Traditionally, hunger is linked to malnutrition, and it is of particular concern for lower to middle-income countries where hunger may be the leading cause of mortality for children. However, in recent decades nutrient-poor but energy-dense diets have become prevalent fueling an obesity epidemic, causing vitamin and mineral deficiencies, which has been coined “hidden hunger”.
The double burden of hidden hunger
“Hidden Hunger” is more common in high-income countries where it is associated with ultra-processed foods of convenience (Western Diet) that are high in sugar, salt, and fat. In lower and middle-income countries obesity is often associated with poverty and monotonous diets with limited choices of staples such as corn, rice, wheat, and potatoes.
However, many developing countries are now faced with the double burden of overnutrition alongside malnutrition due to the rapid increase in the global prevalence of obesity in recent decades, especially among children.
Nutritional deficiencies
Global estimates are that over half of the population from 185 countries consumes inadequate levels of 15 micronutrients that are essential to health: calcium, iodine, iron, riboflavin, folate, zinc, magnesium, selenium, thiamin, niacin, and vitamins A, B6, B12, C, and E.
Even small deficiencies in their essential micronutrients can have a significant impact on health, productivity, quality of life, and overall well-being. For example, iron deficiency is the most common cause of anemia, and this deficiency can lead to fatigue, weakness, and impaired cognitive function among other things. Iodine is crucial for thyroid function and brain development. Vitamin E helps to protect cells from damage, and calcium is essential for bones and teeth.
Disturbing view of global nutrition
The study from Harvard T.H. Chan School of Public Health, UC Santa Barbara (UCSB), and the Global Alliance for Improved Nutrition (GAIN) published in The Lancet Global Health brings to light a disturbing view of global nutrition.
According to the researchers, the effects of hidden hunger are apparent with more than 5 billion people don’t get enough calcium, iodine or vitamin E, close to 5 billion are iron deficient, and over 4 billion people have sub-par levels of vitamin C, riboflavin, and folate. Their analysis revealed that an alarming 68% of the global population was deficient in iodine, 67% had vitamin E deficiencies, 66% calcium, and 65% had inadequate levels of iron.
Additionally, over half of the people consumed inadequate levels of riboflavin, folate, and vitamins C and B6. Inadequate intake of iodine, iron, selenium, and vitamin B12 was more common among women and inadequate intake of calcium, niacin, zinc, thiamin, magnesium as well as vitamins A, C, and B6 was more common among men.
The hidden hunger public health challenge
“These results are alarming,” said Ty Beal, senior technical specialist at GAIN. “Most people — even more than previously thought, across all regions and countries of all incomes — are not consuming enough of multiple essential micronutrients. These gaps compromise health outcomes and limit human potential on a global scale.”
“The public health challenge facing us is immense, but practitioners and policymakers have the opportunity to identify the most effective dietary interventions and target them to the populations most in need,” added senior author Christopher Golden, associate professor of nutrition and planetary health at Harvard Chan School.
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