Eliminating hidden hunger through cross-sector partnerships

By Petra Klassen, Janet Voûte 22 January 2016

A woman sells iron- and iodine-fortified stock cubes at a market in Nigeria.Over 30 percent of the world’s population suffer from micronutrient deficiency. Photo by: Nestlé / CC BY-NC-ND

An estimated 2 billion people — over 30 percent of the world’s population — suffer from deficiencies in essential vitamins and minerals. “Hidden hunger” is how health experts often refer to micronutrient deficiencies because most people affected do not show the visible physical symptoms and hence may not be aware of their condition.

However, the consequences of hidden hunger can be devastating, leading to mental impairment, poor health, low productivity and in severe cases, death. Even mild to moderate deficiencies can affect a person’s well-being and development. Hidden hunger disproportionately affects infants, young children and women, preventing them from achieving their full potential in life.

Putting an end to this situation is within our reach. Proven, low-cost solutions can be implemented but we will only be successful if governments, civil society and the private sector build on each other’s know-how to close the nutrient gap.

A role for industry

In an ideal world, people would obtain essential nutrients from a balanced and varied diet. However, this is not always possible, particularly for poorer populations. Micronutrient fortification is a cost-effective way to address hidden hunger alongside efforts towards diversifying diets.

Staple food fortification programs — such as adding iron and folic acid to bread, or vitamin A to cooking oil and sugar — have been very successful in reducing the disease burden from micronutrient deficiencies.

Yet, many young children and women still fail to fill their nutrient gap because they do not get to eat enough nutritious food. The food and beverage industry can help tackle this major global health problem by adding relevant micronutrients to foods and beverages that people already enjoy eating.

In Cote d’Ivoire, for example, Nestlé’s iron-fortified bouillon cubes are estimated to have helped reduce iron deficiency anemia by 5-8 percent.

Joining forces to overcome challenges

Reaching the people who will benefit the most is the biggest challenge we face. In the Philippines, a study of the use of fortified foods to address iron deficiency in infants and young children concluded that the most cost-effective interventions are those targeting the poorest 20 percent of the population. However, it’s difficult to reach mothers, young children, the rural areas and the very poor through the existing way products are marketed. We could more efficiently reach them with fortified foods by increasing collaboration with governments in social programs, as well as humanitarian organizations.

Balancing taste and nutrient value is also challenging because often people first buy a product because it tastes good and then look for an added value. It can be tricky to fortify foods without impacting their taste and appearance, while ensuring the nutrients are being well absorbed by the body. Companies can support governments and civil society’s efforts by investing in R&D and by educating consumers about the benefits of fortified foods.

Finding the right level of fortification to improve health can also be complex. The aim is to fortify foods and beverages at levels that are sufficient to make a positive impact on health, while ensuring that they will not lead to over consumption of vitamins and minerals as part of a varied diet. This is why working with health authorities to establish fortification standards and monitor the impact of food fortification programs is crucial.

Aiming to reach vulnerable populations

To achieve the biggest impact, it is important to fortify a range of popular and affordable products that fit into people’s existing eating habits. Foods chosen to carry nutrients should be those consumed widely and frequently. Good examples are condiments, such as soy and fish sauce, bouillon cubes and seasoning.

For instance, in China, 20 companies joined hands with the government to promote the consumption of iron-fortified soy sauce, which led to an average 30 percent reduction in anemia rates among the targeted 50 million residents within three years. Other good vehicles are fortified complementary foods that showed strong protective effects against anemia in the critical window of 12-17 months of age in a recent analysis done in India.

Besides the improvement of health outcomes in vulnerable populations, micronutrient fortification makes good business sense too. We call this “Creating Shared Value,” creating value for our shareholders, while at the same time creating value for the societies in which we operate. In 2014 we delivered 183 billion servings of food fortified with at least one of the “big four” (iron, iodine, vitamin A and zinc) and we are on target to meet our public commitment to deliver 200 billion by the end of 2016.

Ending hidden hunger is an achievable goal

Eliminating malnutrition is a top priority in the global development agenda and is the second of the United Nation’s Sustainable Development Goals. Business has a role to play as we have the ability and responsibility to contribute towards ending hidden hunger. This is one of the recommendations made in the 2016 Access to Nutrition Index. The private sector can work together with governments and civil society to develop new models to make tasty, nutritious and affordable foods accessible to the people who need them. It’s a win-win investment and the next generation deserves all of our efforts to provide them a healthy future.

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About the authors

Oped petraklassen ed
Petra Klassen

Dr. Petra Klassen holds a Ph.D. in nutrition from the University in Hohenheim, Stuttgart, Germany. In November 2013, she joined the Nestlé Corporate Nutrition, Health and Wellness Unit as scientific advisor working on strategic corporate initiatives such as the Micronutrient Fortification Strategy or United for Healthier Kids, an initiative aiming at helping parents to improve the eating, drinking and lifestyle habits of children, from conception to 12 years of age.


Oped janetvoute ed
Janet Voûte

Janet Voûte became responsible for Global Public Affairs at Nestlé in December 2010. She chairs the Nestlé Creating Shared Value Council, is a member of the internal Nestlé-in-Society Board and is responsible for driving Creating Shared Value including reporting, the Global CSV Forum and Stakeholder engagement. Mrs. Voûte also plays a leading role in Nestlé’s engagement to address the double-burden of malnutrition.


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