Europe is often held up as a global benchmark for food security and healthcare. Yet behind this reputation lies a persistent and underestimated public health challenge: micronutrient deficiencies, commonly referred to as “hidden hunger.” Despite plentiful food availability, large parts of the European population fail to meet requirements for essential vitamins and minerals such as iron, iodine, vitamin D and folate – nutrients fundamental to immune function, cognitive development and long-term health.
This contradiction is at the heart of Zero Hidden Hunger EU, a Horizon Europe-funded research initiative coordinated by Kevin Cashman, Chair of Food and Health at University College Cork, alongside Professor Mairead Kiely. The project brings together experts from across Europe, the UK and Switzerland to assess the scale of hidden hunger and identify sustainable, equitable solutions.
An invisible form of malnutrition
Hidden hunger occurs when people consume enough calories but insufficient micronutrients. Unlike energy deficiency, its effects are often subtle and slow to emerge. Symptoms may go unnoticed for years, contributing to impaired metabolism, weakened immunity and increased disease risk.
This lack of visibility is why the World Health Organization coined the term “hidden hunger.” As highlighted, the central challenge is not only addressing deficiencies, but understanding how widespread they are. Data gaps across Europe remain significant, limiting policymakers’ ability to act decisively.
Who is most at risk?
Risk of micronutrient deficiency is unevenly distributed across the population. Children and adolescents are particularly vulnerable due to rapid growth and diets increasingly dominated by ultra-processed foods. Women of reproductive age frequently experience iron and folate deficiencies, with implications for maternal and infant health.
Older adults face additional risks linked to reduced appetite, medication use and impaired absorption, contributing to deficiencies of vitamin D, calcium and vitamin B12. Socioeconomic factors further exacerbate vulnerability: low-income households often rely on cheaper, nutrient-poor foods, while populations in low-UV regions struggle to maintain adequate vitamin D status. Migrants and marginalised groups face cultural, economic and structural barriers to nutritious diets.
Estimates from the Zero Hidden Hunger EU consortium suggest that up to 70% of Europeans may be at risk of at least one micronutrient deficiency.
Food fortification: proven, but inconsistently applied
Food fortification is widely recognised as one of the most effective population-level strategies to address micronutrient deficiencies. Yet across Europe, policies remain fragmented. Mandatory universal salt iodisation is implemented in only a minority of countries, while fortification of other nutrients such as vitamin D or folic acid is largely voluntary.
This patchwork approach results in uneven coverage and limited reach among vulnerable groups. By contrast, countries such as Finland demonstrate what evidence-based policy can achieve. Following the introduction of mandatory vitamin D fortification of milk products, population deficiency rates fell substantially within a decade – underscoring the importance of monitoring, adjustment and political commitment.
The EU policy balance
At EU level, Regulation (EC) No 1925/2006 provides the legal framework for food fortification, with scientific oversight from the European Food Safety Authority. While Member States retain flexibility to implement national fortification programmes, this autonomy has also contributed to regulatory divergence and inconsistent public health outcomes.
Beyond regulation, social policy plays a critical role. Nutrition support delivered through the European Social Fund Plus and national initiatives such as food vouchers and solidarity grocery schemes shows how dignity, choice and access can support better nutrition alongside social inclusion.
Nutricomms opinion: Hidden hunger is a policy failure, not a knowledge gap
From a Nutricomms perspective, Europe’s hidden hunger problem is no longer about insufficient evidence – it is about insufficient action.
We know which nutrients are lacking. We know which population groups are most at risk. We know that food fortification, when well designed and monitored, works. What remains fragmented is political will, policy coherence and cross-sector coordination.
Voluntary approaches alone will not deliver equitable outcomes, particularly for low-income and marginalised groups. Nor can hidden hunger be solved through consumer education in isolation. Structural solutions – harmonised fortification policies, stronger monitoring systems and nutrition-sensitive social protection – must sit at the core of Europe’s response.
Crucially, micronutrient security must be aligned with sustainability goals. Ensuring adequate intake of essential vitamins and minerals through resilient, environmentally responsible food systems is not a trade-off – it is a prerequisite for a healthy, productive and inclusive Europe.
Hidden hunger may be invisible, but its consequences are not. Addressing it is both a public health necessity and a moral imperative.
References
https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1669008/full
