Thursday, December 11, 2008

The pangs of hidden hunger

Micronutrients defi ciency is another indicator of poor nutritional status, and is one that cuts across economic class. Iodine defi ciency, for instance, is a continuing problem even in the affl uent European continent. A 2004 estimate showed that 20 percent of the global population at risk of iodine defi ciency reside in the region.

According to Unicef, for every four persons in the planet, one is suffering from micronutrients defi ciency. The health impacts of micronutrients defi ciency are varied and can be quite staggering: blindness, mental retardation, and even death, particularly for anemic pregnant women.

Iron deficiency
The World Health Organization characterized iron deficiency as “the most common and widespread nutritional disorder in the world.” Establishing the exact magnitude of the problem is hard, but since iron defi ciency is closely tied to anemia, the global prevalence of iron deficiency anemia (IDA) is used as a proxy indicator. IDA is a key indicator of a country’s maternal and child health, and its prevalence refl ects socio-economic disparity: in developing countries, 52 percent of pregnant women are affected with IDA, while the fi gure is down to 23 percent of pregnant women in developed countries.

While the general population is at risk, a new study published at the Pediatrics Journal showed that overweight children are more than twice as likely to have iron deficiency than children with normal body weight. Iodine deficiency A 1994 study showed that there was a drop of up to 13.5 points in the intelligent quotient of populations living in areas with severe iodine defi ciency, as compared to the
population of non-iodine defi cient areas.

The land-locked region of Central Asia is particularly vulnerable to iodine defi ciency due to its mountainous terrain. UNICEF nutrition specialist Arnold Timmer
attributes the depletion of iodine in the region’s soil to erosion and rainfall. The collapse of the Soviet Union, which used to supply the region with iodized salt, added to the problem.

A 2004 study in Uzbekistan showed that prevalence of goiter – an indicator of iodine defi ciency – was 49.6 percent for children and 41.6 percent for adults. Kazakhstan, meanwhile, had a goiter prevalence of 56.5 percent.

Vitamin A deficiency (VAD)
An estimated 21 percent of children worldwide are Vitamin A-defi cient, with the highest concentration located in Asia and Africa. On top of causing blindness, VAD also increases a child’s susceptibility to malaria and diarrhea. Food fortification and breastfeeding The international community is responding to the problem with the adoption of two key strategies: the promotion of breastfeeding and food fortification. Breast milk contains all the essential nutrients needed for a baby’s full development. However, there is still a low adoption of exclusive breastfeeding particularly in poor regions.

With regards to food fortification, it is undeniably a costeffective way of combating micronutrients defi ciency. The Central Asian region’s adoption of salt iodization program has effectively reduced, if not totally eliminated the prevalence of iodine deficiency. Food fortification is indeed effi cient, but policymakers must not make this the major cornerstone of their micronutrients program. Food manufacturers have jumped in on the fortifi cation bandwagon, with the market for fortified foods expected to grow by an average of 10.1 percent between 2005 and 2012. While some of these manufacturers are really driven by a sense of responsibility, governments must still exercise some caution.

The Philippines, for instance, has a Sangkap Pinoy program where food fortifi ed with micronutrients are given a seal. But here lies the problem: some of the products
bearing the Sangkap Pinoy seal are junk foods. Another thing to be considered is economics. Even if fortifi ed foods are readily available, do the people have the means to buy these items?

Eliminating Iodine Deficiency in Central Eastern Europe,Commonwealth Independent States and the Baltics by Arnold Timmer.

Iodine deficiency in Europe: a continuing problem. Published by the WHO and UNICEF. ciency_in_Europe.pdf

Assessment of Iodine deficiency disorders and monitoring their elimination: A guide to program managers, third edition. Published by the WHO, UNICEF and ICCIDD.