The Nutrition Society Winter Conference Live 2020 was held virtually on 8–9 December 2020 Conference on ‘Micronutrient malnutrition across the life course, sarcopenia and frailty’ Symposium one: Population and clinical vitamin and mineral malnutrition The global challenge of hidden hunger: perspectives from the field Nicola M. Lowe UCLan Research Centre for Global Development, University of Central Lancashire, Preston, UK The aim of this review paper is to explore the strategies employed to tackle micronutrient deficiencies with illustrations from field-based experience. Hidden hunger is the presence of multiple micronutrient deficiencies (particularly iron, zinc, iodine and vitamin A), which can occur without a deficit in energy intake as a result of consuming an energy- dense, but nutrient-poor diet. It is estimated that it affects more than two billion people worldwide, particularly in low- and middle-income countries where there is a reliance on low-cost food staples and where the diversity of the diet is limited. Finding a way to improve the nutritional quality of diets for the poorest people is central to meeting the UN sustain- able development goals particularly sustainable development goal 2: end hunger, achieve food security and improved nutrition and promote sustainable agriculture. As we pass the midpoint of the UN’s Decade for Action on Nutrition, it is timely to reflect on progress towards achieving sustainable development goal 2 and the strategies to reduce hidden hunger. Many low- and middle-income countries are falling behind national nutrition targets, and this has been exacerbated by the COVID-19 pandemic as well as other recent shocks to the global food system which have disproportionately impacted the world’s most vulnerable communities. Addressing inequalities within the food system must be central to developing a sustainable, cost-effective strategy for improving food quality that delivers benefit to the seldom heard and marginalised communities. Micronutrient intake: Sustainable development goals: Biofortification: Dietary supplementation Introduction The year 2020 marked the mid-point of the UN’s Decade for Action on Nutrition (2016–2025) (1) , however, the total number of people living with severe food insecurity has continued to rise since 2015 (2) . Achieving zero hunger by 2030 is one of the seventeen sustainable development goals and now is a time when there is an intensified spot- light on global nutrition research, with the UN Food Systems Summit and Nutrition for Growth Summit both taking place in 2021. Over the past decade, a series of landmark publications in the Lancet (3–8) have provided a sharp focus on the previously unprecedented level of detail on the scale of the challenges the international nutri- tion research community faces to reduce malnutrition in all its forms, frequently referred to as the ‘triple burden of malnutrition’ that encompasses overnutrition, under- nutrition and micronutrient deficiencies. The presence of multiple micronutrient deficiencies in the absence of an energy-deficit diet is often described as ‘hidden hunger’ (9) . Iron, zinc, iodine and vitamin A Corresponding author: Nicola M. Lowe, email nmlowe@uclan.ac.uk Proceedings of the Nutrition Society (2021), 80, 283–289 doi:10.1017/S0029665121000902 © The Author(s), 2021. Published by Cambridge University Press on behalf of The Nutrition Society. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. First published online 26 April 2021 Proceedings of the Nutrition Society https://doi.org/10.1017/S0029665121000902 Downloaded from https://www.cambridge.org/core. IP address: 34.203.239.114, on 20 Jan 2022 at 21:54:21, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms.