More than 2 billion people worldwide experience nutrient deficiencies without knowing it, according to reporting by DW News. The condition, known as malnutrition or "hidden hunger," occurs when people consume enough calories but lack essential micronutrients like vitamin D, B12, iodine, calcium or iron.
Symptoms often appear only after severe damage has occurred. Matthias Pirlich, a nutritional expert and former vice president of the German Society for Nutritional Medicine, told DW that vitamin D deficiency can persist for months before any symptoms emerge. B12 deficiency can cause nerve damage, numbness in the limbs, muscle weakness or paralysis. In severe cases, B12 deficiency can damage the spinal cord or brain, leading to memory loss and mental health problems.
In Germany alone, about 50,000 deaths per year can be attributed to malnutrition, according to the German Society for Nutritional Medicine. The DGEM estimates that 30 percent of patients receiving inpatient care in Germany are affected by or at risk of malnutrition, yet only about 1 percent are screened and treated for nutrient deficiencies.
Malnutrition stems from multiple causes. Poverty limits access to nutrient-dense foods, forcing people to rely on cheap staples like flour and rice. Depression, living alone, and aging increase risk. Certain chronic diseases including Crohn's disease, celiac disease and cancer impair nutrient absorption. Medications can also increase deficiency risk.
Studies show widespread micronutrient gaps even in wealthy nations. Between 2007 and 2010, just under three-quarters of the US population did not meet the recommended daily intake of vitamin D. In Germany, about one-third of the population suffered from vitamin D deficiency in 2017, according to the German Nutrition Society. One-third of Germans also had insufficient iodine intake, which can disrupt thyroid function and impair fetal brain development during pregnancy.
German policymakers and medical associations are developing a roadmap, expected by 2027, to screen all hospital patients for nutritional deficiencies upon admission, following the Dutch model. Pirlich advocates screening at-risk groups including older adults and those with chronic illnesses in outpatient clinics as well.