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. 2025 Jun;31(6):1809-1829.
doi: 10.1038/s41591-025-03624-8. Epub 2025 Apr 22.

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

Collaborators, Affiliations

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

Sooji Lee et al. Nat Med. 2025 Jun.

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.

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Conflict of interest statement

Competing interests: N.J.K. reports grants or contracts from the Bill & Melinda Gates Foundations as well as grant funding for anemia-related research. N.J.K. also reports payment or honoraria for lectures, presentations, speakers’ bureaus, manuscript writing or educational events from Bristol Myers Squibb (presentation on GBD 2021 findings for anemia and dietary iron deficiency), outside the submitted work. Competing interests for the GBD 2021 Dietary Iron Deficiency Collaborators are listed in Supplementary Note 2.

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