Exposing the hidden hunger of micronutrient deficiencies

There is a hidden form of hunger that receives less attention that it deserves, say some advocates. While the world malnutrition will evoke thoughts of hunger and lack of food, meeting the caloric needs of a person is not enough to ensure adequate health.

Micronutrients are the minerals and vitamins that are in food.  Zinc, iron and vitamin A are among the crucial micronutrients that ensure the health and proper development of children. A lack of micronutrients can cause slowed physical growth (stunting) and weaken immune systems to the point of endangering a child’s life.

Hidden hunger accounts for 7% of the global disease burden and comes with a global cost of $180 billion each year. The issue of micronutrient deficiency captures less attention than hunger. That is due in part to a lack of adequate data to display the problem to political leaders. Enter the Hidden Hunger Index.

Researchers collected data on micronutrient deficiencies in young children to map areas where the problem is concentrated.  ‘Hidden hunger hot spots’ were found in India, Afghanistan and sub-Saharan Africa.

Results from the research were published in a paper for the medical journal PLoS ONE. The concentration of hidden hunger is staggering. The 36 countries that account for 90% of the world’s stunting are home to high rates of micronutrient deficiencies that account for a significant portion of health problems, disability and early deaths.

The aim of the index is to provide information for countries and donors that will allow them to focus on the hot spot areas, explained Klaus Kraemer, Ph.D., director of Sight and Life and co-author of the paper to Humanosphere.

“We need leaders and champions to move forward,” said Kraemer. “This index can be used to blame and shame governments that are not doing anything.”

Addressing hunger by only thinking about food is not enough, says Kraemer. He pointed to India’s food distribution network. It has been successful in ensuring that the nation’s poor have enough to eat, but the lack of attention to the nutrients in the food has led to significant levels of micronutrient deficiencies.

“We have to deliver a real balanced diet with nutrients,” said Kraemer. “The nutrient density is important for human capital development.”

He says that as much as 10% of GDP is reduced by malnutrition in some countries. Taking a comprehensive approach that ensures that the food delivered is packed with enriching nutrients will create a lasting impact. One of the challenges is ensuring that the poorest, the people most affected by hidden hunger, are reached.

The private sector can play a role in ensuring that foods deliver important nutrients. Kraemer pointed to the food company Britannia who is fortifying the biscuits with nutrients, for sale in India. When given the choice between a more costly fortified option and a cheaper unfortified option, poor people will prioritize financial savings, explained Kraemer. He said that companies will have to consider selling only fortified options or do a better job communicating the health benefits of proper nutrition. It is also a place for civil society and governments.

“Civil Society can help to hold countries accountable to make sure they are doing the right things,” he said.

For his part, Kraemer hopes that the index can help bring hidden hunger to the greater malnutrition discussion. The index is a starting point for conversation and action, but much more needs to be done to gather adequate information about micronutrient deficiencies.

“This paper highlights that our data basis is pretty poor,” he lamented. “We need more of those indicators that describe deficiencies in populations and better baselines to demonstrate progress in countries.”

Better data is crucial to knowing and addressing the problem of malnutrition, said co-author Dr Robert E. Black. Black also served as the lead author for British health journal The Lancet’s Maternal and Child Nutrition Series.

“The Lancet Series called for better data on micronutrient deficiencies at the national level to guide intervention programs in countries and priorities for support globally. By highlighting hidden hunger hot spots, these Hidden Hunger Index maps and rankings help address this unmet need, and are critical to helping countries and partners prioritize where to implement crucial nutrition solutions,” said Black.

Kraemer agreed saying, “We need to bring hidden hunger to the global and national agenda.”