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Undernutrition is more than just an issue of energy intake – it also takes the form of inadequate intake of micronutrients (vitamins and minerals), leaving children at risk for deficiency diseases. The international agencies monitor certain vitamins and minerals in efforts to reduce the life-long consequences of low intakes of iron, zinc, vitamin A, and iodine [1]. Iron deficiency is the primary cause of anemia in young children, affecting both cognitive and physical development. Zinc intake is of concern, because deficiency limits childhood growth and decreases resistance to infection. Vitamin A intake and supplementation is monitored as vitamin A deficiency is the leading cause of childhood blindness globally. Iodine deficiency is the main cause of impaired cognitive development in children, and thus iodine deficiency and the impact of the universal salt iodization project are also scrutinized.

Prevalence of anemia, defined as hemoglobin <110 g/L at sea level, in children ≤5 years is highest in sub-Saharan Africa (59.9%) and South Asia (55.1%), whereas the rates are 15.3% in the European Union and 8.6% in North America [2]. The highest rates of vitamin A deficiency in young children are also found in sub-Saharan Africa and South Asia, where 60–70% are deficient [2]. Zinc deficiency is less prevalent, ranging from 15 to 50% across sub-Saharan Africa and South Asia, and is generally <5–10% for much of Europe, North America, Central Asia, and Oceania [2]. Universal salt iodization began in the early 1990s to reduce the global burden of iodine deficiency. This program has now been implemented in 120 countries, and as a result of these efforts, approximately 71% of households globally now use iodized salt [7], greatly reducing iodine deficiency.