Micronutrient Malnutrition

What is micronutrient deficiency?

Micronutrient deficiency is a lack of essential vitamins and minerals required in small amounts by the body for proper growth and development. Micronutrients include, but are not limited to:

  • Vitamins A, B, C and D
  • Calcium
  • Folate
  • Iodine
  • Iron
  • Zinc

Common micronutrient deficiencies among orphaned children include:

Learn more about micronutrients and micronutrient deficiencies at:
Orphan Nutrition Library
The World Health Organization
Adoption Nutrition (SPOON Foundation)

Iron Deficiency

Iron deficiency is the most common form of malnutrition worldwide. A lack of iron in the diet results in iron deficiency. The most commonly recognized condition associated with iron deficiency is anemia.

What is Iron?

Iron is a micronutrient that is essential to the structure of every cell in the body, but particularly red blood cells (hemoglobin), which transport oxygen in the blood to tissues in the body. In addition, iron is also a key component in proteins in muscle tissue and is critical for the normal development of the central nervous system.

Iron is rich in foods such as:

  • Meats, poultry and fish
  • Fortified cereals and oatmeal
  • Legumes (e.g. soybeans and lentils)
  • Leafy greens
  • Seeds (e.g. sesame and pumpkin)

What is Iron Deficiency?

In iron deficiency, the amount of iron stored away for later use is reduced as indexed by a low serum ferritin level, but has no effect on the iron needed to meet the daily needs of an individual. If the body requires increased iron (due to a rapid growth spurt, for example), a person with inadequate stored iron has no reserves to use. When the body lacks sufficient iron to make adequate hemoglobin, red blood cells cannot transport adequate oxygen to tissues throughout the body. This can cause iron-deficiency anemia, an advanced stage of iron deficiency. Iron is also critical for normal cardiac and skeletal muscle function and is a key component of enzymes involved in the development of the brain. Learn how to identify iron deficiency.


Oral iron supplementation can be used for both prevention and treatment of iron deficiency anemia. Oral iron supplements are usually best absorbed by an empty stomach. However, because iron can irritate a child’s stomach, supplements may need to be taken with food. A source of vitamin C, like a citrus juice, enhances iron absorption. It usually takes several months of iron supplementation to correct the iron deficiency.

Learn more about Iron Deficiency.

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Iodine Deficiency

Iodine deficiency is the world’s most common, but preventable, cause of mental retardation. A lack of iodine in the diet can affect thyroid gland function and result in a condition called goiter.

What is Iodine?

Iodine is a nutrient essential for normal functioning of the thyroid gland, production of thyroid hormones and metabolism.

Iodine is typically found in small amounts in food and varies depending on environmental factors such as the soil concentration of iodine and the use of fertilizers.

Sources of dietary iodine include:

  • Bread (fortified)
  • Iodized table salt
  • Dairy products (e.g. cheese, cow milk, yogurt)
  • Eggs
  • Soy milk and soy sauce
  • Shellfish

What is Iodine Deficiency?

Iodine is not produced by the body, so it must be obtained through diet. Sufficient thyroid hormone is not produced without enough iodine. Iodine deficiency can lead to enlargement of the thyroid (goiter), hypothyroidism, and mental retardation in infants and children whose mothers were iodine deficient during pregnancy. Learn how to identify iodine deficiency.


Consuming foods high in iodine can help treat and prevent iodine deficiency. When iodine deficiency is seen among children in an entire institution, it can be managed by addressing that group’s diet. Iodized salt, iodized oil, and iodized water supplies have all been effective at preventing iodine deficiencies.

Learn more about Iodine Deficiency.

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Vitamin D Deficiency

Vitamin D deficiency can lead to abnormalities in bone development and a condition in children called rickets.

What is Vitamin D?

Vitamin D is a fat-soluble vitamin naturally produced in the body. It is essential to the absorption of calcium for proper bone development and function.

Vitamin D is found in:

  • Cod and cod liver oil
  • Egg yolks
  • Milk and butter
  • Salmon and shrimp
  • Fortified cereals

What is Vitamin D Deficiency?

Vitamin D deficiency can cause rickets, a deficiency disease of infants and children in which bones are not mineralized. In rickets, bones become soft and may bend, distort, and/or fracture. Rickets is one of the most common childhood diseases in many developing countries. Learn how to identify vitamin D deficiency.


Treatment of rickets involves:

  • Vitamin D supplementation
  • Increasing dietary intake of calcium, phosphates, and vitamin D
  • Daily exposure to small amounts of sunlight (15 minutes/day for lighter skinned children; longer for darker skinned children)
  • Special braces to position the bones (severe cases)
  • Surgery (very severe skeletal deformities)

Learn more about Vitamin D Deficiency.

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What is Selenium?

Selenium is a trace mineral needed by the body in small amounts for good health. It is incorporated into proteins to make important antioxidant enzymes. These enzymes help prevent cellular damage from free radicals that can cause the development of chronic diseases such as cancer and heart disease.

Selenium can be found in the following foods:

  • Brazil nuts
  • Canned tuna and cod
  • Beef and poultry
  • Enriched pasta and rice
  • Eggs
  • Cottage cheese
  • Oatmeal

What is Selenium Deficiency?

Selenium deficiency is a result of too little selenium in the diet. Though rare, it can lead to three specific diseases:

  • Keshan Disease results in an enlarged heart and poor heart function in selenium-deficient children.
  • Kashin-Beck Disease results in osteoarthritis and weakened immune system in children.
  • Myxedematous Endemic Cretinism results in mental retardation in infants born to mothers deficient in both selenium and iodine.

Learn how to identify selenium deficiency.


Selenium supplementation protects people from developing Keshan disease but cannot reverse heart muscle damage once it occurs. There is little evidence that improving selenium nutritional status prevents Kashin-Beck disease.

Learn more about Selenium Deficiency.

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Vitamin A

What is Vitamin A?

Vitamin A is a group of compounds that play a significant role in vision, bone development, immune support, and normal bodily function. Retinol and beta-carotene are forms of pre-vitamin A which are converted to vitamin A in the body.

Food sources of vitamin A include:

  • Eggs
  • Milk and butter
  • Liver
  • Fish (e.g. herring, sardines, and tuna)

Sources of beta-carotene include:

  • Spinach
  • Carrots
  • Oranges
  • Sweet potatoes

What is Vitamin A Deficiency?

Vitamin A deficiency exists when a child regularly fails to eat sufficient amounts of vitamin A or beta-carotene, which results in low levels of blood-serum vitamin A. Serious lack of the vitamin can lead to night blindness. Learn how to identify vitamin A deficiency.


The night blindness associated with vitamin A deficiency can be reversed with treatment. Total blindness, however, cannot be treated. Treatment for vitamin A deficiency includes:

  • Oral and injectable supplementation
  • Food fortification
  • Increasing consumption of vitamin A-rich foods, both animal and fruits and vegetables

Learn more about Vitamin A Deficiency.

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Vitamin B12

What is Vitamin B12?

Vitamin B12 is a water-soluble vitamin that exists in several forms. Vitamin B12 is needed for proper red blood cell formation and the maintenance of healthy nerve cells. It is also essential to making DNA, the genetic material in cells.

Vitamin B12 is found in fortified cereals and found naturally in foods that come from animals, including:

  • Fish
  • Meat
  • Poultry
  • Eggs
  • Milk and milk products

What is Vitamin B12 Deficiency?

Vitamin B12 deficiency results from inadequate dietary intake or impaired absorption. Learn how to identify vitamin B12 deficiency.


Vitamin B12 deficiency can be treated by:

  • Supplements: oral pills, under the tongue pills, liquid, nasal sprays, or injection
  • Increased consumption of animal products

Learn more about Vitamin B12 Deficiency.

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What is Folate?

Folate, also known as vitamin B9, is a water-soluble vitamin naturally found in foods. Folate is necessary for the production and maintenance of new cells. It is especially important during periods of rapid cell division and growth such as infancy and pregnancy. Both adults and children need folate to make normal red blood cells and prevent anemia.

Folate can be found naturally in the following foods:

  • Leafy greens (e.g. spinach and turnip greens)
  • Peas and beans
  • Fruits and vegetables

Folic acid (synthetic folate) is commonly added to enriched grain products such as:

  • Cereals
  • Rice
  • Pasta
  • Bread
  • Flour

What is Folate Deficiency?

Inadequate dietary intake of folate can slow growth rate in infants and children. Advanced folate deficiency can lead to anemia in adults. Learn how to identify folate deficiency.


Folic acid is available in most multivitamins and in some foods. Supplementing the diet with vitamins and foods rich in folate or folic acid can help prevent and treat folate deficiency.

Learn more about Folate Deficiency.

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What is Zinc?

Zinc is an essential mineral found in over 200 enzymes that are involved in a wide range of functions in the body. These zinc-containing enzymes play a role in immune function, wound healing, and making DNA and other proteins. Zinc supports normal growth and development during childhood and adolescence, and is required for proper sense of taste and smell.

Foods high in zinc include:

  • Meats and seafood
  • Eggs
  • Whole grains and oats
  • Nuts and seeds
  • Leafy greens
  • Vegetables and herbs
  • Yogurt

What is Zinc Deficiency?

Because zinc plays so many roles in the body including brain development, a deficiency of zinc can impact multiple bodily functions and result in a wide variety of symptoms. Learn how to identify zinc deficiency.


Zinc deficiency can be managed by:

  • Supplements (zinc sulfate or zinc gluconate)
  • Increasing dietary intake
  • Vitamin and mineral supplements to aid in zinc absorption (e.g. A, E, B6, magnesium, phosphorous, and calcium)

Learn more about Zinc Deficiency.

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