Micronutrient deficiencies, sometimes termed “hidden hunger,” are a significant public health concern within the European Union (EU). Despite the region’s relative economic prosperity and advanced healthcare systems, deficiencies in vitamins and minerals, such as iron, iodine, vitamin D, and calcium persist and are linked to health problems and economic burden. However, the true extent of these deficiencies and the economic burden (e.g., productivity loss, educational impact, reduced quality-of-life) imposed on individuals and healthcare, as well as the cost-effectiveness of interventions, are not fully understood. This highlights the need for more comprehensive data and targeted research.
Prevalence of micronutrient deficiencies in the EU
Previous studies have highlighted micronutrient inadequacies across EU Member States. Approximately 66% of the global population does not consume adequate calcium for healthy bones, with notable deficiencies also observed in Europe, particularly among adolescents and the elderly. The International Osteoporosis Foundation reported 4.28 million fractures in 2019 with projections of 5.34 million fractures across Europe by 2035.
On average, about 30% of women of reproductive age globally have iron deficiency anaemia. This figure rises during pregnancy and contributes to significant health issues including fatigue, impaired cognitive function, weakened immunity, and—in severe cases—complications in pregnancy and delayed growth and development of infants, which can have lifelong impacts. Similarly, vitamin D deficiency is widespread across EU populations, with dietary insufficiencies exacerbated by limited sun exposure during the winter months. Inadequate intake of folate, particularly among women of childbearing age, poses increased risk for neural tube defects, while zinc deficiency has been linked to impaired immune function and slower wound healing, particularly among older adults. These impacts underscore the need for improved dietary strategies and public health initiatives to ensure adequate micronutrient intake across all population groups.
Economic Impact
The economic implications of micronutrient deficiencies in the EU are substantial. Micronutrient deficiencies have a direct impact on individuals and on societies. Deficiencies impair cognitive and physical capabilities, leading to decreased productivity, and employees experiencing chronic fatigue, frequent illness, or conditions rooted in poor nutrition, are more likely to take sick leave. Over time, this translates into substantial economic losses at national levels. For children, deficiencies can impede cognitive development, lowering academic achievement and future earning potential, perpetuating cycles of poverty and inequality.
On an individual level, micronutrient deficiencies significantly impact quality of life. Symptoms such as fatigue, reduced physical stamina, and diminished mental clarity interfere with daily activities, from parenting and work to social interactions. If left undiagnosed and untreated, these deficiencies can lead to more severe health outcomes. Persistent iron deficiency, for example, can cause anaemia as well as complications in heart function and pregnancy. Vitamin D deficiency is associated with osteoporosis, cardiovascular diseases, and weakened immunity. Furthermore, fatigue, brain fog, and frequent illness linked to these deficiencies can worsen psychological conditions, contributing to feelings of frustration, depression, and anxiety.
Conclusion
Estimating the economic burden of micronutrient deficiencies is crucial, as this provides foundations for effective policy decisions. While studies in low- and middle-income countries often highlight reductions in gross domestic product (GDP) caused by dietary deficiencies, data on the economic burden of micronutrient deficiencies in Europe remain sparse. For single nutrient deficiencies, such as iron or vitamin D, health costs have been documented in only a handful of countries, leaving a fragmented understanding of their overall impact. This gap in knowledge is intensified by the lack of comprehensive and integrated data on the health and productivity costs of deficiencies across the EU. Thus, Zero Hidden Hunger EU will produce the first-ever estimates of the economic burden of combined micronutrient deficiencies for Europe, offering a critical resource to inform strategies for tackling hidden hunger in Europe.
Zero Hidden Hunger EU
The Zero Hidden Hunger EU project (Grant Agreement ID. 101137127) aims to address these issues by raising awareness, delivering scientifically validated evidence, and developing targeted strategies to address micronutrient deficiencies in all vulnerable populations including older adults. Through its efforts, the project hopes to see older adults better supported in maintaining their health and quality of life through adequate nutrition.
Author: Lee-Ann Burke
Dr Lee-Ann Burke is a lecturer in the Department of Economics, University College Cork. Her main teaching areas currently are health economics, macroeconomics and data collection and analysis modules but, over the years, has taught across a wide range of economic modules including delivering economics modules in other UCC departments such as The School of Nursing and the Geography Department.
Author: Brendan McElroy
Dr. Brendan McElroy’s research interests are in health economics, particularly social determinants of health, economic evaluation of health technologies and financing healthcare . He has been published in highly regarded academic journals such as Social Science and Medicine and the British Medical Journal Open. His recent work has been on the social determinants of health, including the food system and the effects of both housing and education on health and health inequalities.
Author: Siân Astley
Siân has worked extensively throughout Europe from a variety of disciplines including research, food and biotech industries and the media. She is author of more than 300 popular science articles as well as 27 peer-reviewed papers. She has a particular interest in nutrigenomics, personalised nutrition, sustainable food systems, and co-creation of solutions with stakeholders. In addition to being Secrétaire Générale de EuroFIR AISBL, Siân is an independent science communicator and an editor for Food Chemistry and Editor-in-Chief for Food Chemistry: Molecular Sciences.
