Intended for healthcare professionals

Observations On the Contrary

Thought for food

BMJ 2011; 342 doi: (Published 11 May 2011) Cite this as: BMJ 2011;342:d2926
  1. Tony Delamothe, deputy editor, BMJ
  1. tdelamothe{at}

Commodity speculation, not micronutrient deficiency, is today’s most pressing problem

I can easily visualise what the minimum recommended daily intake of food looks like: a few bowls of rice with side helping of greens and cabbage, an egg, a couple of handfuls of peanuts, a glass or two of milk. It doesn’t add up to much. Yet one billion of the world’s seven billion inhabitants can’t afford to buy this food—or cheaper equivalent amounts of protein, fats, and carbohydrates—each day.

Nevertheless, I’m having problems with the attention given to the “hidden hunger” of micronutrient deficiency, which afflicts an estimated two billion people (BMJ 2011;342:d1086, doi:10.1136/bmj.d1086). The micronutrients in question—iron, iodine, and vitamin A—make up about 0.0005% by weight of the daily ration described above.

It’s not that I don’t believe in micronutrient deficiency—or in efforts to rectify it—it’s just that I think we should be concentrating on food you can see, and the absence thereof. In other words: take care of the big stuff and the small stuff will take care of itself. (And if the problem is, say, iron deficiency anaemia secondary to hookworm or …

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