Hidden Hunger - Scarcity in abundance

Consumption studies and clinical data show that hidden hunger is also a problem in Germany, Austria and Switzerland. While the issue of malnutrition in elderly and geriatric persons is now (but still far from adequately) being addressed in diagnostics, far too little attention is paid to malnutrition in children and adolescents. This is because the prevailing view held by politicians and official nutrition and consumer advisors (and unfortunately even some medical practitioners) is that our food provides us with sufficient nutrition. This makes the following statement in a press release issued by the German Federal Agency for Agriculture and Food all the more shocking: “Hidden hunger affects 15 percent of children and adolescents in Germany, six percent of whom are classified as obese. This figure is almost three times as high for children from families with low socioeconomic status.”

These numbers should be a warning, not just to pediatricians. The negative effects of inadequate nutrition on the development of children and adolescents and on their subsequent performance and lifelong health status are well known. Rapid rectification of vitamin and mineral deficiencies to avoid long-term damage – calcium, iron, iodine, zinc, vitamin D and vitamin E are thought to be especially critical – falls within the responsibility of the attending physician or medical practitioner. Educational projects about healthy nutrition and designed for patients, pregnant women, mothers and their children can sometimes be helpful. But nutrition programs and government advice are not much use if the foods they recommend are too expensive for individuals and families. Simply repeating the mantra that everyone can eat healthily and that there is no such thing as malnutrition in Germany is unlikely to help people living on or below the poverty line. What we need here are social and public health policies. However, medical practitioners will always be the first port of call. They must take micronutrient status into account when diagnosing all their patients, not just the children and adolescents.

Obesity and hidden hunger are serious problems that affect industrialized and newly industrializing countries alike. But while most nutrition policy focuses on undernutrition in less developed countries, the fact that 15% of native children and adolescents in industrialized countries, especially Germany and Austria, exhibit subclinical deficiencies is largely ignored. It is time to face these facts.