The value of an ecological approach to address micronutrient malnutrition

The global public health context has become increasingly complex with the confluence of widespread infectious and noncommunicable diseases, and widespread food insecurity, which has led to alarming rates of hunger and multiple consequences of malnutrition. A key component of this complexity is prevalent deficiencies of micronutrients (MNs, i.e., essential vitamins and minerals), many of which have been overlooked in public health programs addressing malnutrition. Here, we lay out an approach to more comprehensively address this complexity by considering the interactions of internal (biology, health, and developmental context) and external (diet/food environment, social, economic, climate, and physical) environments on humans and their nutritional health, i.e., an ecology. We present a conceptual framework for applying this ecological perspective with foci on the following: 1) how to apply this approach to assessments that capture the complexity of the nutritional ecology; and 2) how to expand the understanding of the biology of MNs in biological systems and the environmental factors that influence them. Suggestions are included for a targeted clinical, public health, and research agenda to inform the development of context-specific nutritional assessment and interventions.