Can a Child Suffer from Hidden Malnutrition?

Hidden malnutrition is caused by micronutrient deficiencies and has an impact on health, school performance, and future productivity.
Can a Child Suffer from Hidden Malnutrition?

Last update: 13 May, 2023

Not everything we see is what it seems, because we’d never suspect that a person with normal weight, excess weight, or obesity could be suffering from hidden malnutrition at the same time. Inadequate intake of micronutrients over a long period of time can lead to significant deficiencies in the body. So, can a child suffer from hidden malnutrition? We’ll answer this and other questions in this article.

What is hidden malnutrition?

A review carried out by Alba Redón in 2021 summarizes the concept of hidden malnutrition or hidden hunger as a state of malnutrition in which there’s a deficient intake of micronutrients, which is sustained over time. The statistics aren’t encouraging, as according to FAO, more than 2 billion people in the world suffer from hidden malnutrition, double the number of those who don’t get enough calories.

Although a greater proportion of hidden malnutrition is observed in developing countries, micronutrient deficiencies, especially iron and iodine, are also an issue in developed countries.

Where’s the problem?

The causes of hidden malnutrition are somewhat complex. For example, in developing countries, there’s a shift from a traditional diet based on minimally processed foods to a high consumption of highly processed food products. The problem is that these edibles are rich in energy, but poor in micronutrients, so they’re known as a source of empty calories.

In fact, Pinstrup- Andersen explains that many developing countries face a phenomenon known as the “triple burden” of malnutrition. This refers to undernutrition, hidden nutrition, and obesity.

An overweight child sitting on a park bench, looking at a cell phone.
Hidden undernutrition can coexist with excess weight and obesity when macronutrient energy, such as fats and carbohydrates, is consumed in excess.

Other causes

This change in eating behaviors and excessive consumption of processed foods and meals are joined by other causes:

  • Poor diets. Diets based on staple foods such as corn, wheat, rice, and cassava provide high levels of energy but are low in vitamins and minerals.
  • Food preferences are determined by culture, group pressures, and geographic, environmental, and seasonal factors.
  • Lack of education about the importance of eating a balanced and nutritious diet.
  • Economic causes. The family may not be able to afford or access a wide variety of nutritious foods, such as animal proteins, fruits, or vegetables, especially in developing countries.

As we can see, the background of hidden malnutrition is complex and multi-causal, but it all translates into an inadequate intake of varied and nutritious foods.

Know if a child may be suffering from hidden malnutrition

Hidden hunger can affect anyone, but there’s a period of life when its consequences are more severe. For example, in 2017, the American Journal of Human Biology published that the period from conception to the first 2 years is critical for the baby’s development. Therefore, maternal-infant nutritional status is key for proper growth and development.

If there’s a micronutrient deficiency in the mother, this will affect the future of the child. Mainly, it will have an impact on learning and performance in adult life.

The main micronutrients affected

In the journal PlosOne, Muthayya’s team published the results of maps and indices of hidden malnutrition in different regions of the world. The main micronutrient deficiencies were found to be iron, zinc, vitamin A, and iodine. However, deficiencies of B12 and other B vitamins also occur.


Hidden malnutrition is characterized by the fact that its effects aren’t immediate, but in the long term have a profound impact on the health of the child. Especially on performance and learning, lower resistance to disease, and even increased risks during childbirth. The International Journal of Unani and Integrative Medicine mentions the consequences of hidden malnutrition according to the deficiency of the micronutrient involved:

  • Iron: Moderate and severe iron deficiency anemia affects the body’s defense system to fight infections. Children are slower to develop language, have decreased attention span, and perform poorly in school. In addition, reproductive health is also compromised. For example, anemia can cause premature births, low birth weight, and perinatal mortality.
  • Iodine: Goiter is a disorder caused by iodine deficiency. This condition can lead to permanent brain damage, impaired mental development, and decreased infant survival.
  • Vitamin A: Causes night blindness, especially in pregnant mothers; ulceration and detachment of the cornea, and total blindness. It can also cause growth retardation, low resistance to infections, and even death.
  • Zinc: This is essential for growth and development. Zinc supplementation helps linear growth while reducing diarrhea, respiratory infections, and infant mortality.
A young girl eating a healthy plate of fish and vegetables.
Eating a varied and complete diet is the best way to prevent hidden malnutrition. Therefore, it’s key to educate children about nutrition.

How to stop hidden malnutrition in children

The prevention of hidden malnutrition aims to achieve a better quality of life in children and in their future as adults. This is the best tool to stop it as deficiency diagnoses are late and costly. But what can we do?

  • Promote a varied and complete diet from pregnancy or earlier, including foods such as fruits and vegetables rich in micronutrients.
  • Have access to foods fortified with vitamins and minerals to prepare children’s food. For example, the fortification policy applied with iodized salt has been a success.
  • Promote biofortification. This consists of adding micronutrients to cereal crops that are low in certain minerals.
  • Supplement with poly-vitamins and minerals. This should be recommended by a pediatrician.

In addition, the WHO suggests a diet that includes the following:

  • Dairy and dairy products: These contain vitamins A and D and calcium.
  • Meats, legumes, and eggs: They have proteins and some vitamins.
  • Flours and grains: They’re a source of energy and B complex vitamins.
  • Fruits and vegetables: These provide vitamins and fiber.
  • Fats, oil, and sugar: These provide energy.

Food and nutrition education

Hidden malnutrition in children requires immediate attention. This is because the consequences of micronutrient deficiencies have a high impact on health, school performance, and future productivity during adulthood.

A key point for the prevention of these deficiencies is to educate families on food and nutrition. Therefore, good eating habits should be encouraged and behavior should be modified towards the selection of healthy foods. In this regard, processed products that provide empty calories should be left aside.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Andersson, M., Karumbunathan, V., & Zimmermann, M. B. (2012). Global iodine status in 2011 and trends over the past decade. The Journal of nutrition142(4), 744–750.
  • FAO, WFP, IFAD.  The state of food  insecurity in the world: Economic growth is necessary but not sufficient to  accelerate  reduction  of  hunger  and  malnutrition. 2014
  • Gani, Gousia & Gulzar, Beenish & Bashir, Omar & Bhat, Tashooq & Naseer, Bazila & Qadri, Tahiya & Jan, Nusrat. (2018). Hidden hunger and its prevention by food processing: A review.
  • Martorell R. (2017). Improved nutrition in the first 1000 days and adult human capital and health. American journal of human biology : the official journal of the Human Biology Council29(2), 10.1002/ajhb.22952.
  • Muthayya, S., Rah, J. H., Sugimoto, J. D., Roos, F. F., Kraemer, K., & Black, R. E. (2013). The global hidden hunger indices and maps: an advocacy tool for action. PloS one8(6), e67860.
  • Pinstrup-Andersen P.  Agricultural research and  policy  for better health and nutrition in developing countries: A  food  systems  approach.  Agriculture  Economics. 2007.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.