The modeling analysis, published in The Lancet Global Health, is reportedly the first to use dietary estimates to evaluate global inadequacies in micronutrient intakes.
Led by scientists from the Harvard T.H. Chan School of Public Health, the study revealed inadequate intakes of key nutrients, including folate, vitamin C, calcium, iron and magnesium. According to the researchers, it shows “empirically that most of the global population has inadequate intake of at least one micronutrient. ”
Fortification inequalities
Folate is a key nutrient for pregnant women to avoid complications such as neural tube defects (NTD) and pregnancy loss. The new figures spotlight folate fortification initiatives, which are still absent in some countries.
“These findings emphasize the pressing need for countries to mandate and effectively monitor the fortification of staple foods with micronutrients like folic acid,” Jessie Genoway, communications director for the Food Fortification Initiative (FFI), told NutraIngredients.
“Large-scale food fortification with folic acid is a powerful and safe nutrition strategy practiced in approximately 70 countries worldwide. Fortification with folic acid saves lives.”
FFI advocates fortifying milled wheat flour, maize flour and rice to address the global burden of micronutrient deficiencies.
A study using FFI data revealed that in 2022, 63,520 cases of folic acid-preventable spina bifida and anencephaly (FAP SBA) were prevented in 68 countries that implemented mandatory folic acid fortification of grains, translating to 23.7% prevention of FAP SBA globally.
Study details
The study used data from the Global Dietary Database (GDD) to estimate intake inadequacies for 15 micronutrients across 34 subnational age-sex groups in 185 countries. Estimates were based on nutrient intake from food, excluding fortification and supplementation.
Findings revealed that more than 5 billion people do not consume enough iodine (68% of the global population), vitamin E (67%) and calcium (66%).
Additionally, more than 4 billion people do not consume enough iron (65%), riboflavin (55%), folate (54%) and vitamin C (53%).
Globally, women had a higher prevalence of inadequacy for iodine, vitamin B12, iron, selenium, calcium, riboflavin and folate. Men had higher intake inadequacy for magnesium, vitamin B6, zinc, vitamin C, vitamin A, thiamin and niacin.
The researchers commented that the sex-specific differences may be due to differing dietary patterns, requirements and consumption quantities.
“We hope this analysis sheds light on crucial nutrition challenges for locations without the necessary means to collect primary data and improves understanding of global micronutrient inadequacy so that public health interventions can more effectively address deficiencies,” they concluded.
5-MTHF
While fortification initiatives usually focus on folic acid (the synthetic form of folate), there has been a growth in interest in folate’s active form, 5-methyltetrahydrofolate (5-MTHF). This active form functions as part of the methylation cycle, keeping oxidative stress and homocysteine in check.
Gnossis by Lesaffre markets 5-MTHF under the brand name Quatrefolic. Commenting on the new analysis, Jean Francois Jeanne, manager of the Gnosis substantiation team, said: “The high number of people—especially women—living with folate inadequacy is both surprising and somewhat disheartening, considering how many countries have implemented folate fortification programs.
“At the same time, this substantiates the need for products containing adequate folate amounts, in its active form 5-MTHF, to ensure improved intake across all populations”.
Source: The Lancet Global Health
Volume 12, Issue 10e, 1590-e1599, doi: 10.1016/S2214-109X(24)00276-6
“Global estimation of dietary micronutrient inadequacies: a modelling analysis.”
Authors: Passarelli, S. et al.
