Abstract
The unified global efforts to mitigate the high burden of vitamin and mineral deficiency, known as hidden hunger, in populations around the world are crucial to the achievement of most of the Millennium Development Goals (MDGs). We developed indices and maps of global hidden hunger to help prioritize program assistance, and to serve as an evidence-based global advocacy tool. Two types of hidden hunger indices and maps were created based on i) national prevalence data on stunting, anemia due to iron deficiency, and low serum retinol levels among preschool-aged children in 149 countries; and ii) estimates of Disability Adjusted Life Years (DALYs) attributed to micronutrient deficiencies in 136 countries. A number of countries in sub-Saharan Africa, as well as India and Afghanistan, had an alarmingly high level of hidden hunger, with stunting, iron deficiency anemia, and vitamin A deficiency all being highly prevalent. The total DALY rates per 100,000 population, attributed to micronutrient deficiencies, were generally the highest in sub-Saharan African countries. In 36 countries, home to 90% of the world’s stunted children, deficiencies of micronutrients were responsible for 1.5-12% of the total DALYs. The pattern and magnitude of iodine deficiency did not conform to that of other micronutrients. The greatest proportions of children with iodine deficiency were in the Eastern Mediterranean (46.6%), European (44.2%), and African (40.4%) regions. The current indices and maps provide crucial data to optimize the prioritization of program assistance addressing global multiple micronutrient deficiencies. Moreover, the indices and maps serve as a useful advocacy tool in the call for increased commitments to scale up effective nutrition interventions.
Highlights
An estimated two billion lives are affected by a chronic deficiency of essential vitamins and minerals, collectively known as hidden hunger [1,2,3,4]
This paper describes the development of global indices and maps depicting hidden hunger, reflecting both the prevalence of multiple micronutrient deficiencies and the associated disease burden, to serve as a tool to stimulate global efforts towards scaling up nutrition interventions
Two separate datasets were compiled for the development of hidden hunger indices and maps: i) a database of the most up-to-date national prevalence estimates of anemia, stunting, vitamin A deficiency (VAD) in pre-school aged children, and iodine deficiency (ID) in school-aged children, for 190 countries for the years 1999-2009; and ii) data of the recent Disability Adjusted Life Years (DALYs) estimates attributed to deficiencies of iron, zinc, vitamin A, and iodine for 192 countries
Summary
An estimated two billion lives are affected by a chronic deficiency of essential vitamins and minerals (micronutrients), collectively known as hidden hunger [1,2,3,4]. Its negative and often lifelong consequences for health, productivity, and mental development are devastating [5]. Young children and women of reproductive age living in low-income countries are the most vulnerable. Volatile food prices and climate change have led to changes in dietary intake, with a shift away from foods which are rich in micronutrients, while retaining the consumption of low-micronutrientcontaining staple foods which are relatively less expensive [6,7]. An increasing proportion of the world’s population may be at risk of hidden hunger, with potential significant negative consequences for both global health and economic growth
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