determining factors for our well-being. According to the Food and Agriculture Organization of the United Nations (FAO for its acronym in English), everyone has the right to have their health preserved by a safe, healthy, balanced and varied diet, adjusted to the needs of each person. subject. However, it is not enough to have food available to satisfy us, but to access what we need to stay healthy. Although we do not suffer from chronic hunger, the absence of necessary vitamin and mineral components for our body affects our physical and intellectual capacity. This deficiency, called “hidden hunger,” is often overlooked even when two billion people suffer from it. 

 

Hidden hunger is a risk factor for the immune system, it increases  the potential for diseases such as anemia, dental caries, diabetes, hyper/hypothyroidism, obesity, heart disease, osteoporosis, or even cancer. The sustained scarcity of healthy foods can aggravate illnesses, delay their recovery, or create secondary illnesses due to neglect of a strict diet. An immune system in these conditions does not fulfill its function of preventing, resisting, or overcoming diseases caused by contagion, poisoning, contamination, or any other adverse condition that puts health at risk. In addition, hidden hunger can deepen lagging diseases, where its impact during gestation and the first 2 to 3 years of life increases the risk of morbidity and mortality from infectious diseases; it can also reduce intellectual performance in the long term. 

 

Hidden hunger is a factor that aggravates food insecurity in Cuba, especially for people in vulnerable health conditions; for example, people over 70 years of age, people under 70 years of age with chronic diseases, as well as pregnant women. On the island, the most frequent concern of these population groups is the impossibility of accessing food that supports their specific needs. This situation tends to become more complex if one takes into account that a majority of people over 70 live alone or with their partners, and depend on their retirement as the only source of income. So, the social condition represents an aggravating circumstance in this group, as it is very difficult for them to acquire food products in the network of stores in MLC or on the black market. 

 

Another obstacle for the elderly in Cuba is their dependence on third parties to ensure their food, due to motor problems and the deficient infrastructure to acquire the products, which prevents them from moving or waiting for hours to buy the distributed goods. Failing that, these people receive support from social centers (such as the Casas de Abuelos distributed in the municipalities), religious institutions and organizations (Caritas, Loyola Centers), public soup kitchens, as well as members of the community. However, is this help enough to prevent a worsening of their health conditions?

 

In Cuba, the National Medical Dietary, resolved jointly between the Ministry of Finance and Prices and the Ministry of Public Health, describes the different medical diets that, although they are intended to treat chronic diseases, do not last longer than one year. In this relationship, conditions derived from deficiencies in the production and absorption of vitamins –peripheral neuropathy, for example– do not have a guaranteed special dietary coverage, even when their treatment depends on a balanced diet. Those that do have an additional food supplement need prescriptions that are subject to a Medical Diet Affidavit, whose models have been lacking in many consultations in the country. In addition, since January 2020, the unexpected reduction of special products in the basic basket, such as powdered milk, for example, has significantly damaged the ability to access basic foods for people who suffer from chronic diseases and depend on special diets.

 

Another element that threatens the guarantee of supplies to people in conditions of medical vulnerability is the country's dependence on imports and the practically non-existent national production. Faced with systemic and autoimmune disorders that are expressed in the body's rejection of certain foods, the country has practically no importation of products, for example, lactose-free or gluten-free. Powdered milk from brands such as Neocate or Prolaxin for intolerant minors come from countries like the Netherlands and are subject to current trade agreements; Other products such as gluten-free pasta have a customs duty that adds up to 10 times the price of the same in their country of origin. 

 

In this sense, hidden hunger does not represent a harmful deficiency in the medium term, but rather has a direct impact on the well-being of people who are doubly vulnerable, due to their medical condition and their poor purchasing power, who must feed themselves with what they find and not with what they find. that they must The term that gastroenterologists and other specialists use for improper substitution of food or for not complying with a strict diet is "poisoning", a term that they justify by direct adverse reactions, for example, in the case of food intolerances that present diarrhea, abdominal pain, tiredness and weight loss.

 

In short, we can identify an important tendency of the Cuban population to develop diseases due to food deficiencies, the prevalence of foods rich in fats, starches and sugars, as well as the added stress of guaranteeing daily meals. These conditions have worsened, or generated others linked to late diagnoses and the inability to guarantee a precise diet. The last two years have worsened the already precarious condition of a society that had been spreading deficiency diseases that emerged in the nineties. People in vulnerable conditions have had to face a pandemic context without having within their reach a diet that can balance their immune system. For diseases that rely more on healthy food than medicine, reducing medical diets in tandem with prevailing shortages means depriving people of their medical treatment. This situation, although largely invisible, would have serious repercussions in a country with increasing migratory bleeding, a low birth rate and an increasingly aging and malnourished population.