Finding the Solution for Hidden Hunger

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Hidden hunger can be defined as a micronutrient deficiency, particularly in iodine, iron, zinc and vitamin A (Harding et al., 2017). Approximately ⅓ of the population suffers from a form of malnutrition (Amoroso, 2018), hidden hunger commonly overlaps with other dietary diseases, such as obesity. While hidden hunger exists everywhere, the worst affected areas are rural and the vast majority of cases are in Africa.

It is very difficult to measure hidden hunger, so it is estimated by looking at risk factors and diseases associated with the relevant deficiencies e.g. iron, zinc, iodine and vitamin A (Gödecke, 2018). For iron, we can look at anemia rates and low serum retinal levels, especially among children, reveal Vitamin A deficiencies (Ul-Allah, 2018). The difficulties with these estimates is that double counting can occur and this needs to be taken into account when looking at the incidence rates.

Hidden hunger is caused by inadequate access to nutrient rich food. Carbohydrates form the staple food in many parts of the world. However, they are not nutrient dense and so while they provide the necessary calories, they do not cover micronutrients (Ul-Allah, 2018). A diverse diet is necessary to prevent hidden hunger. As with most agricultural issues, climate change will exacerbate them. Production will become harder, especially for subsistence farmers. Interestingly increased CO 2 is also linked to increased rates of zinc deficiency and it is predicted that this will lead to 138 million more cases (Harding et al., 2017).

Climate change is not the only reason that hidden hunger will increase, bigger populations and ageing populations will also increase rates (Amoroso, 2018). Elderly populations are at a greater risk of chronic illnesses and infections, many of which are caused by micronutrient deficiencies (Eggersdorfer, 2018). Pregnant women and infants (under the age of 5) are also high risk groups, with 3,000 children dying daily in India due to malnutrition (Ul-Allah, 2018). It is important to recognise these high risk groups and ensure that the most vulnerable are appropriately looked after with targeted solutions. Additionally, there is an economic element to hidden hunger’s impacts as nutritional deficiencies led to global productivity losses of >3% GDP, or $1.4–2.1 trillion.

Current solutions to hidden hunger are supplementation and fortification of staple foods. For example, iodised salt or fortifying rice with vitamin A (Harding et al., 2017). Fertilisers can also be enriched. Zinc enriched fertiliser was shown to boost the amount of zinc in wheat harvests, but it was less impactful on rice crops (Ul-Allah, 2018). However, this does expose the link between soil quality and nutrient density. Overuse of land does not only have environmental consequences, it also affects our health. Supplementation has been effective in South Asian infants, lowering incidence rates of diarrhoea and measles, both linked to vitamin A deficiency (Harding et al., 2017).

While fortified food and supplements have been effective, they are not sustainable solutions. The goal should be to encourage more diverse diets and crops (Eggersdorfer, 2018) and improve nutritional education (Miteva, 2018). This can be done with evidence based interventions, public investment and a focus on high risk groups and areas (Harding et al., 2017). Public policy should focus on lowering the demand for food with a low nutrient density, while increasing the supply of nutrient dense food. Nutrient density should enter into food standard regulation and crops should be selectively bred for their high nutrient content.

Chronic hunger (caloric deficit) has been successfully tackled, with rates falling by 50% between 1990 and 2010. However, hidden hunger fell by only 30% (Gödecke, 2018). Chronic hunger can be tackled at the macro level, where hidden hunger cannot. It requires micro level interventions that target specific deficiencies, areas and populations. It is not just about getting food on the table. It is about producing high quality, nutrient rich foods to sustain our growing population.

References

Amoroso, L., 2018. Post-2015 Agenda and sustainable development goals: Where are we now? Global opportunities to address malnutrition in all its forms, including hidden hunger. World Review of Nutrition and Dietetics, 118, pp.45–56.

Eggersdorfer, M.L. et al., 2018. Hidden hunger: Solutions for America’s aging populations. Nutrients, 10(9).

Gödecke, Stein & Qaim, 2018. The global burden of chronic and hidden hunger: Trends and determinants. Global Food Security, 17, pp.21–29.

Harding, K., Aguayo, V. & Webb, P., 2018. Hidden hunger in South Asia: a review of recent trends and persistent challenges. Public Health Nutrition, 21(4), pp.785–795.

Miteva, P., Ruano, E. & Jordan, I., 2018. Latin America and the Caribbean: Strategies to fight hidden hunger. World Review of Nutrition and Dietetics, 118, pp.167–175.

Ul-Allah, S., 2018. Combating hidden hunger in agriculture perspective. World Review of Nutrition and Dietetics, 118, pp.161–166.

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