Micronutrient deficiencies: the socio-economic case for supplementation in mothers

This was the key message from the presentation given by Martin Mwangi, program lead for the ‘Healthy Mothers Healthy Babies’ programme at the Micronutrient Forum​, during IADSA's ​World Supplement Forum last week.

He highlighted that a recent report​ had noted a substantial global micronutrient deficiency prevalence of 1.6 billion within preschool-aged children and women of reproductive age. He noted such deficiencies were substantial within both high and low-income countries, with one in two women of reproductive age deficient in the UK.

Such deficiencies were estimated​ to translate to yearly losses of $3 trillion in terms of workplace productivity, yet supplementation for mothers with MMSs are predicted​ to add 5 million additional school years, as well as $18 billion in cumulative lifetime income.

Mwangi stressed: “We believe to have a healthy baby, you first need a very healthy mother. So, the entry point is through the mother. And therefore, we need to look at the micronutrients and what we need to do at that level.”

He emphasised the importance of the government, NGOs, and academics to unite against this global burden: “Everyone has a piece of the puzzle. But often these players are silent. The problem is that we spend decades talking about solutions but doing nothing about it.

“For example, if we look at rates of anaemia, for the last 40 years we have not had an impact on anaemia for women. Why is that? The supplement for that is on the table,” he added.

Deficiency prevalence​

Describing the importance of micronutrients, Mwangi explained: “They are small and compact food elements, which are important for brain development, physical growth, and immune function.”

He highlighted a recent report​ collating population-based survey data on global micronutrient deficiency prevalence, which is noted to be the first of its kind. Focusing on preschool-aged children and women of reproductive age, due to data availability, it was found that 1.6 billion of this population had micronutrient deficiencies worldwide.

This is observed to translate to one in two preschool-age children and two in three women of reproductive age, highlighting a “unacceptably high” global prevalence.

“On a global level, we have at least 1.2 billion non-pregnant women with deficiencies in one or more of three core micronutrients. Therefore, there is a case to be made for supplements,” he emphasised.

Causes and repercussions ​

Mwangi specified the root cause of such widespread deficiencies to be due to the inaccessibility​ of healthy diets, with 122 million more people unable to afford such diets in 2021 when compared to 2019.

He stressed that climate change may further threaten micronutrient status, with rising temperatures altering nutrient value of many crops, as well as sea levels threatening agricultural land.

Listing the health implications of micronutrient deficiencies throughout the life stages, he spotlighted increased risks​ of anaemia, low birth weights, growth and cognitive development disorders, poor immune system, and high morbidity.

In order to achieve real change, he explained the importance of demonstrating the economic losses for the country to policy makers.

As an example, Mwangi specified that physical productivity losses due to iron deficiencies have been linked to potentially billions of dollars worth of GDP (measure of the market value of all the final goods and services produced in a country) annually: “If you are iron deficient, I can assure you that your productivity is reduced. Therefore, you have a loss of income, resulting in a loss of capital. This can also happen as a baby, impairing cognitive development, leading to learning constraints, and again a loss of human capital.”

“Our economy and society is paying three trillion USD a year from this productivity loss,” he emphasised.

Solution​

In addition to dietary diversity, Mwangi highlighted the proven effects of supplementation during times of heightened need, such as with single nutrients including high-dose vitamin A in children under five, which has demonstrated​ a 12-24% reduction in all-cause mortality. He adds that intervention with multiple micronutrient supplements (MMS) within pregnant women resulted in an 8% reduced risk of still birth, as well as a 12% reduced risk of low birth weight.

One such supplement, the UNIMMAAP MMS​, developed as part of a comprehensive antenatal care program, contains 15 essential vitamins and minerals. A report ​by Unicef stated the supplement is one of the most impactful nutrition interventions to improve maternal health and birth outcomes.

“Why have we denied these mothers this life-changing intervention? It’s not only for them, but also for their babies,” he emphasised.