Public Health Interventions to Combat Micronutrient Deficiencies

Abstract

Micronutrient defi ciency conditions are global in scope, with developing countries suffering most from such "silent epidemics". There are several different approaches to combating micronutrient malnutrition at the level of populations and vulnerable groups. We review these briefl y with attention to successes, advantages and disadvantages. We recommend active governmental leadership and policy review on a continuing basis to address these fundamental public health problems.

What is the “New Public Health”?

“…New scientifi c and policy advances hold promise in the use of nanotechnologies, new methods of early detection, management, prevention and treatment methods (e.g., micronutrient fortifi cation of basic foods and vitamin and mineral supplements, fruit and vegetable access) of cancers, and new social and urban planning approaches (e.g., recreational opportunities, access to healthy foods) to reduce the harmful effects of poverty. 13,[29][30][31] Advances in science have contributed both to increasing costs of new technologies, and also to cost containment through advances such as eradication or control of many infectious diseases (e.g., smallpox, soon hopefully, poliomyelitis, measles), and major reductions in infectious conditions leading to chronic diseases such as rheumatic heart and peptic ulcer diseases. New methods of payment and management in health systems are also vital to maintaining and promoting health within sustainable economic capacity of a country.…”

“…However, some 47 million Americans suffer from a lack of health insurance due to the loss of employment or the presence of pre-existing health conditions. 20,29 Current health insurance reforms initiated by President Obama will alleviate some of the inequalities in access to care in the coming years. This will require functional and administrative linkages or integration in an organized systems context, so there is seamless provision of services for the population and the society.…”

“…29 Since then, new micronutrient defi ciency conditions have been identifi ed, such as those concerning folic acid and vitamin D. Fortifi cation of basic foods with essential trace elements has become part of high quality public health practice, to reduce the burden of disease. 60,61 Gradual reduct ion in micronutrient defi ciency conditions such as goiter, rickets, and vitamin A defi ciency have been of great benefi t to child health in many parts of the world.…”

Editorial: Why an Issue on the New Public Health?

“…[14][15][16][17] Theodore Tulchinsky, Gail Harrison, Michael Holick, and Godfrey Oakley address important fl agship issues in public health nutrition, especially fortifi cation of basic foods, focusing on folic acid, vitamin B12, and vitamin D defi ciency. The advantages and shortcomings of supplementation and fortifi cation programs are reviewed.…”

Applying the food multimix concept for sustainable and nutritious diets

“…Similarly, protein, vitamins A, B 6 , B 12 and E; and the minerals iron, copper and zinc which play various important roles in the formation of healthy erythrocytes and preventing anaemia (19,20) can be extracted from a combination of plant and animal-based food ingredients. Thus employing a food-based approach to prevent and/or address nutritional needs of vulnerable groups is a more cost-effective and sustainable means to improve nutrition in poor communities (21)(22)(23)(24) . Conversely, a meal which focuses on ingredients providing one or two nutrients but lacks diversity does not create a balance involving other nutrients and will not provide the full complement of nutrients required for optimum health.…”