By Lt Col Dr Carl A Nutsugah, Special Columnist
Ghana sits under generous skies, brims with colourful markets and an abundance of fresh foods — yet many of its men suffer from a quieter, less visible problem: micronutrient deficiency, often called “hidden hunger.” This article pulls together the best available evidence, paints real-world vignettes, and recommends sensible, safe approaches to supplements and diet for Ghanaian men.
The problem in one paragraph
Micronutrient shortfalls — iron, vitamin D, zinc, iodine and others — remain important public-health issues in Ghana. National surveys and focused studies show persistent gaps in nutritional status and dietary diversity; at the same time, most large nutrition surveys focus on children and women of reproductive age, leaving the picture for adult men understudied and underreported. That knowledge gap makes targeted action harder but does not mean men are spared.
What the data tell us (key facts)
Vitamin D. Contrary to expectations, measurable vitamin D insufficiency/deficiency is common in Ghanaian adults despite plentiful sunlight. Multiple studies report sizable proportions of adults with low 25-hydroxyvitamin D levels — a reminder that sunlight exposure patterns, skin pigmentation, indoor work and diet all affect status.
Iron / anaemia. Anaemia remains common in Ghana, and while most national reporting prioritizes children and women, smaller studies and local surveys document substantial anaemia burden in men in some communities — especially those with high parasitic disease burden, poor dietary iron bioavailability, or socio-economic deprivation. National micronutrient surveys (and the Ministry of Health profile) note high overall anaemia and caution about extrapolating child/women data to men because of measurement gaps.
Iodine. Thanks to decades of salt iodization, iodine deficiency has been reduced, but monitoring shows variable household coverage and occasional local gaps in iodine content of sold salt — which means pockets of risk can persist.
Zinc and dietary diversity. Recent research links lower dietary diversity with lower serum zinc and vitamin C — a pattern that increases infection risk and slows recovery from illness. In settings with limited animal-source foods, zinc deficiency risk rises.
Real-life vignettes (composite, typical cases)
“Kojo, 38 — the night-shift mechanic.” Kojo works long nights under artificial light, grabs street food between jobs and rarely eats fruits. He felt tired and short of breath when climbing stairs. Blood tests at a clinic showed low haemoglobin and low iron markers; helminth screening found hookworm. A combined plan of deworming, iron therapy and counselling on iron-rich foods (beans, small fish, liver, vitamin C with meals) improved his energy in weeks.
“Yaw, 45 — office manager and weekend gamer.” Yaw spends most of his workday indoors. Despite sunny Accra, he has low vitamin D on testing and complains of generalized aches. After a supervised short course of vitamin D supplementation and guidance about safe sun exposure (mid-day brief exposure on forearms/face several times weekly where culturally acceptable), his levels and symptoms improved.
These are typical composite examples drawn from clinical patterns reported in Ghanaian studies and practice; they illustrate how occupational and lifestyle factors interact with diet and infections to create deficiency. (They are not drawn from identifiable patient records.)
Why men are overlooked
Large nutrition programmes and surveys traditionally concentrate on children and women of reproductive age because of well-documented risks to child growth and maternal health. That focus is correct — but it means adult men receive less routine screening and fewer public messages about micronutrients. In practice this leads to under-detection and under-treatment of male deficiencies even when prevalence is significant locally.
Practical, evidence-backed guidance for clinicians and public health teams
1. Measure, don’t guess. Where possible, check haemoglobin, ferritin (adjusted if inflammation), 25-hydroxyvitamin D, and, for specific concerns, serum zinc/iodine markers. Local lab capacity varies — but targeted testing prevents unnecessary or harmful supplementation.
2. Fix the basics first — treat infections and improve diets. Deworming in high-risk areas, malaria control, and improving access to iron-rich and vitamin-C-rich foods (to boost iron absorption) yield big returns. Promote small, affordable changes: dried fish or sardines, legumes, leafy greens, fruits, and fortified staples.
3. Supplement sensibly.
• Iron: Give therapeutic iron for confirmed iron-deficiency anaemia (dosing and duration per clinical guidelines). Routine iron without evidence risks masking other diagnoses and may be harmful in some infections.
• Vitamin D: Supplement when testing shows deficiency or when risk factors (very low sun exposure, obesity, malabsorption) exist. Daily or weekly dosing should follow accepted protocols.
• Zinc: In supplementation programmes, use zinc where deficiency is likely (or in acute diarrhoea per WHO child guidance), but routine high-dose zinc for all adults is not recommended.
Always counsel on possible interactions (e.g., iron and calcium compete for absorption) and side effects.
4. Fortification and food systems. Support and monitor national fortification efforts (iodized salt, fortified wheat/maize flour) and small-scale interventions (school and workplace meals) that reach men. Fortification is cost-effective and reaches broad populations.
5. Targeted public messaging. Design male-friendly nutrition messages addressing workplace choices (e.g., healthy quick meals for shift workers), safe sun advice, and deworming uptake. Use workplaces, unions and sports clubs as outreach points.
Supplements: realistic advice for Ghanaian men
• Food first. Aim to obtain nutrients from diet: small fish, offal once in a while, beans and legumes, a variety of vegetables and fruits, and fortified staples.
• Test before supplementing when feasible. Blind supplementation wastes resources and risks harm.
• If you must supplement: use products from reputable suppliers, follow dosing instructions, and seek medical advice if you have chronic disease (e.g., liver, kidney disease), take medications, or are older than 50.
• Avoid “mega-doses” sold online or in markets promising quick fixes — these can be dangerous (fat-soluble vitamins can accumulate; excess iron or zinc causes toxicity).
Policy implications and research needs
• Include adult men in national micronutrient surveys. The Ghana Micronutrient Survey and Ministry profiles have advanced understanding, but routine nationally representative male data are sparse and should be rectified.
• Strengthen surveillance of fortification quality. Iodization success shows what policy can do — but sustained monitoring of salt and staple fortification will keep gains real.
• Workplace health programmes. Employers and unions are a high-yield locus for screening and nutrition promotion for men.
A final word to clinicians, policymakers and men
Hidden hunger does not announce itself with a bright symptom; it creeps in through diets, jobs and infections. For Ghanaian men, the path to healthier micronutrient status runs through better data, sensible screening, diet-first approaches, and targeted, medically supervised supplementation when needed. As clinicians and public-health professionals, we must broaden our attention beyond the long-standing focus on women and children to include men — not to compete for scarce resources, but to build healthier families and communities. As men themselves, a simple start is often all it takes: add one vitamin-C fruit a day, choose fish twice a week, get tested when tiredness is persistent, and ask a clinician before starting pills.
Key references and further reading
• Ghana National Micronutrient Survey (GMS) 2017 — national survey and findings.
• Sakyi SA et al., Vitamin D deficiency is common in Ghana despite abundant sunlight. (2021).
• Doku GN et al., Iodine levels in brands of salt on the markets of Accra, Ghana — monitoring of iodization 2018.
• Recent research on dietary diversity, zinc and infection risk (PLOS, 2025).
• Nutrition Country Profile — Ghana Ministry of Health (note on data gaps for adult men).
