By Nutrition Expert – Trupti Gurav,Mumbai
Hidden hunger is a lack of vitamins and minerals. Hidden hunger occurs when the quality of food people eat does not meet their nutrient requirements, so the food is deficient in micronutrients such as the vitamins and minerals that they need for their growth and development. (1)
The word hidden hunger refers to a more insidious type of deficiency caused by eating food that is cheap and filling but deficient in essential vitamins and micro-nutrients. Though, the consequences of subclinical deficiency of micro-nutrients are better understood and monitored, they often go unnoticed within the community.
In India, according to NFHSIII data, 63% of children below 5 years in urban areas (72% in rural area) are found to be anemic and 55% of women and 24% of men are found to be anemic. Anemia is found to increase with the number of children ever born and decreases with education and higher household wealth. (2)
Mahalingam,Govindrajetal found that; dietary deficiency of micronutrients (iron, zinc, vitamin A), leading to micronutrient malnutrition or hidden hunger, has been recognized as a widespread food-related health problem, affecting more than 2 billion people worldwide. This is primarily attributable to lack of affordability and access to diversified diet, such as fruits, vegetables and livestock products. As a consequence, women, children and infants, belonging to the poorer section of society are malnourished. In particular, deficiencies of iron and zinc are widespread, leading to numerous adverse health consequences, as they play a vital role in various physiological body functions. (3)
Various reports published by international organisations such as Food and Agricultural Organisation and the International Food Policy Research Institute highlight the hidden hunger crisis across the world. More than 2 billion people worldwide suffer from hidden hunger, whereas 805 million do not have enough calories to eat. Most of this crisis is spread over the developing world. But micronutrient deficiency, particularly iron and iodine deficiency, is prevalent even in the developed world. (4)
Factors that contribute to micronutrient deficiencies include poor diet, increased micronutrient needs during certain life stages, such as pregnancy and lactation, and health problems such as diseases, infections, or parasites. Diets based mostly on staple crops, such as maize, wheat, rice, and cassava, which provide a large share of energy but relatively low amounts of essential vitamins and minerals, frequently result in hidden hunger.(5)
How it can be prevented?
- Try to avoid eating junk food regularly, as all these foods provide little to nutrition.
- Diversification of diet: This is the most effective way of tackling any form of hunger. A diverse diet is linked with better nutritional outcomes, irrespective of socio-economic status. In the long term, it ensures a healthy diet. A balanced diet of an adequate combination of macronutrients (carbohydrates, fats, and protein); essential micronutrients; and other food-based substances such as dietary fibre, along with cereals, legumes, fruits, vegetables, and animal-source foods, is essential in ensuring a healthy life.
- Fortification of commercial foods: According to the Food Safety and Standards (Fortification of Foods) Regulations, by January 2019, all food business operators must comply with all the regulations regarding food fortification, which includes providing for 50% of micro-nutrient required for an individual in a day. The fortification guidelines include rice, wheat flour (folic acid, iron, vitamin B12), milk, edible oil (vitamins A and D) and salt (iodine and iron). A solution has been implemented in many countries not just to curb hidden hunger but also to curb nutritional deficiencies, called fortified food. Nutrients have been separately added to such foods to boost the vitamin and mineral content. Fortified food ensures you get additional nutrients. Food fortification programs with the B vitamins have drastically reduced the incidence of diseases of extreme deficiency, such as pellagra and beriberi
- Bio fortification: Bio fortification involves breeding food crops, using conventional or transgenic methods, to increase their micronutrient content. Another plus is that bio fortified crops are sustainable, climate-resilient and inexpensive. Today, at least 15 million people in more than 30 countries grow and eat bio fortified crops. Bio fortified pearl millet, rice, and wheat is available to farmers in India. After a decade of testing, the first iron-rich pearl millet named Dhanashakti was released in 2012 in Maharashtra and in 2013 across India.
- Supplementation: Vitamin A supplementation is one of the most cost-effective interventions for improving child survival. According to UNICEF, at least 70 per cent of young children ages 6 to 59 months need to receive vitamin A supplements every six months in order to achieve the desired reductions in child mortality. In some countries, iron-folate supplements are prescribed to pregnant women though coverage rates are often low and compliance rates even lower. (5,6)
A review published, In International Journal of Unani and Integrative Medicine 2018 By Gousia Gani, concluded that; hidden hunger requires an immediate attention. More than 2 billion people, one-third of the world’s population, suffer from micronutrient deficiencies.
The consequences of malnutrition and micro-nutrient deficiencies, beginning with women and their young children account for a large proportion of child and maternal deaths, mental disability, and less productivity of the workforce.
So optimum mix of food fortification, dietary diversification, bio fortification, and supplementation helped in early detection and effective treatment of micronutrient deficiencies and also showing a great progress by reducing the number of morbidity and mortality attributed to them. (7)
To conclude, food fortification and supplementation are the effective ways to help hundreds of millions of people simultaneously improve quality of life and health. With enough attention and support, hidden hunger can be erased from the population.