Malnourishment: A worldwide enemy

By Danuil Dueas

Worlds food supply is one of the most critical and challenging issues for humanity. Not only

is it threatened by an irrational misuse of natural resources, but also the rapid growth of

population raises a more demanding scenario. The current world population of 7.5 billion of

people will be increasing in more than 21% in the next 35 years. As a result, the current food

production must be doubled to satisfy the total demand (1) (2). It is estimated that about 36

million people will perish in 2017 due to hunger (3). However, another issue has been

gradually becoming serious for human health: malnourishment. Unfortunately, it has been

mainly neglected due to its not evident impact and relation with diseases. According to Dr

Michael Mosely, people could be not starving to death but their diets do not contain the

adequate nutrient-rich food (2). In fact, malnutrition affects 2 billion people a year, where the

most vulnerable population are the children under 5 years. Among other consequences, the

protein deficiency stunts their physical and mental development generating an impairment

social and decreasing the opportunities to overcome other challenges such as poverty and

inequality (4). Even though the poorer countries have been the most affected by

undernutrition, the diets based on high-processed food have caused that people in developed

countries like the United States of America are getting undernourished. Iron, iodine and

vitamin A deficiencies have been identified as the most frequent and noticeable impacts of

malnutrition. Europe presents the highest level of iodine deficiency of 57% affecting about 436

million people, whereas Asia exhibits an iron and vitamin A deficiencies of 57% and 69%,

respectively, affecting more than 780 million people (5). The evolution in the understanding of

the malnutrition-related diseases have led the world community to strengthen the efforts to

combat malnourishment by using solutions such as food fortification, insects eating and

synthetic food. These complementary strategies are briefly described below.

Food fortification refers to the improvement of the nutrient content of the food by adding

proteins, vitamins or minerals into it (5). This process has been widely used for almost 100
years as a preventive tool for some specific micronutrient deficiencies. In the 1920s, it was

implemented by both the United States of America and Switzerland as a strategy to improve

the iodine levels in the population with successful results. From that period on, it became

common practice, including cereal fortification, in almost all countries (5). There are two

techniques of food fortification: traditional food fortification and biofortification. The former is

performed by adding nutrients into the food while it is produced. Depending on the type of

food, this process can be classified into three categories: Universal fortification, process of

adding micronutrients into staple food, i.e. potatoes, rice, and grain, and it is commonly

implemented by governments. Targeted fortification, in order to increase the consumption of

some nutrients in a specific vulnerable population, particular foods are fortified, for example,

the food used in school feeding programmes or special biscuits for pregnant women. Free-

market fortification, it refers to the process of fortifying non-staple food. This type of fortification

can play an important role as a complement for the universal fortification. The main advantage

of the traditional fortification is that it is designed to provide the proper amounts of compounds

and cover the majority of a population. However, its principal limitation is that it depends on

the distribution channels which are not regularly well developed in developing countries (5).

On the other hand, biofortification is the process of improving the levels of a specific nutrient

in a crop by using selective breeding or genetic modification. Selective breeding is a technique

that involves the selection of some plants that already have an amount of the desired nutrient

and then they are bred for several generations until obtaining the required level of the

compound. Genetic modification consists of the insertion of one or more properly cultivated

and multiplied genes into the DNA of the crop to make it metabolize the required nutrient. Its

main advantage is its sustainability, once the crop is designed, it can be used by farmers to

cultivate for years. However, environmentalist consider that it is not a solution for poverty and

its results can be unpredictable, making food harmful for humans (6) Food fortification is

considered to be implemented as a complementary strategy with other solutions, such as

nutrition education to improve the diet diversity, in a robust nutrition scheme.

regular diet of about 2 billion people, are insects (2). According to Dr. Marce Dicke (2), insects

consist of 50% protein and substantial levels of zinc, iron, and magnesium. Therefore, they

might eventually replace beef in a normal diet. In fact, in countries like Thailand, there are

about 20.000 insects farms, and bugs, such as weaver ants, are essential ingredients of

traditional dishes. Similarly, in Japan, Malawi, and Africa, wasp larvae, cicada and termites

are highly desirable. In addition, currently, the growing list of edible insects includes over 1900

species (7). Sustainability and lower investment are the most relevant benefits of

entomophagy. In fact, producing a determined amount of insect meat requires 10 times less

feed than conventional meat, and it also produces fewer contaminants emissions than

livestock industry, reducing the devastating impact on the environment. However, the general

psychological perception of insect eating arises as its major limitation. This perception has

been developed for centuries and supported on the apparent relation between insects with

waste, dirt and disease. Consequently, the insect food industry has been slowly introducing

the insect supplement as an ingredient in common and popular products. For example, in the

US, a company created cricket-based crisps. Other cases can be found in the UK, Belgium

and Netherlands, where insect-based food have been well received. Although, entomophagy

is not a new concept as it is mentioned in the bible and some ancients Greek and Roman

texts, its industrialization is still at initial stage (7). Nevertheless, the main limitation of this

practice is that not all insects are safe for human consumption. As they are raised and fed with

waste and animal manure, dangerous amounts of fungus, bacteria, and even drugs (present

in the animals) can be stored in the insects bodies, representing a potential risk for people

health (7).

Beyond growing cells in the lab, which has been possible for more than a century, growing

synthetic meat is a novel strategy to produce and supply food. This biotechnological process

involves the extraction of stem cells, also called myo-satellite cells, from an animal, then those

are cultivated in a nutrient bath and grown into muscle tissue. Scientist try to replicate the
natural growth in animal by using electrical, physical and chemical procedures to simulate

exercise and stimulate the generation of tissue. At a final stage, nutrients and flavour are

added to produce edible meat. Currently, efforts are focused on developing new technology

that allows scientist to production large-scale meat at low prices. The benefits of this potential

solution to food supply include: reduction of the carbon footprint associated to conventional

meat production, which produces more greenhouse gases than all means of transportation, it

also might reduce the bacterial contamination and is more hygienical, and the content and

type of fat can be designed to meet the healthy limits. However, this cellular agriculture has

generated a lot of concern due to the possible arising of monopolies which might control all

the production. In addition, although, animals-free broths such as mushrooms and algae have

been evaluated, their cost are too elevated to be commercial. Consequently, it is estimated

that the first generation of synthetic meat might cost up to twice the price of conventional meat.

(8).

Summarizing, malnutrition has a huge impact on the world health, affecting mainly children

under five years with preventable diseases. The rapid population growth and the improvement

of income represent a challenging scenario for the food supply in the next decades. The most

likely solution to generate the most noticeable impact in the medium term is the insect-eating

movement, because it generates a reduced carbon footprint and provides a nutrient-rich diet

notwithstanding the complexity involved in its implementation. However, each population

needs to be assessed to identify its conditions and design a robust nutrition programme to

supply high-quality and accessible food.

2 Mullins B. Youtube. [Online].; 2016 [cited 2017 September 17. Available from:
. https://www.youtube.com/watch?v=qA5SNqTsNbY.

3 The World Counts. [Online].; 2017 [cited 2017 September 17. Available from:
. http://www.theworldcounts.com/counters/global_hunger_statistics/how_many_people_die
_from_hunger_each_year.

4 Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030.
. Washinton: International Food Policy Research Institute; 2016. Report No.: 2380-6443.

5 Allen L, De Benoist B, Dary O, Hurrell R. Guidelines on food fortification with

6 Gearing ME. Science in the News. [Online].; 2015 [cited 2017 September 17. Available
. from: http://sitn.hms.harvard.edu/flash/2015/good-as-gold-can-golden-rice-and-other-
biofortified-crops-prevent-malnutrition/.

7 Anthes E. The Guardian. [Online].; 2014 [cited 2017 September 17. Available from:
. https://www.theguardian.com/news/2014/oct/30/-sp-how-insects-could-feed-the-world.

8 Allison N. Science in the News. [Online].; 2011 [cited 2017 September 17. Available from:
. http://sitn.hms.harvard.edu/flash/2011/issue90/.