Hidden hunger - a narrative review

Abstract Objective Malnutrition is characterized by situations of undernutrition and obesity resulting from the lack of micronutrients with the greatest impact on children. The objective of this review was to highlight inadequate food consumption, food security, and nutritional inadequacy leading to hidden hunger and the prevention and treatment of the main micronutrient deficiencies in Brazil. Data source Literature review carried out through a bibliographic survey in PubMed (National Library of Medicine, United States), Lilacs (Latin American and Caribbean Literature in Health Sciences), and SciELO (Scientific Electronic Library Online) databases. The search used the terms Occult hunger, (hidden hunger), and Child, in articles published between 2013 and 2023 in Portuguese, English and Spanish. The search was performed on 06/25/2023. Data synthesis The lack of micronutrients can occur insidiously and without clinical manifestations, being called hidden hunger. The prevention of nutritional deficiencies is part of the recommended actions in childcare, with healthy eating. Studies were cited related to macro and micronutrient intake deficiencies, both national and international, and strategies to improve micronutrient intake, including routine supplementation of iron, and vitamins D and A. The diagnosis, prevention, and treatment of the main deficiencies in Brazil (iron, vitamin A, vitamin D, zinc), currently adopted, concluded the topic. Conclusion Zero hunger and zero obesity must be part of the same policy, together with a nutritional education program.

Seguridad alimentaria y fortificación de alimentos a base de pulpa de café en tiempos pandémicos

Introducción: la pandemia de COVID-19 originó pérdidas humanas, tensiones en la atención médica, la economía y otros sistemas sociales. Objetivo: recopilar información sobre seguridad alimentaria y fortificación de alimentos a base de pulpa de café considerando que una buena nutrición contrarresta las infecciones. Metodología: se analizó literatura en las bases SciELO y SCOPUS restringiendo términos de búsqueda a: seguridad alimentaria, COVID-19, tecnología de bloques o blockchain, suministro alimenticio, micronutrientes, regulación, fortificación con hierro con énfasis en productos a base de pulpa de café. Resultados: en tiempos de pandemia y otros desastres, uno de los factores que afectan la respuesta de un huésped al virus es la nutrición, la seguridad alimentaria es importante especialmente en países con altas tasas de desnutrición y anemia, por ende, es fundamental la fortificación de alimentos comunes para contribuir en garantizar la adecuación nutricional como parte de las respuestas de los gobiernos, especialmente en áreas rurales y urbanas empobrecidas, planteándose sistemas de suministro de alimentos con la tecnología de bloques o blockchain. Conclusión: la fortificación de productos alimenticios a base de pulpa de café y el suministro que aplique tecnología de bloques podría ser una estrategia de respuesta a las consecuencias de la pandemia

SUMMARY Introduction: The COVID-19 pandemic caused human losses, tensions in medical care, the economy and other social systems. Objective: To collect information on food safety and fortification of foods based on coffee pulp, considering that good nutrition counteracts infections. Methodology: Literature in SciELO and SCOPUS bases was analyzed, restricting search terms to food safety, COVID-19, block chain technology, food supply, micronutrients, regulation, iron fortification with emphasis on coffee pulp-based products. Results: In times of pandemic and other disasters, one of the factors that affect the response of a host to the virus is nutrition. The importance of food security is recognized with proposals especially in countries with high rates of malnutrition and anemia, for the fortification of common foods to contribute to guaranteeing nutritional adequacy as part of the governments' responses, especially in impoverished rural and urban areas, considering food supply systems with block or Block Chain technology. Conclusion: The fortification of food products based on coffee pulp and their supply using block chain could be a response strategy to the consequences of the pandemic.

Introdução: a pandemia de COVID-19 causou perdas humanas, tensões na assistência médica, na economia e em outros sistemas sociais. Objetivo: coletar informações sobre segurança alimentar e fortificação de alimentos à base de polpa de café, considerando que uma boa nutrição combate infecções. Metodologia: a literatura foi analisada nas bases de dados SciELO e SCOPUS, restringindo os termos de busca a: segurança alimentar, COVID-19, tecnologia de bloco ou blockchain, abastecimento de alimentos, micronutrientes, regulação, fortificação de ferro com ênfase em produtos à base de polpa de café. Resultados: em tempos de pandemia e outros desastres, um dos fatores que afeta a resposta de um hospedeiro ao vírus é a nutrição, a segurança alimentar é importante principalmente em países com altos índices de desnutrição e anemia, portanto, a fortificação é essencial dos alimentos comuns para ajudar a garantir a adequação nutricional como parte das respostas governamentais, especialmente em áreas rurais e urbanas empobrecidas, considerando sistemas de abastecimento de alimentos com tecnologia block ou blockchain. Conclusão: a fortificação de produtos alimentícios à base de polpa de café e abastecimento aplicando tecnologia de blocos pode ser uma estratégia de resposta às consequências da pandemia.

Ciência da disseminação em DOHaD para a promoção da saúde nas futuras gerações / Dissemination Science in DOHaD for health promotion in future generations

Após o reconhecimento de princípios evolutivos e da epigenética associada à plasticidade do desenvolvimento, a ciência de DOHaD (Origens Desenvolvimentistas da Saúde e Doença) floresceu. Segundo DOHaD, a exposição a condições adversas no início da vida, como a subnutrição, leva a respostas adaptativas para aumentar as chances de sobrevivência imediata e posterior, as quais podem aumentar o risco de doenças crônicas não transmissíveis (DCNT) no curso da vida. Outros insultos como obesidade (materna e paterna) na preconcepção e gestação, diabetes gestacional, aleitamento e a alimentação inadequada na infância podem induzir respostas não adaptativas e aumentar o risco de doenças, independentemente do ambiente posterior. A exposição à desreguladores endócrinos, substâncias tóxicas e poluentes também podem ter efeitos de longo prazo. Esses efeitos são mediados por alterações epigenéticas, as quais se tornam mais sensíveis nesse período crítico de desenvolvimento de intensa reorganização. Diante da transição nutricional e coexistência das diferentes formas de desnutrição nos países de baixa e média renda (PBMR); do aumento global das DCNT, cujo impacto social e econômico é maior nesses países; da fraca contribuição de fatores genéticos fixos na etiologia dessas doenças; e da ineficácia das atuais intervenções, a implementação de DOHaD representa uma estratégia potencial para beneficiar as futuras gerações. Considerando que a disseminação de DOHaD não têm acompanhado seu florescimento científico, esse trabalho teve como objetivo o desenvolvimento de um ebook direcionado para nutricionistas e um artigo relativo aos impactos da pandemia de COVID-19 na perspectiva de DOHaD, a fim de aproximar a ciência destes profissionais e fomentar sua implementação. Trata-se de uma revisão narrativa de literatura a partir artigos científicos em inglês e português, publicados nas bases de dados SciELO, PubMed e BVS, sem limite de data. O trabalho evidenciou que o desafio da dupla carga de doenças e das diferentes formas de desnutrição nos PBMR, foi agravado pela pandemia, tornando imperativo medidas de intervenção por seu provável impacto no ciclo intergeracional de DCNT e desenvolvimento dos países. A aproximação dessa ciência do nutricionista, propicia uma formação mais ampla e integrativa, através de capacitação técnica e habilidades interpessoais, capazes de acionar as fragilidades biopsicossociais, e melhor intervir, equacionando resultados de curto e longo prazo, a fim de interromper o ciclo intergeracional de DCNT, assim como otimizar o capital humano, a capacidade de produção e renda da futura geração. Conclui-se que o material desenvolvido é de grande valia, dado que a disseminação desse conhecimento deve se estender aos nutricionistas de todas as áreas e ser multiplicado

After evolutionary and epigenetics principles associated with the plasticity of development were recognized, DOHaD (Developmental Origins of Health and Disease) science flourished. According to DOHaD, the exposure to adverse conditions at the beginning of life, like undernutrition, leads to adaptive responses to increased immediate and later odds of survival, which may increase the risk of noncommunicable diseases (NCD) during life. Other conditions such as obesity (maternal and paternal) in preconception and pregnancy, gestational diabetes, lactation, and inadequate nourishment during infancy can induce non-adaptive responses and increased risk of diseases, regardless of the upcoming environment. The exposure to endocrine disruptors, and toxic and pollutant substances can also have long-term effects. Those effects are mediated by epigenetic changes, which become more sensitive during this critical period of development under intense reorganization. Considering the nutritional transition and coexistence of the different forms of undernutrition in the low- and middle-income countries (LMIC); the global increase of NCDs, with a higher social and economic impact in those countries; the weak contribution of fixed genetic factors in the etiology of those diseases; and the inefficacy of current interventions, the implementation of DOHaD represents a potential strategy to benefit future generations. Considering that the dissemination of DOHaD have not followed its scientific progress, the goal of the present work was to develop an e-book targeting nutritionists and an article about the impacts of the COVID-19 pandemic in the perspective of DOHaD, intended to drive the science closer to those professionals and foster its implementation. It is a narrative review of the literature regarding scientific articles published in English and Portuguese on the data bases SciELO, PubMed and BVS, with no date limit. The work has highlighted that the challenge of the double burden of the diseases and the several forms of undernutrition in the LMIC, was aggravated by the pandemic, making intervention measures imperative due to its likely impact on the intergenerational cycle of NCD and the development of countries. By inching closer to nutritionists this science provides larger and more integrative education through technical training and interpersonal abilities that help activate biopsychosocial fragilities, and better intervention; providing short- and long-term results aiming to interrupt the NCD intergenerational cycle, as well as optimize the human capital, the work and income capacity of the future generation. It is concluded that the material developed is of great value, given that the dissemination of this knowledge should reach all nutritionists from all areas and be multiplied

La perspectiva histórica y el análisis crítico en el abordaje del desafío alimentario y social del hambre oculta / The historical perspective and critical analysis in addressing the food and social challenge of hidden hunger

El trabajo plantea la necesidad de abordar el hambre oculta a partir de los retos alimentarios y la casuística socioeconómica que la explican. Se analizan los usos que ha recibido desde la historia de la población y su asociación con los síndromes de miseria, atraso social y pauperización, Así como la nueva dimensión que ha adquirido con la emergencia de la pandemia de obesidad y la doble carga de la malnutrición y el sobrepeso. Tanto las lecciones de la historia, como el reto que representan los más de 2.000 millones de seres humanos afectados por el hambre oculta, muestran que para superarla, más allá de suplementar el déficit de micronutrientes, hay que corregir las desigualdades sociales ante la disponibilidad de alimentos y otras necesidades básicas(AU)

The work raises the need to address hidden hunger based on food challenges and the socioeconomic casuistry that explain it. Are analysed the uses it has received from the history of the population and its association with the syndromes of misery, social backwardness and pauperization. As well as the new dimension that it has acquired with the emergence of the obesity pandemic and the double burden of malnutrition and overweight. Both the lessons of history, and the challenge posed by the more than 2 billion human beings affected by hidden hunger, show that to overcome it, beyond supplementing the deficit of micronutrients, it is necessary to correct social inequalities regarding the availability of food and other basic necessities(AU)

Effect of Different Mutagens on Some Mineral, Phytochemical and Proximate Composition of Two Red Pepper Varieties

Aim: This research was designed to evaluate the effects of different levels of three mutagens on two pepper varieties with a vision of choosing mutants with high values in biochemical contents that may possibly be valuable in breeding improved varieties of the plant. Methods: Seeds of pepper were exposed to varying doses of gamma rays 60Co (50, 100, 150, and 200Gy), X-ray doses (40, 60, 80, and 100KV) and sodium azide (0.01, 0.02, 0.03 and 0.04%). The treated seeds and the controls were grown in the Botanic Garden of the University of Nigeria, Nsukka using a Completely Randomized Design. Results: The result showed that vitamin C and β-carotene ranged from 5.89 – 26.88 and 2.62 – 11.35 mg/100 g, Fe and Ca (14.70 and 13.78 mg/100 g) were highest in Shombo at 100Gy. Values ranging from 0.36-2.00 and 3.96 – 18.82 mg/100 g were recorded for flavonoid and alkaloid content across all treatment combinations. The result also revealed that at 100Kv and 150Gy, ash content increased in both varieties. The highest protein concentration of 9.57% was recorded at 100Kv of X-ray in Shombo and 6.96% at 150Gy of gamma irradiation in Tatase variety. Principal component analysis explained extracted five principal axis which accounted for the variability of 72.54%. Conclusion: This study reveals that biochemical content in pepper could be improved with exposure to mutagens especially gamma irradiation.

El hambre oculta y la fibromialgia: Una revisión sistemática / The hidden hunger and fibromyalgia: A systematic review

RESUMEN Recientemente há sido discutida la posibilidad de una relación causal entre la fibromialgia (FM) y la deficiencia de micronutrientes, un tipo de deficiencia nutricional conocida como "hambre oculta". Sin embargo, los estudios son pocos y los resultados controversiales, lo que genera debates sobre la influencia real del "hambre oculta" en el proceso de la enfermedad en las personas con fibromialgia. En está revisión se presentan y discuten evidencias científicas relacionadas con la deficiencia de micronutrientes y FM, destacando los principales micronutrientes relacionados. El levantamiento de información fue realizado en los bases de datos de PubMed y Science Direct en estudios observacionales publicados entre los años 2000 y 2017. Fueron seleccionados 14 estudios, ocho dirigidos a la asociación de la deficiencia de vitamina D y la presencia de FM y seis enfocados en la asociación de la deficiencia de minerales con FM. Se sugiere una relación entre la deficiencia de vitamina D y el aumento de la sensibilidad al dolor en la FM. Aunque esa insuficiencia también está asociada a otras enfermedades muscoesqueléticas crónicas. Además, parece que la deficiencia mineral (p.ej.o., hierro, magnesio, zinc y calcio) también desempeña un papel importante en el inicio de la FM y sus principales síntomas.

ABSTRACT Recently the possibility of a causal link between fibromyalgia (FM) and micronutrient deficiency, a type of malnutrition known as "hidden hunger", has been suggested. However, the results are controversial, which raises questions and debates on the actual influence of "hidden hunger" on the development of FM. In this review, we present and discuss scientific evidence related to micronutrient deficiencies and FM, highlighting key micronutrients involved. We searched PubMed and Science Direct databases for all observational studies published between 2000 to March 2017. We selected fourteen observational studies, eight studies aimed at linking vitamin D deficiency to the presence of FM and six studies focused on the association of mineral deficiency with FM. The association between vitamin D deficiency and increased pain sensitivity in FM is suggested, although such insufficiency is also associated with other chronic musculoskeletal disorders. It appears that mineral deficiency (e.g., iron, magnesium, manganese, zinc and calcium) plays an important role in the onset of FM and its main symptoms.

Staple Crops Biofortification Linking Agriculture, Food and Nutrition towards Eliminating Hidden Hunger

Agriculture is the mainstay of most of people globally. Despite the fact that agriculture has been a traditionally food and nutrition source, people go to bed without food and suffer from malnutrition even within the same households. Similarly, hunger and hidden hunger remains a worldwide widespread challenge. In response, researchers have tried to enhance micronutrients through staple food crops biofortification. The promotion of biofortified crops and unintended narrowed food choices might have been the underlying factor for the coexisting forms of malnutrition: undernutrition, obesity and increased incidence of non-communicable diseases; a malnutrition double burden problem. Therefore, this paper provides views to rethinking critically in order to take steps towards integrating nutrition education in modern agriculture crop biofortification programs more effectively.

Nutritional security through crop biofortification in India: Status & future prospects

Malnutrition has emerged as one of the most serious health issues worldwide. The consumption of unbalanced diet poor in nutritional quality causes malnutrition which is more prevalent in the underdeveloped and developing countries. Deficiency of proteins, essential amino acids, vitamins and minerals leads to poor health and increased susceptibility to various diseases, which in turn lead to significant loss in Gross Domestic Product and affect the socio-economic structure of the country. Although various avenues such as dietary-diversification, food-fortification and medical-supplementation are available, biofortification of crop varieties is considered as the most sustainable and cost-effective approach where the nutrients reach the target people in natural form. Here, we have discussed the present status on the development of biofortified crop varieties for various nutritional and antinutritional factors. Ongoing programmes of the Indian Council of Agricultural Research on the improvement of nutritional traits in different crops have been presented. Challenges and future prospects of crop biofortification in India have also been discussed. The newly developed biofortified crop varieties besides serving as an important source for livelihood to poor people assume great significance in nutritional security.

Venezuela entre la inseguridad alimentaria y la malnutrición / Venezuela between food insecurity and malnutrition

En América Latina y el Caribe la mayoría de los países con subalimentación (2011-2017), desaceleraron sus economías y, profundizaron la crisis alimentaria y los conflictos sociales. Venezuela vive un empobrecimiento masivo e inseguridad alimentaria que motiva la migración a otros países. Para conocer la situación actual de la seguridad alimentaria (SA) y la malnutrición, se estudiaron los principales determinantes, mediante el análisis de informes técnicos de acceso público en el último quinquenio. Se encontró que las dimensiones de la SA están severamente comprometidas: el acceso, la disponibilidad, la bioutilización y la estabilidad de las anteriores. Las preferencias alimentarias están afectadas por la distorsión entre precios e ingresos reales. El patrón de consumo de alimentos ha cambiado, resultando insuficiente en cantidad y calidad, sin variedad, basado en arroz, maíz, pasta, granos y aceite; carente en proteínas animales, vitaminas A, B y C, y minerales (hierro, ácido fólico zinc y calcio). El efecto directo es el incremento de la malnutrición y del hambre oculta, en los más vulnerables. La desnutrición crónica, principal problema nutricional, se solapa con el déficit calórico-proteico y las deficiencias de nutrientes. El programa de nutrición comunitaria y el Proyecto de emergencia social (2017-2018) reportaron severidad del retraso de crecimiento en talla (moderado y severo) y desnutrición aguda que afectaron principalmente a los niños menores de dos años, de las zonas de menores recursos rurales o periurbanas. Los tres determinantes inmediatos del estado nutricional del niño: seguridad alimentaria, atención adecuada y salud, están fuertemente afectados por la pobreza(AU)

In Latin America and the Caribbean, most countries with undernourishment (2011-2017) slowed their economies and deepened the food crisis and social conflicts. Venezuela is experiencing massive impoverishment and food insecurity that motivates migration to other countries. In order to know the current situation of food security (SA) and malnutrition, the main determinants were studied, through the analysis of technical reports of public access in the last five years. It was found that the dimensions of the SA are severely compromised: access, availability, bioutilization and stability of the above. Food preferences are affected by the distortion between prices and real incomes. The pattern of food consumption has changed, resulting in insufficient quantity and quality, without variety, based on rice, corn, pasta, grains and oil; lacking in animal proteins, vitamins A, B and C, and minerals (iron, folic acid zinc and calcium). The direct effect is the increase in malnutrition and hidden hunger in the most vulnerable. Chronic malnutrition, the main nutritional problem, overlaps with the caloric-protein deficit and nutrient deficiencies. The community nutrition program and the Social Emergency Project (2017-2018) reported severity of stunted growth (moderate and severe) and acute malnutrition that mainly affected children under two years of age, from areas with less rural resources or periurban. The three immediate determinants of the child's nutritional status: food security, adequate care and health, are strongly affected by poverty(AU)

Dinámicas y estrategias alimentarias instauradasen hogares de Medellín / Nutrition dynamics and strategies implemented in the homes of Medellín

Objetivo: comprender la dinámica familiar alimentaria enhogares beneficiarios de programas de complementaciónalimentaria de Medellín en aspectos como las estrategias deconsumo de alimentos instauradas en épocas de escasez dealimentos y en el rol asumido por las mujeres en el consumoalimentario. Metodología: el enfoque utilizado fue cualitativo,y el método de etnografía focalizada, con la utilizaciónde técnicas como entrevistas individuales, entrevistasgrupales y observaciones participantes. Resultados: entrelos principales mecanismos instaurados en los hogares debeneficiarios de programas de complementación alimentariapara preservar el consumo acorde a lo acostumbrado están:hacer preparaciones con los alimentos que tienen disponiblesen el hogar, servir porciones más pequeñas, consumir conmayor frecuencia alimentos económicos, del gusto familiar yde fácil preparación; tomar solo una bebida durante todo el díay disminuir el número de comidas al día. También se evidencióque es la mujer quien asume el papel principal en la obtenciónde los alimentos en el hogar, y en la preparación y servida; sonestas quienes dan prioridad a la alimentación de los niños y sonquienes menos alimentos consumen en el hogar...

Objective: To understand the family dynamics food inhousehold beneficiaries of supplementary food programs ofMedellin such as food consumption strategies introduced intimes of food shortages and in the role assumed by womenin family feeding. Methodology: the approach was qualitativeand the method was focused ethnography. Data wascollected through techniques such as individual interviews,group interviews and participant observations. Results: thefollowing are some of the main mechanisms implemented inthe households benefiting from supplementary food programsto keep consumption at the usual levels: making preparationswith foods that are available at home, serving smaller portions,consuming cheap, tasty and easy-to-prepare foods more often,taking only one drink throughout the day and reducing the number of meals per day. Similarly, it was observed that itis usually the woman who takes the lead role in preparing,obtaining and serving food at home. Likewise, women givepriority to feeding children, and they consume the lowestamount of food at home...