Think about malnutrition and you probably imagine harrowing images of desperately hungry children batting for survival as a result famine or war driven food shortage.
These types of harrowing images are of course malnutrition in its most extreme form. Thankfully the nearest any of us will come to this form of malnutrition will be through donating the charity appeals for emergency food aid.
We are lucky! Most of us will never experience real hunger let alone famine, however malnutrition comes in many guises and is occurring right here, right now, right under your nose. You can't see it but it affects you even if you are not the person who's malnourished.
From the emerging economies like India, Brazil and China to the world's Super powers malnutrition exists in epidemic proportions. Billions of children throughout the world are suffering the effects of nutrient deficiencies. Few of these victims are hungry, food is available in abundance, most of these malnourished children are not underweight, they may not show any physical sings of their malnourishment yet, but the clock is ticking for them.
This form of malnutrition is silent. It's not as immediately devastating as that seen in famine torn Sudan or Ethiopia. Never the less its victims lives will be deeply affected.
•Girls will grow into women who struggle to conceive and bare healthy children because they were deprived of enough iron in child hood.
•Potential academic achievers will not reach anywhere near their potential as a result of impairments caused by insufficient iodine
•Others will develop chronic illnesses because their immune system cannot fight off infections due to a lack of vitamin A.
Malnutrition at this end of the scale is happening here in the UK, across Europe the USA and Australasia- in fact The Global Nutrition Report published in November 2014 suggests over 1/3rd of the world's children are deficient in at least one essential nutrient. These deficiencies are often not life threatening, but they most certainly can be life altering. All of them are easily preventable.
Is this type of malnutrition important?
You bet it is- vitamins and minerals are needed by the body in small amounts, nutrition experts call them micronutrients. No matter how small the amount needed, a vitamin or mineral has an essential role to play in physical or intellectual development. If it's not supplied that role cannot be met and the development is hindered and faulty.
•1/3rd of the world's children under 5 do not get enough vitamin A- the result is that their immune system will not develop properly and they will become susceptible to disease and infection.
•More children suffer from mental impairment around the world as a result of iodine deficiency than any other cause
•500 million girls suffer from iron deficiency anaemia and will endure reproductive problems as a result.
•They will also have less success academically and in the workplace as girls who are not anaemic.
While they are children, none of these children will look malnourished. They will be fed, you may well pass them in the street without giving them a second glance. This form of malnutrition is not about hunger, it's not even always about poverty.
What's causing this silent malnutrition?
As you'd expect there's not one definitive cause for this form of malnutrition, if there was it probably wouldn't exist because the solution would be simple.
- •At it's most basic level malnutrition happens because of an inadequate diet either in quantity (e.g. Not enough food as in famine) or in quality (much more difficult to detect.
- •It may be that particularly nutrient dense foods like meat, eggs, fish or specific vegetables are not featuring enough in the diet. Again because of lack of availability or because individuals choose not to eat them.
- •Lastly it may be that there is an abundance of food, but the food is lacking in nutrients- AKA Junk Food.
It's this last potential cause of malnutrition which is increasing more year on year. Evidence from developing countries as their economy grows shows that fast food, convenience food brands move in like nutritional predators. The traditional, local diet and especially the diet of children changes and takes on a western style diet high in fast, sugar and salt. There are very definite correlations and consequences as this change takes place.
Calorie increase = Nutrient decrease.
Obesity increase = chronic disease increase
Can we stop or prevent silent malnutrition?
There are a few things which need to happen simultaneously if we are going to prevent silent malnutrition from happening.
We'll need the supply- nutrient dense food that people want to eat either alongside or instead of calorie rich foods which supply few nutrients
We'll need the demand- interventions which inspire people to take responsibility for their and their children's health
We'll need political backing- Governments will need to get behind these initiatives which may mean taxing high calorie/low nutrient foods, legislation may be needed restrict where and how junk food is sold. Governments may also choose to increase nutrient intake through national food fortification programmes (E.G. adding nutrients to foods eaten regularly by large sections of the population).
We'll need an up to date baseline- the data which we use to tell us the nutritional value of foods is often very out of date and full of inaccuracies. At some stage Governments around the world will need to collaborate to establish new food and nutritional value tables which take into account regional variations as well as farming, cooking and production methods which can all affect the level of nutrients.
All of these factors will of course take an enormous collaborative effort and a great deal of time, if they happen at all.
Parents will want to know "what can I do right now?"
- •You can do your best to ensure children eat as wide a variety of foods as possible. This is by far the easiest way of getting a good range of nutrients.
- •You can cook more from scratch at home and limit how much fast and convenience food your children eat.
- •You can consider boosting your child's nutrient intake with a children's multivitamin and mineral supplement
My advice is that parents use all three approaches for peace of mind. Most children will go through periods where they choose not to eat certain foods. Some will grow into adult's never eating fish, or green vegetables or drinking milk for example.
You can lead a horse to water and a child to the salad bar- but why would you leave it to chance?