Abstract
Micronutrient deficiencies and inadequacies constitute a global health issue, particularly among countries in the Middle East. The objective of this review is to identify micronutrient deficits in the Middle East and to consider current and new approaches to address this problem. Based on the availability of more recent data, this review is primarily focused on countries that are in advanced nutrition transition. Prominent deficits in folate, iron, and vitamin D are noted among children/adolescents, women of childbearing age, pregnant women, and the elderly. Reports indicate that food fortification in the region is sporadic and ineffective, and the use of dietary supplements is low. Nutrition monitoring in the region is limited, and gaps in relevant information present challenges for implementing new policies and approaches to address the problem. Government-sponsored initiatives are necessary to assess current dietary intakes/patterns, support nutrition education, and to reduce food insecurity, especially among vulnerable population groups. Public–private partnerships should be considered in targeting micronutrient fortification programs and supplementation recommendations as approaches to help alleviate the burden of micronutrient deficiencies and inadequacies in the Middle East.
Highlights
IntroductionMicronutrient deficiencies have long been a major healthcare problem in the Middle East
Micronutrient deficiencies have long been a major healthcare problem in the Middle East.over the past three decades, the region has been subject to substantial changes in the demographic, economic, political, and social environment that impact the challenges associatedNutrients 2017, 9, 229; doi:10.3390/nu9030229 www.mdpi.com/journal/nutrientsNutrients 2017, 9, 229 with diet, nutrition, and health
No prevalence was reported on vitamin D deficiency among pregnant women in the Middle East; high insufficiency levels were found in the Kingdom of Saudi Arabia (KSA) (86.4%) [14] and Egypt (40%) [23]
Summary
Micronutrient deficiencies have long been a major healthcare problem in the Middle East. Many countries in the Middle East are undergoing a nutrition transition where undernutrition coexists with non-communicable diseases associated with other forms of malnutrition (including overweight and obesity). In addition to documenting these micronutrient deficiencies and/or inadequacies, the WHO has stressed the growing public healthcare challenge presented by non-communicable diseases, accounting for 47% of morbidity and 52% of total mortality [2] Much of this total is derived from conditions associated with poor nutrition; for example, in those aged ≥20 years, 11% were diabetic, 26% were hypertensive, 50% were dyslipidemic, and 65% were overweight or obese. Improvements in nutrition in some Middle East countries are taking place as a result economic growth and associated health sector development, the burden of disease associated with inadequate dietary intake remains the immediate cause of undernutrition, with the situation worsening in certain areas as a result of the nutrition transition. This review focuses on the prevalence and impact of micronutrient deficiencies and inadequacies in select Middle Eastern countries and discusses approaches to diet, fortification, and supplementation that may contribute to solving this problem
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