Micronutrient deficiencies in South Asia – Current status and strategies

This article provides a comprehensive review of the extent of prevalence of micronutrient deficiencies (vitamin A & D, iron, zinc and iodine) among different population groups in India, Pakistan, Bangladesh and Sri Lanka. The article also covers several health implications associated with these deficiencies, their economic impact and numerous strategies to combat this issue in low income South Asian countries. An extensive computer-based bibliographic review of the literature was performed via PubMed, Web of Science, Scopus, and Google Scholar by using keywords “micronutrients”, “vitamin A and D”, “iron”, “zinc”, “iodine” and “South Asia”. Data were identified under various sections and the most relevant full-text articles and abstracts were selected and screened for inclusion in this review. The results indicate that micronutrient deficiencies are widely prevalent in these regions and are now a significant public health problem. Preschool-age and school children, pregnant women and women of childbearing age are at the risk of these deficiencies. Vitamin A deficiency (VAD) was found among school-age children and adolescents in Bangladesh and Sri Lanka. Vitamin D deficiency (VDD) seemed to affect 84% of pregnant women in India, 70% of healthy volunteers in Pakistan, 26% of male children in Sri Lanka and 8% of children in Bangladesh. Data illustrate that iron deficiency anemia (IDA), zinc and iodine deficiency affect all population groups, suggesting immediate measures to be taken to address the issue. Restricted dietary intake of these nutrients associated with a number of socioeconomic constraints exacerbates the problem of micronutrient malnutrition. Dietary diversification, food fortification and supplementation are the pragmatic and recommended approaches to overcome these nutritional deficiencies. However, the goal to virtually eliminate micronutrient deficiencies in these poorer societies demands a series of well integrated actions at all levels.

► Deficiencies of vitamin A & D, iron, zinc and iodine in India, Pakistan, Sri Lanka and Bangladesh are extensively prevalent.
► Existing strategies like dietary diversification, supplementation and fortification need to be strengthened.
► Huge investment to address malnutrition in South Asia is to be made to control micronutrient deficiencies.