Hidden Hunger

H. K. Biesalski, R. E. Black

• Publisher: S. Karger
• ISBN:
  9783318056853
• Topic: Medicine
• Subtopic: Pediatric Medicine

Malnutrition caused by deficiencies of vitamins and minerals - also called hidden hunger - impairs both the intellectual and physical development of a child. Due to the absence of clinical symptoms and assessments, no intervention can be staged. The tragedy is that this, in turn, decreases the child's chance to escape from poverty. This book looks at malnutrition in high-income countries, the nutrition transition and nutritional deficiencies in low-income countries, consequences of hidden hunger, and interventions to improve nutrition security. Written by leading experts in the field, it clearly stresses that national governments and international organizations must make malnutrition one of their top priorities in order to provide children with optimal conditions for a healthy future.

Interventions to Improve Nutrition Security

Biesalski HK, Black RE (eds): Hidden Hunger. Malnutrition and the First 1,000 Days of Life: Causes, Consequences and Solutions. World Rev Nutr Diet. Basel, Karger, 2016, vol 115, pp 134-141 DOI: 10.1159/000442080

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The Second International Conference on Nutrition, as Seen by a Member State

Hanns-Christoph Eiden · Simone Welte

Federal Office for Agriculture and Food, Bonn, Germany

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Abstract

For years now, providing people with food and balanced diets has been a problem unsolved by the world community. Despite numerous initiatives, the great breakthrough has still not happened, not least because the issue is so complex. Hunger and undernourishment must be fought as much as hidden hunger, overweight and obesity. Increasingly, several forms of malnutrition have been occurring simultaneously. The so-called double burden of malnutrition has become the new normal. The follow-up process of the Second International Conference on Nutrition assumes a vital role in that context. The Rome Declaration and the Framework for Action commit the international community, international organizations and civil society to undertake joint efforts across and beyond sectorial policies. Both documents also indicate numerous starting points for actions that consider individual national examples. Germany has been actively engaged at both the national and the international levels. Since its inception in 2008, the National Action Plan ‘IN FORM’ has taken up a number of suggestions made by the Second International Conference on Nutrition. While IN FORM is further developed, the ideas given in the Framework for Action shall provide a fresh impetus. Within its development cooperation, Germany is increasingly focusing on improving the nutritional situation, such as through its One World, No Hunger initiative. In the follow-up process, all stakeholders, including the Food and Agriculture Organization and the World Health Organization, will have to offer platforms to promote exchange among all parties involved and to initiate coherent actions that also reach beyond national borders. Only then can the improvement of the nutritional situation really be seen as a truly global challenge. Given the issue's complexity, it is equally important to establish priorities in each case in order for progress not to be thwarted by lengthy decision-making processes. Improving the situation of particularly vulnerable groups, such as young women and small children, shall be as prominent as the support and promotion of diversified agriculture. Building networks among partners is of equal importance for joint action and exchange between stakeholders at the national and international levels to generate added value on the way toward solving the nutrition problem. Science will also have to be more closely involved for that matter and purpose. Research is required to supply scientific evidence for certain measures to be taken, and it assumes a prominent role where political consultation, knowledge management and the implementation of measures are concerned.

© 2016 S. Karger AG, Basel

The Second International Conference on Nutrition, as Seen by a Member State

The Second International Conference on Nutrition (ICN2), organized by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) on 19-21 November 2014 in Rome, was the first global intergovernmental conference toward solving food- and nutrition-related issues in the 21st century. It underlined the subject's importance and explosive nature. The issues of hunger and malnutrition remain unsolved by the world community. Progress registered in recent years is still too slow. New challenges have emerged and are increasing: overweight and obesity. Furthermore, anemia in women of reproductive age is stagnant, and stunting levels are declining slowly and are uneven.

Both the conference and the statements presented by high-ranking political and social stakeholders emphasized the will to act. The final documents, or the Rome Declaration on Nutrition and the Framework for Action, are milestones on the way toward tackling the challenges in the framework of the follow-up process, jointly directed by the FAO and the WHO, even in a decade focusing on food and nutrition [1].

Background

For many years now, the consequences of malnutrition have been discussed intensely. Irrespective of both numerous declarations of intent and general recognition of the importance of the issues of hunger and malnutrition and despite ambitious goals, such as halving the number of people who suffer from hunger by 2015 [2], progress is limited. Were recent years mainly marked by rhetorical declarations of intent? Has the world community mainly talked instead of taking action? Such across-the-board criticism would not be justified, given that the issue is complex and that success depends on many factors. Seen in this light and against the backdrop of rapid world population growth, the fact that the number of people who suffer from hunger has been reduced [3] is a big success!

However, as the focus was put on fighting hunger, the phenomenon of hidden hunger, which 2 billion people are affected by, has been given less attention for a long time. Hidden hunger often affects people who take in sufficient, or at times even excess, amounts of calories while their food lacks quality. A lack of vitamin D, iodine, zinc and iron and other vitamin and mineral deficiencies have grave and often irreversible effects on a person's development.

Hidden hunger often also occurs in countries where large parts of the population are challenged by overweight. This double burden has become the ‘new normal’ [4]. Overweight and obesity spread quickly; across the globe, 1.9 billion people are overweight, and 600 million of them are considered obese [5]. Margaret Chan, WHO Director-General, and the Organization for Economic Cooperation and Development are talking about a global obesity epidemic that no country has been able to curb yet [6, 7]. Overweight does not concern rich countries only. On the contrary, the global community and people living under different social and economic conditions are affected [8], but excess weight and obesity do particularly present a challenge in poorer regions around the world. Problems often start when parts of a population become wealthier and increasingly give up their traditional diets in favor of high-energy, highly processed foods with high fat and sugar contents (nutrition transition). As incomes increase, so does the share of foods of animal origin in people's diets [8].

To date, why has no one been able to realize the decisive step of providing balanced diets and sufficient food, with calorie supplies neither too low nor too high, for the majority of people? During the past 30 years, a number of efforts were undertaken to solve the food and nutrition problem: the green revolution, strengthening of both the roles of women and rural areas, involvement in international trade, etc.

The reason lies in the fact that nutrition is a very complex issue that depends on and is influenced by a number of factors; access to water, health services, climate, soils, agricultural technology, education, and the value of agricultural goods in the national and international markets are only a few of the aspects that determine the nutrition situation.

In the individual states concerned, a good political framework is indispensable to providing people with optimal food and nutrition. Additionally, priorities must be clearly established, and respective policies must involve all areas and all stakeholders affected. For the longest time, countless initiatives at the state and international levels have managed neither to translate the manifold issues into coherent and target-oriented actions nor to firmly place the fight against hunger and malnutrition on the world community's agenda as a vital field of action.

For some years, however, this picture has been changing! Initiated by the Food Price Crisis [9] and the Lancet Series in 2008 [10], which supplied a scientifically sound and concentrated presentation of the grave consequences of maternal and child undernutrition in particular, the Scaling Up Nutrition (SUN) movement has, since 2010, motivated a growing number of countries to make the improvement of their populations’ nutrition a central and cross-sectoral issue at the government level.

Within the movement, donor countries, civil society, international organizations and economic partners are joining efforts toward the success of these individual state initiatives. A report that evaluated the work done by the SUN movement between 2010 and 2015 [11] illustrated various achievements and also made important suggestions on how to further develop and permanently establish the initiative's work, in which more than 50 states are currently participating.

In addition to intensifying the dynamics of this process, the ICN2 final documents also spread the conference's contents to every state within the world community. Both the Rome Declaration and the Framework for Action also suggest pursuing approaches that involve various policy areas and all stakeholders concerned. However, while SUN currently focuses on fighting undernutrition due to insufficient food supplies, the Declaration and the Framework include all forms of malnutrition, i.e. overweight and obesity in particular, and address all governments.

The ICN2 conclusions underline the need to enshrine the fight against hunger and malnutrition as a prominent goal of global sustainable development [12]. The conference asked for a multisectoral and multistakeholder approach, including, inter alia, the improvement of water, sanitation and hygiene, and access to health services and education, which is already at the center of all SUN activities.

The General Assembly of the United Nations (UN) acknowledges the need for action and welcomes the fact that the FAO and the WHO are offering to provide the platform for states and governments to exchange experiences and form alliances to benefit from each other and to achieve more by joining efforts [13].

Against this background, the question as to the steps to be taken by the FAO and WHO member states in the wake of the ICN2 arises with particular emphasis.

Germany's Answer to the Challenges regarding the Nutritional Situation in the 21st Century: ‘IN FORM'

The German government took action several years ago already. The National Action Plan ‘IN FORM’, Germany's initiative for heal...