Nutrition Publication

Hidden Hunger

Editor(s): H. K. Biesalski, R. E. Black.

Hidden Hunger describes a state of deficiency in humans of essential vitamins and minerals (referred to collectively as micronutrients) that occurs largely without signs and symptoms of micronutrient deficiency diseases. There is a long history of discovery of essential vitamins and minerals, and considerable success has been made in the prevention and treatment of related classic deficiency disorders (e.g. rickets, scurvy, and anemia). Only more recently has it been appreciated that an inadequate intake of micronutrients may have health consequences even without overt signs of disease.

The 1,000-day window, from conception till the end of the second year of life, is a very critical period for growth and development requiring an adequate supply of micronutrients. Hidden hunger during this period is a problem not only in low-income countries but also in middle- and high-income countries. Poverty and poor knowledge of the importance of dietary diversity are the basic conditions leading to food insecurity and a poor-quality diet. Hidden hunger during pregnancy results in intrauterine growth restriction with consequences for the development of the child.

Babies who are too small for their gestational age, as well as premature births, are the visible consequences of maternal malnutrition. Growth restriction of several organs may have an impact on the development of diseases in a child’s later life. Poor-quality complementary feeding limited in calories and micronutrients, suboptimal breastfeeding, and an inadequate diet of the preschool child will adversely impact physical and cognitive development with consequences for adult health and productivity. The articles in the book describe the causes and consequences of hidden hunger during the 1,000-day window, as well as possible interventions and program-based responses. Knowledge about hidden hunger may help to detect, prevent, and treat these avoidable conditions and improve the health and prosperity of the next generation.