitamins and minerals can compromise the immune system, cognition and school performance, reduce work productivity and contribute to the risks of non-communicable diseases such as heart problems,” Lynnette Neufeld, Director of the Food and Nutrition Division at the United Nations Food and Agriculture Organisation, adds: “This is a widespread problem, affecting individuals, families and communities around the world, particularly in low-income countries”.

Micronutrient deficiencies are highest in developing countries, where rice, wheat and corn are mainly consumed, and starchy foods that, while providing sufficient calorie levels, are nutritionally poor. That is why nine out of ten women in South Asia and sub-Saharan Africa suffer from a lack of essential vitamins or minerals.

The fact is that, surprisingly, even in high-income countries, the number of women suffering from “hidden hunger” is significant. Such as in the United States and the United Kingdom, where one-third to half of the women of reproductive age are deficient in at least one nutrient.

“In high-income countries, the hidden hunger can be caused by the spread and excessive consumption of hyper-processed foods, produced industrially by the processing of foods that are low in nutrients,” Ty Beal explains: “We must encourage the consumption of simple foods with high nutritional value, support local and national companies that produce these foods, strengthen markets, improve accessibility and generate demand for these foods. The focus should be on switching to fresh and minimally processed foods to meet the needs of essential vitamins and minerals”.

Saskia Osendarp, Executive Director of the Micronutrient Forum, also notes: “The solution is very clear: we must increase the access to simple foods naturally dense in micronutrients, such as meat and animal-source foods, but also dark green leafy vegetables, beans, lentils and peas. Food fortification is a useful tool to make a difference when these foods are not available or inaccessible”.

It is assumed that these results are even underestimated, as the study did not evaluate the deficiencies of all key micronutrients in all population groups. This is why further in-depth investigations are needed to understand the context of micronutrient deficiencies better. The aim is to find specific solutions and effective strategies for good nutrition and resort to fortification and integration where high nutrient-density animal-source foods are unavailable.