Micronutrient deficiencies, often described as “hidden hunger” because they persist even when people consume enough calories, remain a significant public health challenge in the Philippines, according to the Department of Science and Technology–Food and Nutrition Research Institute (DOST-FNRI).
Based on the 2023 National Nutrition Survey (NNS), DOST-FNRI reported that 23.6% of Filipino children under five are stunted, while 5.6% are wasted and 15.1% are underweight—indicators linked to chronic undernutrition and poor diet quality.
The same national survey found that 31.4% of households experienced moderate to severe food insecurity and 2.7% experienced severe food insecurity, conditions that often limit access to diverse, nutrient-rich foods.
Anemia, commonly associated with iron deficiency and other micronutrient gaps, also remains present across age groups. DOST-FNRI’s adult nutrition results show anemia prevalence at 8.0% among adults aged 20–59 years.
Taken together, these findings show that malnutrition in the Philippines is no longer only about insufficient food, but also about insufficient nutrients.
Calories are not the same as nutrition
Hidden hunger occurs when diets provide enough energy but fall short of essential vitamins and minerals needed for growth, immunity, learning, and healthy pregnancy.
According to the World Health Organization, micronutrient deficiencies can impair physical and cognitive development, increase susceptibility to infections, and reduce productivity, with women and children among the most affected groups.
In practical terms, meals dominated by rice, refined carbohydrates, and highly processed foods can leave individuals busog yet nutritionally deprived, lacking iron, vitamin A, iodine, zinc, folate, and key B-vitamins.
Diet quality, however, does not depend solely on individual choice. Food prices, access, and household constraints strongly shape what families eat. When budgets tighten, households often prioritize foods that are filling and affordable per calorie, even when those foods lack adequate micronutrients.
As a result, hidden hunger persists quietly and often surfaces later as poor growth, repeated illness, learning difficulties, or pregnancy complications rather than visible starvation.
READ: LGUs Drive Stunting Cuts as Human Capital Losses Mount
Early childhood reveals the sharpest gaps
The 2023 NNS data show that the youngest Filipinos bear a disproportionate share of micronutrient deficiencies.
According to DOST-FNRI’s 2023 NNS national summit brief, 11.4% of children aged 6–59 months are anemic overall. Prevalence rises sharply among infants aged 6–11 months at 35.0% and remains elevated among children aged 12–23 months at 21.2%.
This pattern matters because these months coincide with the transition from exclusive breastfeeding to complementary feeding, when iron and other micronutrient needs increase rapidly.
Chronic undernutrition during early childhood also helps explain why stunting remains high nationwide. Stunting at 23.6% among under-five children reflects long-term exposure to inadequate diets and repeated infection. While stunting may not always be immediately visible, its consequences—lower school performance, reduced adult productivity, and higher risk of chronic disease—extend across the life course.
Riboflavin and less visible deficiencies
Public discussion often focuses on iron and vitamin A, yet hidden hunger frequently involves multiple micronutrients.
Riboflavin (vitamin B2), which supports energy metabolism and cellular function, appears in foods such as milk, eggs, meat, fish, and fortified products. Diets low in animal-source foods and fortified staples may therefore fall short not only in iron but also in B-vitamins.
Evidence of these broader gaps appears in peer-reviewed Philippine research. A study by Angeles-Agdeppa and colleagues, published in Food & Nutrition Research and based on national dietary intake data, reported widespread inadequacy of several micronutrients among Filipino schoolchildren and adolescents, including riboflavin, calcium, iron, folate, and vitamin C.
The authors noted that inadequacy was particularly common among children from poorer households and rural areas, highlighting the close link between diet quality and socioeconomic conditions.
Importantly, these findings do not imply that every individual has clinical deficiency symptoms. Instead, they indicate population-level risk when usual diets consistently fail to meet recommended nutrient intakes.
The double burden of malnutrition
Hidden hunger does not disappear when body weight increases.
DOST-FNRI’s 2023 adult nutrition report documented obesity prevalence at 39.8% among adults aged 20–59 years, while anemia remained present at 8.0% in the same age group. This coexistence illustrates the Philippines’ growing “double burden” of malnutrition, where overweight and obesity rise alongside micronutrient deficiencies.
This pattern reflects a changing food environment in which energy-dense, ultra-processed foods often cost less and remain more accessible than fresh, nutrient-dense options. As a result, individuals and households can consume excess calories while still lacking essential vitamins and minerals.
Hidden hunger, therefore, is not only a problem of scarcity or poverty; it also reflects how food systems shape everyday diets.
KEEPING TRACK OF YOUR MICRONUTRIENTS MADE EASY: GET THE JOURNAL NOW!
Food insecurity and diet diversity
Food insecurity remains a central driver of hidden hunger. According to the 2023 NNS, nearly one-third of Filipino households experienced moderate to severe food insecurity.
Such instability does not always mean skipped meals. More often, it means reduced dietary variety. Rice, instant noodles, sugary drinks, and fried snacks stretch limited budgets but do not consistently deliver the micronutrients needed for growth and health.
Global evidence shows that the Philippines is not alone in this challenge. UNICEF’s 2024 report on child food poverty estimated that 181 million children under five worldwide—about one in four—live in severe child food poverty, meaning their diets lack diversity during critical growth periods.
Likewise, WHO data show that anemia affected 30% of non-pregnant women and 37% of pregnant women globally in 2019, confirming that micronutrient deficiencies remain a widespread concern.
Policies in place, gaps in practice
The Philippines has long recognized micronutrient deficiencies as a national issue. Republic Act No. 8976, or the Philippine Food Fortification Act of 2000, established a framework for fortifying staple foods with essential nutrients to reach broad segments of the population.
National planning frameworks such as the Philippine Plan of Action for Nutrition (PPAN) 2023–2028 also emphasize improving diet quality, strengthening nutrition services across life stages, and addressing all forms of malnutrition.
Nevertheless, the persistence of hidden hunger suggests gaps between policy intent and everyday impact. Fortification requires consistent compliance and monitoring, supplementation programs depend on sustained supply and uptake, and diet quality ultimately hinges on whether households can afford and access diverse foods.
Without these conditions, micronutrient gaps can persist even when policies exist on paper.
When “hidden” becomes structural
When infant anemia reaches 35.0% at 6–11 months, when 23.6% of children under five remain stunted, and when obesity rises alongside micronutrient deficiencies, the problem is no longer hidden—it is structural.
Hidden hunger reflects how economic pressures, food environments, and service delivery intersect to shape daily diets.
Ensuring enough calories keeps people alive. Ensuring adequate micronutrients allows children to grow, students to learn, adults to work productively, and mothers to carry pregnancies safely.
The real measure of progress, therefore, is not simply whether Filipino households feel full, but whether their diets consistently provide the nutrients needed to support health across generations.
Photo by Yanping Ma on Unsplash
*This article is intended to inform and empower readers with general, science-based health information drawn from reputable public health sources. It does not replace medical advice. For personal health concerns or symptoms, readers are encouraged to consult a licensed healthcare professional.
REFERENCES
Department of Science and Technology–Food and Nutrition Research Institute (DOST-FNRI. DOST-FNRI presents the latest Philippine nutrition situation: 2023 National Nutrition Survey results. Accessed via:
https://www.fnri.dost.gov.ph/index.php/programs-and-projects/news-and-announcement/880-dost-fnri-presents-the-latest-ph-nutrition-situation
DOST-FNRI. 2023 National Nutrition Survey: Adults (20–59 years old).
https://enutrition.fnri.dost.gov.ph/uploads/7_2023_NNS_ADULTS.pdf
DOST-FNRI. 2023 National Nutrition Survey: Part 1 – National Nutrition Summit Brief.
https://enutrition.fnri.dost.gov.ph/uploads/2024%20National%20Nutrition%20Summit_Part%201.pdf
Angeles-Agdeppa, I., et al. (2019). Dietary inadequacies and nutrient intake among Filipino children and adolescents. Food & Nutrition Research, 63.
https://foodandnutritionresearch.net/index.php/fnr/article/view/3435/9250
World Health Organization (WHO). Anaemia. Updated fact sheet.
https://www.who.int/news-room/fact-sheets/detail/anaemia
World Health Organization (WHO). Anaemia in women and children – Global Health Observatory.
https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children
UNICEF. Child Food Poverty: Nutrition deprivation in early childhood (2024).
https://www.unicef.org/reports/child-food-poverty
Food and Agriculture Organization of the United Nations (FAO). Hidden hunger and micronutrient deficiencies.
https://www.fao.org/about/meetings/icn2/news-archive/news-detail/en/c/265240/
World Health Organization, FAO, UNICEF, WFP. The State of Food Security and Nutrition in the World 2024.
https://www.who.int/publications/m/item/the-state-of-food-security-and-nutrition-in-the-world-2024
