Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study

GBD 2021 Dietary Iron Deficiency Collaborators

doi:10.1038/s41591-025-03624-8

Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study

GBD 2021 Dietary Iron Deficiency Collaborators

Kyung Hee University
Broad Institute
Massachusetts General Hospital
University of Washington
University of Washington School of Medicine
An-Najah National University
Hormozgan University of Medical Sciences
Khyber Medical University
Kazakh National Medical University
Chinese University of Hong Kong
Dalian University of Technology
Peking University Health Science Center
Johns Hopkins University
Mekelle University
Jimma University
Al-Azhar University
University of Ha’il
Sina Medical Biochemistry Technologies
Hospital San Juan de Dios
San Pablo Catholic University Tarija Bolivia
University of Duhok
Wuhan University
University of Toyama
Juntendo University
Xuzhou Medical University
Dire Dawa University
St Paul's Hospital Millennium Medical College
Independent Consultant
Imperial College London
Shiraz University of Medical Sciences
Mashhad University of Medical Sciences
National Institute for Research in Environmental Health
University of New South Wales
The George Institute for Global Health
Bahir Dar University
Samara University
University of Innsbruck
University of Cambridge
Monash University
Rajarata University of Sri Lanka
King's College London
National University of Sciences & Technology
Near East University
Grigore T Popa University of Medicine and Pharmacy
Regional Institute of Oncology
Icahn School of Medicine at Mount Sinai
University of Southampton
University of Edinburgh
Central University of Punjab
Bharathiar University
UKK Institute Finland
University of Tampere
Jazan University
KU Leuven
Urmia University of Medical Sciences
University of Bahrain
Mayo Clinic
Tehran University of Medical Sciences
McMaster University
University of Ibadan

Research output: Contribution to journal › Article › peer-review

26 Citations (Scopus)

Abstract

Although iron deficiency is well documented, less is known about dietary involvement in symptomatic iron deficiency manifesting in medical conditions. In this study, we quantified the global burden of dietary iron deficiency, focusing on where inadequate dietary iron intake leads to clinical manifestations such as anemia. We analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate dietary iron deficiency prevalence and disability-adjusted life years (DALYs), stratified by age, sex, geography and socio-demographic index (SDI) across 204 countries. In 2021, global age-standardized prevalence and DALY rates were 16,434.4 (95% uncertainty interval (UI), 16,186.2–16,689.0) and 423.7 (285.3–610.8) per 100,000 population, with rates decreasing by 9.8% (8.1–11.3) and 18.2% (15.4–21.1) from 1990 to 2021. A higher burden was observed in female individual (age-standardized prevalence, 21,334.8 (95% UI, 20,984.8–21,697.4); DALYs, 598.0 (402.6–854.4)) than in male individual ((age-standardized prevalence, 11,684.7 (11,374.6–12,008.8); DALYs, 253.0 (167.3–371.0)). High-SDI countries presented greater improvement, with a 25.7% reduction compared to 11.5% in low-SDI countries. Despite global improvements, dietary iron deficiency remains a major health concern with a global prevalence of 16.7%, particularly affecting female individuals, children and residents in low-SDI countries. Urgent interventions through supplementation, food security measures and fortification initiatives are essential.

Original language	English
Pages (from-to)	1809-1829
Number of pages	21
Journal	Nature Medicine
Volume	31
Issue number	6
Early online date	22 Apr 2025
DOIs	https://doi.org/10.1038/s41591-025-03624-8
Publication status	Published - Jun 2025

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Nature America, Inc. 2025.

Funding

This study was funded by the Bill and Melinda Gates Foundation, the Australian National Health and Medical Research Council and the Queensland Department of Health, Australia. This work was supported by the Yonsei Fellowship, funded by Lee Youn Jae (J.I.S.). This research was supported by the Ministry of Science and ICT (MIST), Korea, under the Information Technology Research Center (ITRC) support program (IITP-2024-RS-2024-00438239 to D.K.Y.), supervised by the Institute for Information & Communications Technology Planning & Evaluation (IITP). The funders of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report. All authors had full access to the study data and had final responsibility for the decision to submit for publication.

Funders
Bill and Melinda Gates Foundation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 2 Zero Hunger

ASJC Scopus subject areas

General Medicine
General Biochemistry,Genetics and Molecular Biology

Access to Document

10.1038/s41591-025-03624-8

Cite this

@article{81e7852ab4564a5ab82428aa2f72205e,

title = "Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study",

abstract = "Although iron deficiency is well documented, less is known about dietary involvement in symptomatic iron deficiency manifesting in medical conditions. In this study, we quantified the global burden of dietary iron deficiency, focusing on where inadequate dietary iron intake leads to clinical manifestations such as anemia. We analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate dietary iron deficiency prevalence and disability-adjusted life years (DALYs), stratified by age, sex, geography and socio-demographic index (SDI) across 204 countries. In 2021, global age-standardized prevalence and DALY rates were 16,434.4 (95\% uncertainty interval (UI), 16,186.2–16,689.0) and 423.7 (285.3–610.8) per 100,000 population, with rates decreasing by 9.8\% (8.1–11.3) and 18.2\% (15.4–21.1) from 1990 to 2021. A higher burden was observed in female individual (age-standardized prevalence, 21,334.8 (95\% UI, 20,984.8–21,697.4); DALYs, 598.0 (402.6–854.4)) than in male individual ((age-standardized prevalence, 11,684.7 (11,374.6–12,008.8); DALYs, 253.0 (167.3–371.0)). High-SDI countries presented greater improvement, with a 25.7\% reduction compared to 11.5\% in low-SDI countries. Despite global improvements, dietary iron deficiency remains a major health concern with a global prevalence of 16.7\%, particularly affecting female individuals, children and residents in low-SDI countries. Urgent interventions through supplementation, food security measures and fortification initiatives are essential.",

author = "\{GBD 2021 Dietary Iron Deficiency Collaborators\} and Sooji Lee and Yejun Son and Jiyoung Hwang and Kim, \{Min Seo\} and McLaughlin, \{Susan A.\} and Victor Vilchis-Tella and Leo Zoeckler and Nandita Perumal and Zyoud, \{Sa{\textquoteright}ed H.\} and Ghazal Zoghi and Hafsa Zia and Abzal Zhumagaliuly and Zhong, \{Claire Chenwen\} and Liqun Zhang and Haijun Zhang and Zeru, \{Naod Gebrekrstos\} and Zeariya, \{Mohammed G.M.\} and Iman Zare and Nelson Zamora and Zaman, \{Burhan Abdullah\} and Chuanhua Yu and Naohiro Yonemoto and Dehui Yin and Muluken Yigezu and Yesuf, \{Subah Abderehim\} and Sanni Yaya and Amir Yarahmadi and Vikas Yadav and Xiaoyue Xu and Wubie, \{Yihun Miskir\} and Woday, \{Abay Tadesse\} and Peter Willeit and Holly Wild and Weerakoon, \{Kosala Gayan\} and Yanzhong Wang and Yasir Waheed and Volovat, \{Simona Ruxandra\} and Manish Vinayak and Dominique Vervoort and Verras, \{Georgios Ioannis\} and Balachandar Vellingiri and Vasankari, \{Tommi Juhani\} and Joe Varghese and \{Van den Eynde\}, Jef and Rohollah Valizadeh and Vaithinathan, \{Asokan Govindaraj\} and Sanaz Vahdati and Vahabi, \{Seyed Mohammad\} and Kurmi, \{Om P.\} and Fagbamigbe, \{Adeniyi Francis\}",

note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Nature America, Inc. 2025.",

year = "2025",

month = jun,

doi = "10.1038/s41591-025-03624-8",

language = "English",

volume = "31",

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T1 - Global, regional and national burden of dietary iron deficiency from 1990 to 2021

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AU - Lee, Sooji

AU - Son, Yejun

AU - Hwang, Jiyoung

AU - Kim, Min Seo

AU - McLaughlin, Susan A.

AU - Vilchis-Tella, Victor

AU - Zoeckler, Leo

AU - Perumal, Nandita

AU - Zyoud, Sa’ed H.

AU - Zoghi, Ghazal

AU - Zia, Hafsa

AU - Zhumagaliuly, Abzal

AU - Zhong, Claire Chenwen

AU - Zhang, Liqun

AU - Zhang, Haijun

AU - Zeru, Naod Gebrekrstos

AU - Zeariya, Mohammed G.M.

AU - Zare, Iman

AU - Zamora, Nelson

AU - Zaman, Burhan Abdullah

AU - Yu, Chuanhua

AU - Yonemoto, Naohiro

AU - Yin, Dehui

AU - Yigezu, Muluken

AU - Yesuf, Subah Abderehim

AU - Yaya, Sanni

AU - Yarahmadi, Amir

AU - Yadav, Vikas

AU - Xu, Xiaoyue

AU - Wubie, Yihun Miskir

AU - Woday, Abay Tadesse

AU - Willeit, Peter

AU - Wild, Holly

AU - Weerakoon, Kosala Gayan

AU - Wang, Yanzhong

AU - Waheed, Yasir

AU - Volovat, Simona Ruxandra

AU - Vinayak, Manish

AU - Vervoort, Dominique

AU - Verras, Georgios Ioannis

AU - Vellingiri, Balachandar

AU - Vasankari, Tommi Juhani

AU - Varghese, Joe

AU - Van den Eynde, Jef

AU - Valizadeh, Rohollah

AU - Vaithinathan, Asokan Govindaraj

AU - Vahdati, Sanaz

AU - Vahabi, Seyed Mohammad

AU - Kurmi, Om P.

AU - Fagbamigbe, Adeniyi Francis

PY - 2025/6

Y1 - 2025/6

N2 - Although iron deficiency is well documented, less is known about dietary involvement in symptomatic iron deficiency manifesting in medical conditions. In this study, we quantified the global burden of dietary iron deficiency, focusing on where inadequate dietary iron intake leads to clinical manifestations such as anemia. We analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate dietary iron deficiency prevalence and disability-adjusted life years (DALYs), stratified by age, sex, geography and socio-demographic index (SDI) across 204 countries. In 2021, global age-standardized prevalence and DALY rates were 16,434.4 (95% uncertainty interval (UI), 16,186.2–16,689.0) and 423.7 (285.3–610.8) per 100,000 population, with rates decreasing by 9.8% (8.1–11.3) and 18.2% (15.4–21.1) from 1990 to 2021. A higher burden was observed in female individual (age-standardized prevalence, 21,334.8 (95% UI, 20,984.8–21,697.4); DALYs, 598.0 (402.6–854.4)) than in male individual ((age-standardized prevalence, 11,684.7 (11,374.6–12,008.8); DALYs, 253.0 (167.3–371.0)). High-SDI countries presented greater improvement, with a 25.7% reduction compared to 11.5% in low-SDI countries. Despite global improvements, dietary iron deficiency remains a major health concern with a global prevalence of 16.7%, particularly affecting female individuals, children and residents in low-SDI countries. Urgent interventions through supplementation, food security measures and fortification initiatives are essential.

AB - Although iron deficiency is well documented, less is known about dietary involvement in symptomatic iron deficiency manifesting in medical conditions. In this study, we quantified the global burden of dietary iron deficiency, focusing on where inadequate dietary iron intake leads to clinical manifestations such as anemia. We analyzed data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 to estimate dietary iron deficiency prevalence and disability-adjusted life years (DALYs), stratified by age, sex, geography and socio-demographic index (SDI) across 204 countries. In 2021, global age-standardized prevalence and DALY rates were 16,434.4 (95% uncertainty interval (UI), 16,186.2–16,689.0) and 423.7 (285.3–610.8) per 100,000 population, with rates decreasing by 9.8% (8.1–11.3) and 18.2% (15.4–21.1) from 1990 to 2021. A higher burden was observed in female individual (age-standardized prevalence, 21,334.8 (95% UI, 20,984.8–21,697.4); DALYs, 598.0 (402.6–854.4)) than in male individual ((age-standardized prevalence, 11,684.7 (11,374.6–12,008.8); DALYs, 253.0 (167.3–371.0)). High-SDI countries presented greater improvement, with a 25.7% reduction compared to 11.5% in low-SDI countries. Despite global improvements, dietary iron deficiency remains a major health concern with a global prevalence of 16.7%, particularly affecting female individuals, children and residents in low-SDI countries. Urgent interventions through supplementation, food security measures and fortification initiatives are essential.

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DO - 10.1038/s41591-025-03624-8

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SN - 1078-8956

VL - 31

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JO - Nature Medicine

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ER -

Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study

Abstract

Bibliographical note

Funding

UN SDGs

ASJC Scopus subject areas

Access to Document

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