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. 2025 Jul 2:12:1565620.
doi: 10.3389/fnut.2025.1565620. eCollection 2025.

Global, regional and national trends in the burden of nutritional deficiencies in children, 1990-2021

Zhuoqiong Liu  1 , Yangyang Liu  1 , Jiaxin Yang  2 , Liru Yan  1 , Qiushi Li  1 , Ying Gao  2
Affiliations

Global, regional and national trends in the burden of nutritional deficiencies in children, 1990-2021

Zhuoqiong Liu et al. Front Nutr. .

Abstract

Background: The objective of this study was to systematically assess global, regional, and national trends in the prevalence and burden of nutritional deficiencies among children aged 0-14 years from 1990 to 2021. Specifically, four major subtypes of malnutrition: protein-energy malnutrition, Vitamin A deficiency, iodine deficiency, and dietary iron deficiency.

Methods: This study utilized data from the 2021 Global Burden of Disease (GBD) database to analyze incidence and disability-adjusted life year (DALY) rates. The estimated annual percentage change (EAPC) was calculated, with the data stratified based on age, gender, region, socio-demographic index (SDI), and country.

Results: Between 1990 and 2021, the global burden of nutritional deficiencies (all ages 0-14 combined) in children declined. The age-standardized DALY rate of dietary iron deficiency had the lowest EAPC (- 0.53; 95% CI: - 0.62, - 0.45). The highest burden of nutritional deficiencies and its subtypes was in Sub-Saharan Africa, but the age-standardized DALY rate of dietary iron deficiency and the age-standardized incidence rate (ASIR) of protein-energy malnutrition were highest in South Asia (1103.19 and 3185.45 respectively). Age-standardized DALYs of protein-energy malnutrition increased substantially in high-income North America (EAPC: 3.30) and Western Europe (EAPC: 2.29). The age group with the greatest burden of nutritional deficiencies and of its subtypes was 0-4 years age group.

Conclusion: From 1990 to 2021, Sub-Saharan Africa has consistently faced the most severe nutritional deficiencies. Meanwhile, South Asia continues to struggle with significant protein-energy and dietary iron nutritional shortfalls. Conversely, high-income North America and Western Europe have experienced a notable rise in protein-energy deficiency.

Keywords: DALY; children; disease burden; incidence; nutritional deficiencies.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
ASR of change trend for nutritional deficiencies and its subtypes among children aged 0–14 years old in 7 super regions, 1990–2021. (A) Age-standardized DALY rate. (B) Age-standardized incidence rate. ASR, age-standardized rate.
Figure 2
Figure 2
Age-standardized DALY rate of nutritional deficiencies among children aged 0–14 years old in 21 regions, in 2021 and its trends from1990 to 2021.
Figure 3
Figure 3
The age-standardized DALY rate and ASIR of nutritional deficiencies and its subtypes among children aged 0–14 years old among 204 countries in 2021. (A) Age-standardized DALY rate. (B) Age-standardized incidence rate. ASR, age-standardized rate.
Figure 4
Figure 4
SDI-related health inequality regression for the burden of ASR due to five nutritional deficiencies among children aged 0–14 years old, 1990 and 2021. (A) Age-standardized DALY rate. (B) Age-standardized incidence rate. ASR, age-standardized rate; SDI, socio-demographic index.
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