chapter 04
Micronutrient Deficiency in the Developed World
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with continued breastfeeding until the child is at least two years of age, in order for it to have the best start in life and be protected against malnutrition and, eventually, the development of chronic diseases later in life.
Education in the field
A longitudinal study carried out in Guatemala highlighted how important it is that children have an adequate diet at the start of life, as it showed how this impacted on the individual’s overall performance and eventually their income potential. Studies have also demonstrated that women in developing countries often do not themselves have adequate diets. This not only impacts on their health, but also results in low birth weight babies and, ultimately, impacts on the short- and long-term cognitive and physical development of the infant when the complementary diet of the child is inadequate. It is important to note that for the first six months of a child’s life a mother’s breast milk is expected to meet the infant’s nutritional needs – nature has established that the child will receive the nutrition it needs, at the expense of the mother’s nutritional status. As has also been highlighted, micronutrient deficiency is not only limited to developing countries. A study in Germany measured the blood levels of vitamin A in well-educated women and found that they were considerably lower than the recommended level. The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, which has investigated nutrient intake and the status of male and female European adolescents, also found that more than 50 per cent of adolescents had vitamin D deficiencies, while 30 per cent had problems with iron metabolism and anemia. More research is needed to develop indicators for nutrient status that are reliable and easy to measure, and in order to allow us to intervene to improve health outcomes around the world – in developed and developing countries – so as to improve the lives and health outcomes of millions. Attitudes also vary, not only between the developed and developing world, but also within the developed world and, more specifically, between America and Europe. Americans, for example, are more open to taking dietary supplements than are Europeans, while the latter remain more skeptical about food fortification or any alterations to the traditional diet. In many developing countries there is also a lack of recognition that the traditional diet is inadequate and that, although food-based strategies are important in the long-term, proven cost-effective interventions are required in the short and medium term to prevent deficiencies. This is especially critical for women of childbearing age, and at the time when complementary foods are introduced after six months of age.