Hidden hunger: the silent nutritional deficiency that causes health problems – 08/09/2021

Is your diet really healthy? With the rush of daily life, it is not always possible to guarantee that the diet is balanced and has all the necessary nutrients. The lack of micronutrients causes a phenomenon little known to the population: hidden hunger.

According to the WHO (World Health Organization), the problem is due to the lack of vitamins and minerals in the body, due to insufficient consumption of foods such as fruits, vegetables, fish and meat. It is estimated that hidden hunger affects one in four people in the world, that is, 25% of the population.

“Unlike classic hunger, hidden hunger occurs even among people who ingest calories in sufficient quantities. It is also common among individuals who are overweight”, emphasizes Maria Fernanda Elias, nutritionist and PhD in Human Nutrition at USP (University of São Paulo) and manager of DSM Nutrition and Human Health for Latin America.

Hidden hunger does not only affect people who live in situations of food scarcity. It can impact those who consume food in adequate amounts (or in excess) and also those who eat foods that satiate but do not nourish. Therefore, even if a person eats a lot, he is not balancing the micronutrients necessary for his health.

Possible causes

In addition to an inadequate diet, some intestinal diseases impede the absorption of nutrients, causing hidden hunger. Some stages of life, such as pregnancy and lactation, can also increase the risk of the problem, as the need for some micronutrients such as iron is increased.

“Obesity and hormonal dysfunctions also lead to metabolic imbalances that lead to hidden hunger”, completes Elias. Other factors that increase the risk for the problem are: lack of exercise, low sun exposure (in the case of vitamin D), few hours of sleep and stress.

Child eating hamburgers / childhood obesity - iStock - iStock

The problem with hidden hunger is not a lack of food, but of nutrients.

Image: iStock

How do I know I have the problem?

A key point to be considered is that hidden hunger is usually asymptomatic, as it causes few physiological changes. There is a non-explicit lack of one or more micronutrients, which may be imperceptible in a routine clinical examination, for example.

In general, the individual does not realize he has a problem until the condition gets worse. It is common for the diagnosis to occur only when the lack of nutrient turns into a disease. However, even if hidden hunger does not evolve, the condition causes damage to health in early stages.

“Signs usually appear when there is already a large amount of deficiency. So it is worth paying attention to manifestations of fatigue, difficulty concentrating and cramps. Irritation, mood swings and decreased immunity may also arise”, says Durval Ribas Filho, nutritionologist and president of Abran (Brazilian Association of Nutrology).

When there is a lack of a specific micronutrient, hidden hunger causes very different health problems. Among the most common are iron deficiency anemia, night blindness or vision problems and low immunity.

Over time, the situation worsens and chronic diseases such as cardiovascular diseases, hypertension, diabetes, dyslipidemia (fatty plaques in the blood) and osteoporosis begin to appear.

Children, pregnant women and the elderly are most affected

At all stages of life, it is essential to maintain healthy eating habits. However, children, for example, need to have an adequate diet to develop. But, unfortunately, this is not a global reality.

According to UNICEF (United Nations Children’s Fund), at least one in two children under the age of five suffer from hidden hunger in the world. For Ribas Filho, children are more affected because they depend on their parents’ food choices and the type of food they offer. “When the diet is based on fast-food and ultra-processed foods, it is difficult for the child not to be affected by hidden hunger. It is necessary to offer a colorful dish to reach the sufficient amount of nutrients and vitamins needed per day”, he says.

Hidden hunger in young children has devastating effects. The experts interviewed by Live well highlight that, in addition to malnutrition, several health problems arise, which can even lead to death. “Lack of iron, for example, reduces children’s ability to learn. Deficiencies in essential vitamins and minerals rob children of all age groups of vitality and compromise their health and well-being,” says Elias.

It is noteworthy that overweight and obese children are also affected by hidden hunger and must be carefully observed. This is because, despite consuming an amount of energy greater than necessary, they do not receive nutritious food for the body.

Another group that deserves attention from health specialists are pregnant women. Generating a life causes many changes in women’s bodies and they need more micronutrients. Iron deficiency, for example, in some cases causes anemia and increases the risk of postpartum death.

And newborns are also hit by the hidden hunger of mothers: an estimated 18 million babies are born with brain damage due to iodine deficiency each year.

According to Milton Lins, nutritionist at AmorSaúde, a network of clinics partnering with Cartão de TODOS, in João Pessoa (PB), elderly people are also affected by hidden hunger when they do not eat properly because they have problems chewing or swallowing food. “Furthermore, in cases of more debilitated and dependent elderly people, the responsibility for feeding is with the caregivers. With the rush and routine, the diet can be lacking in the amount of nutrients, increasing the risk”, he highlights.

Child eating chocolate - iStock - iStock

Children are more affected because they depend on their parents’ food choices and the type of food they offer

Image: iStock

How to treat and prevent?

The first step is to be able to diagnose hidden hunger. The identification of the condition involves physical evaluation, analysis of food and lifestyle habits, up to clinical examinations. “Basically, the diagnosis is made through clinical and laboratory (blood) tests, which will identify deficient vitamins and minerals. Therefore, it is important to carry out a regular check-up”, says Lins.

The treatment is carried out individually, making up for nutritional deficiencies, through changes in diet or supplementation with vitamins and minerals.

According to Elias, nutritional education is extremely important for people to know how to make healthier choices when eating. “It is essential that individuals learn to identify and choose foods with greater nutritional density, such as fruits, vegetables, vegetables, fish, whole grains, dairy products and foods fortified with vitamins and minerals.”

It is noteworthy that the WHO, the UN (United Nations) and UNICEF work together promoting various programs to combat and prevent hidden hunger. Among the guidelines identified by the organizations are:

  • Use of vitamin supplements: mainly vitamin A and iron with medical indication;
  • Fortification of staple foods: the recommendation is to add micronutrients to staple foods or condiments during processing to help achieve recommended levels per day. This is the case of salt with iodine, flour with vitamin B, iron and zinc and oil and sugar with vitamin A;
  • Investing in food diversity: It is important to bet on a balanced and adequate diet of macronutrients (carbohydrates, proteins and “good” fats) and regularly consume fruits, vegetables and cereals in order to have a diet full of essential micronutrients in everyday life.