What Are Micronutrients?

The word ‘micronutrient’ might not be in your everyday vocabulary. And you might be asking, ‘what is a micronutrient anyway?’ We can help. Micronutrients are at the core of the Micronutrient Forum. Here, we provide an overview of these tiny, all-powerful vitamins and minerals for your body.

Your body only needs small amounts of micronutrients, such as vitamin A and iron, but these essential nutrients are necessary for growth, immune function, brain development, and other vital functions. We need to obtain micronutrients from food since our bodies cannot produce most vitamins and minerals on our own. Since the micronutrient content of each type of food differs, it is important to eat a variety of foods so that your body has enough vitamins and minerals for optimal health. Nutritious foods, such as fruits, vegetables, and animal source foods, are particularly good sources of micronutrients.

Know Your Key Micronutrients

Vitamin A

Vitamin B12

Folic Acid

Iodine

Iron

Zinc

Micronutrient deficiencies are a significant global public health issue

The World Health Organization (WHO) estimates that more than two billion people—30% of the global population—are deficient in essential micronutrients, primarily vitamin A, iodine, iron, and zinc (1). People living in low-income countries are the most vulnerable to these deficiencies due to limited access to nutrient-rich foods such as fruit, vegetables, and meat which are often inaccessible locally or, when available, are too expensive for families to purchase. In 2019, three billion people, particularly the poor, in every region of the world could not access healthy diets. And we know this inequity will likely widen and be more entrenched following the COVID-19 pandemic (2,3). Access to nutrient-rich food will continue to decline as the COVID-19 pandemic pushes more people into poverty and continues to disrupt supply chains and food systems.

Pregnant women, lactating women, and young children are the most vulnerable to micronutrient deficiencies because a child’s healthy development requires a relatively higher level of vitamins and minerals. The most critical life stage for nutrient-rich diets is known as ‘the first 1,000 days’, which is the period between a woman’s pregnancy and her child’s second birthday.

While there has been progress in reducing the burden of malnutrition over the past two decades, it has been uneven and insufficient: pregnant and lactating women and young children are still disproportionately impacted by deficiencies. Wasting, stunting, and maternal anemia levels are projected to rise (4). In low- and middle-income countries, 63.2% of women of reproductive age were vitamin D deficient, 41.4% were zinc deficient, 31.2% were anemic, and 22.7% were folate deficient, and 15.9% were vitamin A deficient (5). Globally, 2 in 3 children do not have access to the minimum diverse diets needed for healthy growth and development (6). Micronutrient malnutrition has devastating consequences, including increased child mortality, poor child growth and mental development, increased vulnerability to infectious diseases, increased risk of diet-related chronic disease later in life, and a loss of human potential.

The COVID-19 pandemic has further exposed vulnerable populations to food insecurity and exacerbated nutrition challenges by disrupting food systems, reducing income sources, and widening gaps in coverage of essential health and nutrition services. Now is the time for the global nutrition community to deepen its commitment to designing long-term, sustainable reforms to ensure broad access to nutrient-rich diets and resilient food systems.

Micronutrient interventions are one of the world's most cost-effective public health solutions

And yet, we have evidence-based, cost-effective solutions available and ready to scale to reverse the impact of micronutrient deficiencies. In addition to promoting breastfeeding and healthy diets, there are a host of proven micronutrient interventions, such as bio-fortification, fortification, and supplementation. Such interventions are particularly valuable in countries where it might be challenging to improve access to or the availability of nutrient-rich diets or in stages in life when requirements are high and difficult to meet through the diet alone.

A 2021 Lancet series identified eleven ‘Samurai’ interventions that can improve health outcomes and save lives (7). At least eight of these interventions involve micronutrients:

1) vitamin A supplementation for children under the age of 5 years in deficient contexts,

2) preventive and

3) therapeutic zinc supplementation for the treatment of diarrhea,

4) breastfeeding promotion and counseling,

5) maternal calcium supplementation in low intake populations,

6) maternal multiple micronutrient supplementation (MMS),

7) large-scale food fortification, and

8) small-quantity lipid nutrient supplements for children 6-23 months of age.

And these interventions belong to the most cost-effective development solutions we have on hand. Economists have long hailed micronutrient supplementation and fortification and biofortification among the world’s best investments. The cost-benefit ratio for improved health and productivity for these three interventions is a minimum of $10 for every $1 invested, but as high as $55 for every $1 invested, depending on the particular intervention used (8) 

Mighty foods are rich in micronutrients

While several proven interventions – will improve micronutrient status, optimal micronutrient security should  also be supported by increasing availability, access and consumption of nutritious diets. Diets rich in nutrients require a diverse and sufficient daily intake of fresh fruits, vegetables, and meatYoung children are the most vulnerable to the consequences of poor diets and have the most difficulties fulfilling their high micronutrient needs from diets alone. Breastmilk is a critical source of micronutrients, especially during the first six months of life so adequate promotion and support of breastfeeding is important, after which the child should continue to get breastfed along with special, micronutrient-dense complementary foods up to at least two years of age. Inadequate nutrition in the first two years of life can cause delays in growth and development. 2021 UNICEF analysis of 91 countries found that half of children aged 6-23 months are being fed the minimum recommended meals per day. Only a third consume the minimum number of food groups they need for healthy growth and development (9). An insufficient intake of the essential nutrients found in vegetables, fruits, eggs, fish, and meat required for early growth and development puts children at risk for poor brain development, reduced learning, low immunity, increased infections, and ultimately death.

Additional Resources

References

  1. Committee on Micronutrient Deficiencies, Board on International Health, Food and Nutrition Board. Prevention of Micronutrient Deficiencies: Tools for Policymakers and Public Health Workers. Washington; 1998. 
  2. Food and Agriculture Organization of the United Nations (FAO). The State of Food Security and Nutrition in the World 2021. Rome; 2021. 
  3. Laborde D, Herforth A, Headey D, de Pee S. COVID-19 pandemic leads to greater depth of unaffordability of healthy and nutrient-adequate diets in low- and middle-income countries. Nat Food. 2021;2(7):473–5. 
  4. Osendarp S, Akuoku JK, Black RE, Headey D, Ruel M, Scott N, et al. The COVID-19 crisis will exacerbate maternal and child undernutrition and child mortality in low- and middle-income countries. Nat Food. 2021;2(7):476–84. 
  5. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51. 
  6. UNICEF. Food Systems for Children: UNICEF in Action for Food Systems Transformation. Geneva; 2021. 
  7. Heidkamp RA, Piwoz E, Gillespie S, Keats EC, D’Alimonte MR, Menon P, et al. Mobilising evidence, data, and resources to achieve global maternal and child undernutrition targets and the Sustainable Development Goals: an agenda for action. Lancet. 2021.
  8. Horton S, Alderman H, Rivera JA. The challenge of hunger and malnutrition. Copenhagen Consens. 2008;3–4. 
  9. UNICEF. Fed to Fail? The Crisis of Children’s Diets in Early Life. New York; 2021. 
  10. Victora CG, Christian P, Vidaletti LP, Gatica-Domínguez G, Menon P, Black RE. Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. Lancet. 2021.
  11. UNICEF. Coverage at a Crossroads: New Directions for Vitamin A Supplementation Programmes. New York; 2018. 
  12. de Benoist B, Andersson M, Takkouche B, Egli I. Prevalence of iodine deficiency worldwide. Lancet. 2003;362(9398):1859–60. 
  13. Patriota ESO, Lima ICC, Nilson EAF, Franceschini SCC, Gonçalves VSS, Pizato N. Prevalence of insufficient iodine intake in pregnancy worldwide: a systematic review and meta-analysis. Eur J Clin Nutr. 2021.
  14. Pearce EN, Lazarus JH, Moreno-Reyes R, Zimmermann MB. Consequences of iodine deficiency and excess in pregnant women: an overview of current knowns and unknowns. Am J Clin Nutr. 2016;104(suppl_3):918S-923S. 
  15. Iodine Global Network. Why Should We Eliminate Iodine Deficiency? 2021. 
  16. World Health Organization. Vitamins and Mineral Nutrition Information System (VMNIS). 
  17. Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) Project. Changing the Way We Think about Micronutrient Assessment and Anemia Programming. Findings from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia (BRINDA) Project. Arlington; 2017. 
  18. Shekar M, Kakietek J, Dayton Eberwein J, Walters D. An Investment Framework for Nutrition: Reaching the Global Targets for Stunting, Anemia, Breastfeeding and Wasting [Internet]. World Bank. 2016 [cited 2021 Nov 9]. Available from: http://elibrary.worldbank.org/doi/book/10.1596/25292
  19. Molloy AM, Kirke PN, Brody LC, Scott JM, Mills JL. Effects of folate and vitamin B12 deficiencies during pregnancy on fetal, infant, and child development. In: Food and Nutrition Bulletin. UnitedNations University Press; 2008.  
  20. Wessells KR, Brown KH. Estimating the global prevalence of zinc deficiency: results based on zinc availability in national food supplies and the prevalence of stunting. PLoS One. 2012;7(11):e50568. 
  21. Gupta S, Brazier AKM, Lowe NM. Zinc deficiency in lowand middleincome countries: prevalence and approaches for mitigation. J Hum Nutr Diet. 2020;33(5):624–43. 
  22. Scholl TO, Johnson WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr. 2000;71(5):1295S-1303S. 
  23. Peña-Rosas JP, De-Regil LM, Garcia-Casal MN, Dowswell T. Daily oral iron supplementation during pregnancy. Vol. 2015, Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd; 2015. p. 1–527. 
  24. Haggarty P. UK introduces folic acid fortification of flour to prevent neural tube defects. Lancet. 2021;398(10307):1199–201.

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