Billions of people suffer from a kind of hunger that they do not feel, and this is referred to as hidden hunger. This hunger refers to the inadequate intake of vitamins and minerals that are vital for the body to function properly. You might think that this only happens in developing countries, but this is also rather prominent in well-to-do, developed countries like Singapore.
What is hidden hunger?
When the deficiency becomes severe, it no longer becomes hidden. Deficiency in vitamin C causes scurvy and appears in the form of general fatigue, swelling of limbs and skin problems that cause bruise-like spots to form on the skin. Vitamin A on the other hand is important for many bodily functions such as a strong immune system and proper vision. A lack of this vitamin can result in dry skin and dry eyes and some cases, it can lead to night blindness. These deficiencies and their symptoms are just the tips of the iceberg as there are many essential vitamins and minerals that our body needs and yet we go about our day not knowing if our daily meals are meeting the daily requirements. We may only require small amounts of these micronutrients and yet, these vitamins and minerals are crucial for our basic physiological functions such as metabolism, growth, and development. Being deficient in one or more micronutrients may result in detrimental health impacts and increase our risk of chronic diseases.
For decades, health organisations have been reporting on micronutrient malnutrition, including deficiencies in iodine, iron, folate, vitamin A, and zinc, which continue to be prevalent worldwide. National Health and Nutrition Examination Surveys (NHANES) suggest that micronutrient malnutrition is common in the United States with an estimated 31% of the population at risk of developing one or more micronutrient deficiencies.
The salads that we eat today are probably not as nutritious anymore, as compared to decades ago. This is due to soil depletion – where modern agricultural methods have stripped the nutrients out of the fruits and vegetables that are grown, in exchange for faster-growing and more pest-resistant crops. Not forgetting the fast-paced society that we live in; it is not surprising that one would experience stress and anxiety daily. This takes a toll on our body and causes us to turn to unhealthy habits to de-stress such as alcohol, smoking or even medications to feel better. We look for a quick fix to satisfy our hunger so that we can quickly get back to our work desks, and these food choices are often not the most ideal. All these factors have made it almost impossible for us to get all the vitamins and minerals we need solely from the food we eat.
As the famous Chinese philosopher Sun Tzu once said, “Know yourself and you will win all battles”.
So, let us answer some of these questions.
Uncover the hidden
How do you tell if someone is nutritionally hungry/deficient?
While each nutrient has its own distinct set of symptoms, some carry across almost all deficiencies. These include:
- General lethargy, tiredness, aches, and pains
- Increased anxiety and restlessness
- Brittle hair, hair loss and nails
- Brain fog
While each nutrient has its own distinct set of symptoms, some carry across almost all deficiencies. These include: While this is not an exhaustive list, it is also important not to pass off these symptoms as something that you experience on a bad day. These symptoms are often clues to something deeper going on in the body.
How common is it for Singaporeans to actually have hidden hunger?
One cause of hidden hunger is an unbalanced diet. According to Biesalski, one-third of the world’s population currently consume approximately 80% of the calories they need from staples such as rice, corn and wheat alone. While those cereals contain important macronutrients (fat, protein and carbohydrates), they hardly include any micronutrients (vitamins, minerals, trace elements and certain amino acids). Biesalski stresses that both nutrient groups are vital.
Macronutrients are the energy-yielding components of food, while micronutrients are essential for many metabolic processes and bodily functions without providing energy. The human body has a very effective signalling mechanism to prevent macronutrient deficiencies – it makes us feel hungry – but scientists are so far not aware of endogenous alarm signals for a lack of essential micronutrients.
Combined US reports indicate that micronutrients, such as magnesium, calcium, potassium, iron, and vitamins A, D, and C, are under-consumed by children and adults in the US relative to dietary guidelines and the estimated average requirements. The overall high-calorie, low-nutrient quality of the commonly consumed Western-type diet, comprising more processed foods and fewer vegetables, is one important component of this nutritional issue. Furthermore, analyses of surveys suggest that certain sub-populations in the US are more vulnerable to micronutrient deficiencies or may have an increased micronutrient need. These sub-groups are:
One of the sub-groups that is more vulnerable to micronutrient deficiencies is women who are looking to bear a child. (Photo credits: pexel.com)
- Individuals with low-nutrient diets or on restrictive diets
- People of low socio-economic status or those experiencing food insecurity
- Women, particularly those of child-bearing age
- Older adults
- Individuals with certain medical conditions or disease states
In addition, long-term users of medications may also experience interference with their body’s ability to absorb and benefit from the nutrients found in foods. Potential drug-nutrient depletions have been noted for commonly prescribed pharmaceuticals with micronutrients such as magnesium, calcium, B vitamins (B12 and folate), potassium, and zinc most often mentioned as potentially impacted.
How dangerous is it to have hidden hunger?
The long-term consequences of malnutrition and hidden hunger in the developed world are significant. For example, inadequate intake of vitamin D alone increases the risk of fractures, weak muscles, development of cancers such as breast cancer and prostate cancer and several
autoimmune diseases such as multiple sclerosis, rheumatoid arthritis and type-1 diabetes. An unhealthy, unbalanced diet full of saturated fats, sugars and salts may contribute to a wide range of diseases such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. Simply put, having hidden hunger in the long run, will predispose one to chronic health diseases and lead to decreased physical performance.
What can we do to take note of it?
Evaluating nutrient deficiencies is vital during clinical intake assessments to determine the underlying causes of chronic symptoms or conditions. Due to the essential nature of micronutrients at the cellular level, addressing one or multiple deficiencies has the potential to resolve many health issues, be it in part or completely. Personalised nutrition can help in assessing what an individual lacks and thereby come up with strategies to tackle the issue in the form of supplementation, new dietary habits or structured food plans.
The Functional Medicine Model uses a framework that prioritises a comprehensive view of a patient’s historical and current conditions, including nutrition intake and dietary patterns, to determine appropriate interventions for each individual. The Functional Medicine approach also emphasises a practitioner-patient collaboration to fully involve the patient in their treatment plan and to support them during their journey to wellness. As each individual is uniquely different, this approach takes into account an individual’s genes, environment and lifestyle and treatments are suggested based on that profile to ensure the last benefits of the treatments.
Dr Menka Gupta
IFMCP, MSc, MBBS
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