Micronutrients

Micronutrients are essential vitamins and minerals. They are necessary in tiny amounts but perform vital functions within the body, including enabling the production of hormones, enzymes, and other substances essential for proper growth and development. Globally, iron, iodine and vitamin A are recognized as the most important micronutrients in public health. Successful strategies to improve intake include promoting healthy, diverse diets, implementing food fortification programmes, and providing supplementation where needed. Successful strategies have included universal salt iodization and the fortification of wheat flour with iron and folic acid.

The WHO Eastern Mediterranean Region is actively working to address micronutrient deficiencies, which are part of the complex challenge of malnutrition in the Region. Intake of vitamin D, calcium, potassium, zinc, and magnesium were below that recommended. Inadequate vitamin A intake remains highly prevalent among women of childbearing age and children under 5 years in the Region. However, significant progress has be made to curb iodine deficiency disorders through iodized dietary salt, moving many countries toward elimination of these deficiencies. The Region continues to focus on improving nutrition outcomes through its Strategy on nutrition for the Eastern Mediterranean Region 2020–2030.

Micronutrient deficiencies can cause several serious health issues. A lack of iron, folate and vitamins B12 and A can lead to anaemia. Anaemia is a condition in which there is a reduced number of red blood cells or haemoglobin concentration, causing fatigue, weakness, shortage of breath and dizziness. This can further lead to difficulties in functioning in work, education and community engagement. An estimated 42% of children under 5 years of age and 40% of pregnant women worldwide are anaemic.

Severe iodine deficiency can lead to brain damage and during pregnancy can cause a number of issues including stillbirth, spontaneous abortion and congenital anomalies. Less severe iodine deficiency may still cause mental impairment that reduces intellectual capacity. The preferred strategy for the control of iodine deficiency remains universal salt iodization, which requires that all food-grade salt used in household and food processing be fortified with iodine. UNICEF estimates that 66% of households globally have access to iodized salt.

Vitamin A deficiency is the leading cause of preventable blindness in children and increases the risk of disease and death from severe infections such as diarrhoeal disease and measles. Vitamin A deficiency may also occur in women during the last trimester of pregnancy in high-risk areas. Breastfeeding is the best way to protect babies from vitamin A deficiency and, in areas where vitamin A deficiency is a public health problem, vitamin A supplementation is recommended in infants and children 6-59 months of age.

WHO works with Member States and partners to prevent micronutrient deficiencies though a number of programmes and following the WHO 2016–2025 nutrition strategy. These programmes include iron and folic acid supplementation, high dose vitamin A supplementation, the promotion of breastfeeding, fortification of foods with micronutrients, and healthy, diverse diets containing foods naturally rich in vitamin and minerals. For example, salt iodization has helped reduce the rate of iodine deficiency around the world, while the fortification of wheat flour with iron and folic acid has helped reduce rates of anaemia and neural tube defects.

WHO collaborates with UN partners to disseminate global guidance on the assessment of micronutrient status and effective micronutrient interventions. These guidelines allow WHO and other agencies to better respond to populations affected by emergencies when micronutrient deficiencies are more common due to chronic and severe food insecurity.

Efforts in the Eastern Mediterranean Region are guided by the comprehensive Strategy on nutrition for the Eastern Mediterranean Region 2020–2030, which commits countries to strengthening action to achieve food security and eliminate all forms of malnutrition by 2030. WHO joined FAO, UNICEF, and the World Food Programme in launching a regional UN nutrition collaboration framework in Cairo in August 2023 to enhance synergy and coordinate regional efforts.