The Global Prevalence of Multiple Micronutrient Inadequacy by Age and Sex

Abstract

Micronutrient deficiency is one of the most recognized and critical forms of malnutrition. Generally, micronutrient deficiency is quantified by low levels of a micronutrient biomarker in the body, but key micronutrients often lack sensitive and specific biomarkers. Additionally, there is a shortage of data on micronutrient status, especially surveys that assess multiple biomarkers on the same population. To quantify multiple micronutrient inadequacy, and provide insights into micronutrient consumption patterns around the world, we estimate the prevalence of inadequate intake of iron, vitamin A and zinc, using a standardized set of nutrient requirement levels and a copula joint distribution approach. We found that a large proportion of the world is at risk of inadequate intake of key micronutrients, ranging from 60% of people in high-income locations to 94% of people in locations in South Asia. Globally, 5.9 billion people have dietary inadequacy of at least one of the three micronutrients examined. There is higher prevalence of inadequate intake of vitamin A and zinc than iron, likely because dietary recall surveys and requirement levels do not distinguish between the differential absorption of heme and non-heme iron. By assessing the prevalence of multiple micronutrient inadequacy rather than a single micronutrient, we revealed that a much higher number of people are at risk for micronutrient inadequacy than the 2 billion previously thought. Our findings highlight the need for better data on micronutrient status indicators across geographically diverse populations. Further research is warranted to define the relationship between inadequacy and deficiency, which has implications on the management and planning of nutrition interventions.