How Vitamin Angels tackles hidden hunger in infants and pregnant women

Amid rising acute hunger and malnutrition worldwide in 2025, US-based NGO Vitamin Angels highlights the distinction between hunger and hidden hunger — a form of malnutrition in which people have enough calories to survive but not enough essential vitamins and nutrients.

The organization points to the FAO’s most recent report on food insecurity and malnutrition, “The State of Food Security and Nutrition in the World 2024,” which estimates that over “one-third of people in the world — about 2.8 billion — could not afford a healthy diet in 2022.” Although these levels are decreasing, the FAO cautions that progress is uneven across regions. 

Vitamin Angels aims to improve nutrition for pregnant women, infants, and young children by providing nutritional interventions and educational programs to people across 65 countries. 

Nutrition Insight meets with Colleen Delaney, Ph.D., registered dietitian nutritionist, and technical adviser of US programs at the organization, to examine causes of hidden hunger and how to reverse this trend. 

“The systems change required to address hidden hunger will need to be highly collaborative,” says Delaney. “Governments, NGOs, academic organizations, and other public health stakeholders must collaborate to achieve effective change.” 

She explains that Vitamin Angels follows this strategy, collaborating with community-based organizations to understand and address the unique barriers to nutrition a community faces.

“While we focus on other partnerships within the nutrition ecosystem, another way to reverse this trend involves the behavior of food manufacturers. Product development, marketing, and food policy shape the landscape in which nutrient-rich foods are affordable and accessible.” 

Hidden hunger

Delaney explains that hidden hunger is more covert than insufficient food. 

“If my diet consisted solely of candy bars or white rice, for example, and I were meeting or exceeding my daily recommended calorie intake, I would still be susceptible to hidden hunger,” she explains. 

“Micronutrients are especially crucial for growing children and pregnant women because they support the increased growth and development during these life stages.” 

Vitamin Angels focuses on pregnant women, infants, and young children, which Delaney says are the most nutritionally vulnerable populations.Delaney stresses the importance of understanding both forms of malnutrition as distinct issues caused by different deficiencies to inform adequate policies and public health responses.

“It’s one thing to provide school lunch; it’s another to provide a nutritious lunch. Public health interventions that increase access to food must also account for diet quality and micronutrient intake.” 

She highlights a common misperception that this form of malnutrition only exists in areas of extreme poverty. “Hidden hunger can and does affect people from all walks of life. Even people who never worry about when they’ll eat their next meal can experience hidden hunger.” 

For example, Delaney says that areas with an overreliance on processed foods or a lack of diet diversity often lack essential nutrients. 

Prenatal care and infant nutrition

Vitamin Angels focuses its interventions on pregnant women, infants, and young children, which Delaney says are the “most nutritionally vulnerable populations.” 

“During pregnancy, women have increased nutritional demands to support the growth and development of their babies,” she details. “The daily required intake of several key vitamins and minerals can increase by as much as 50% and often cannot be met solely through diet.” 

“For women in low-resource settings, increased nutritional needs are even more acute, as many are already deficient in several micronutrients before pregnancy.” 

Moreover, she says that when pregnant women are malnourished, they can give birth to malnourished children — “perpetuating a cycle that impacts their health and economic well-being for years and even generations to come.”

During pregnancy, women have increased nutritional demands, e.g., of key vitamins and minerals, to support the development of their babies.“Prenatal vitamins can make all the difference in supporting the nutritional needs of underserved mothers and their babies and set children on a path toward healthy growth and development.” 

Role of nutrient deserts

A study released last year detailed that people living in food or nutrient deserts with limited access to affordable and healthy food options eat more snacks and sweets than people in higher-income areas with many food stores. 

The WHO warns food deserts are widening global health inequities that severely impact people’s life expectancy. 

Delaney reiterates that nutrient deserts lack access to nutrient-rich foods such as fruits and vegetables. Moreover, low-resource settings characterized by limited access to economic resources, infrastructure, education, and job opportunities further exacerbate hidden hunger. 

“Primarily, it is due to a lack of access to a diverse diet. Inaccessibility can mean not living close to a supermarket, not having transportation to access a store, insufficient financial means to purchase food, or lacking adequate healthcare that enables screening for signs of hidden hunger and micronutrient deficiencies.”

Local context is key

Vitamin Angels works at national and local levels to deliver “evidence-based and context-specific” nutrition interventions. The organization systematically collaborates with partners to identify solutions that resonate within a regional context and community. 

Vitamin Angels collaborates with partners to deliver evidence-based and context-specific nutrition interventions that resonate within a community.“We utilize a framework called landscaping to understand the local context and identify solutions, offer grants of multiple micronutrient supplements (MMS), technical assistance, and supply chain solutions.” 

“Local community-based organizations must prioritize the implementation of evidence-based nutrition interventions, such as facilitating the distribution of MMS to pregnant women, advocating for policies and funding to support individuals experiencing hidden hunger, and providing educational resources that facilitate the uptake and adherence of nutrition support.”  

The organization supports communities by: 

• Working with governments to advance policy change.
• Developing evidence-based social behavior change communications strategies to increase uptake and adherence.
• Training local community health workers.
• Integrating solutions into local maternal and child health programs. 
• Providing access to an initial supply while supporting infrastructure changes that enable local ownership and scale-up.

Cross-sector collaborative success

Delaney says cross-sector collaboration is crucial to developing sustainable nutrition solutions that address the availability, affordability, and consumption of micronutrients. 

For example, Vitamin Angels is collaborating with Indonesia’s Ministry of Health, researchers, universities, manufacturers, and other stakeholders to enhance maternal nutrition nationwide. 

“For many years, we’ve been working to support Indonesia’s national transition from iron and folic acid (IFA) supplements to MMS and build product manufacturing resilience,” details Delaney. 

“Because MMS provides 15 essential vitamins and minerals, whereas IFA offers only two, it can improve pregnancy and birth outcomes for mothers and their babies compared to IFA alone. Together, we improved the antenatal care system in Indonesia, which will help enhance maternal health and improve birth outcomes nationwide.”

Last year, Vitamin Angels’ annual report highlighted it reached over 72 million pregnant women, infants, and children in 2023, working with 1,200 partners. 

Delaney says the organization aims to double its impact, reaching “140 million underserved women and children annually by 2033.”