50,000 annual deaths in Germany linked to undernutrition, experts warn

As of November 6, 2026, the German Association for Nutritional Medicine (DGEM) estimates that about 50,000 deaths each year in Germany are linked to undernutrition and micronutrient deficiencies. In practical terms, DGEM says tens of thousands of people could survive or live longer if missing nutrients were identified and corrected sooner.

Many deficiencies remain invisible for a long time and only become apparent once damage has already occurred. "In most cases nothing is noticed at the beginning," says Matthias Pirlich, a specialist in nutritional medicine and internal medicine and former vice‑president of DGEM. He warns that late recognition often means irreversible harm.

What are undernutrition and "hidden hunger"?

Micronutrients — vitamins and minerals such as vitamin D, B12, calcium, magnesium, iron, iodine and zinc — cannot be produced by the body and must be obtained from food. Macronutrients (carbohydrates, proteins and fats) supply energy, but a calorie‑sufficient diet can still be poor in essential micronutrients.

Global estimates from the UN Food and Agriculture Organization (FAO) put chronic undernourishment at about 645 million people, while roughly two billion people suffer from so‑called "hidden hunger" due to insufficient micronutrients. Even in high‑income countries deficits are common: US data from 2007–2010 showed nearly three‑quarters of the population failed to meet recommended vitamin D intake and more than two‑thirds were short of vitamin E. In Germany the German Nutrition Society reported that around one‑third of the population had vitamin D deficiency in 2017, and about one‑third were not sufficiently supplied with iodine.

Longstanding lack of vitamin B12 can damage the spinal cord; consequences may include numbness in the limbs, muscle weakness or signs of paralysis. Less commonly, brain damage can occur, leading to memory impairments and psychiatric symptoms. Deficiencies of vitamin D increase the risk of bone, joint and muscle pain, more falls and fractures.

Several social and medical factors drive these deficits: diets high in "empty calories" (fast food and highly processed products), poverty that limits access to nutritious food, depression with reduced appetite, older age, living alone, and the use of multiple medications. Diseases that impair absorption — Crohn's disease, celiac disease, liver disease or cancer — also increase risk.

DGEM estimates that about 30 percent of hospitalized patients in Germany are affected by or at risk of nutrient deficiencies, yet health insurers' data indicate only around 1 percent are actually screened and treated for these problems. Pirlich calls for systematic screening of at‑risk groups in outpatient care: "This includes all people with chronic and serious illnesses, and especially older people." Politicians and medical associations in Germany have been urged to develop a plan to improve detection and treatment in hospitals by the end of 2027; the Netherlands already screens all patients at hospital admission.

Prevention means improving access to healthy food — including proposals such as free school meals — and promoting a varied, mostly plant‑based diet. "The numerous secondary plant substances have many positive effects, and if you eat variedly, you take in many different foods with beneficial nutritional properties," Pirlich says. Short cooking times, seasonal local produce and blood tests where deficiency is suspected can help; supplements can be used to correct confirmed deficits.

Photo: press material from the event