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; Sooji Lee; Yejun Son; Jiyoung Hwang; Min Seo Kim; Susan A. McLaughlin; Victor Vilchis-Tella; Leo Zoeckler; Nandita Perumal; Sa’ed H. Zyoud; Ghazal Zoghi; Hafsa Zia; Abzal Zhumagaliuly; Claire Chenwen Zhong; Liqun Zhang; Haijun Zhang; Naod Gebrekrstos Zeru; Mohammed G.M. Zeariya; Iman Zare; Nelson Zamora; Burhan Abdullah Zaman; Chuanhua Yu; Naohiro Yonemoto; Dehui Yin; Muluken Yigezu; Subah Abderehim Yesuf; Sanni Yaya; Amir Yarahmadi; Vikas Yadav; Xiaoyue Xu; Yihun Miskir Wubie; Abay Tadesse Woday; Peter Willeit; Holly Wild; Kosala Gayan Weerakoon; Yanzhong Wang; Yasir Waheed; Simona Ruxandra Volovat; Manish Vinayak; Dominique Vervoort; Georgios Ioannis Verras; Balachandar Vellingiri; Tommi Juhani Vasankari; Joe Varghese; Jef Van den Eynde; Rohollah Valizadeh; Asokan Govindaraj Vaithinathan; Sanaz Vahdati; Seyed Mohammad Vahabi; Tolassa Wakayo Ushula; Bhaskaran Unnikrishnan; Muhammad Umar; Shahid Ullah; Saeed Ullah; Aniefiok John Udoakang; Munkhtuya Tumurkhuu; Abdul Rohim Tualeka; Thien Tan Tri Tai Truyen; Domenico Trico; Thang Huu Tran; Ngoc Ha Tran; Nghia Minh Tran; Marcos Roberto Tovani-Palone; Krishna Tiwari; Mariya Vladimirovna Titova; Jansje Henny Vera Ticoalu; Nikhil Kenny Thomas; Sathish Thirunavukkarasu; Samar Tharwat; Rekha Thapar; Mohamad Hani Temsah; Yibekal Manaye Tefera; Birhan Tsegaw Taye; Nathan Y. Tat; Md Tariqujjaman; Ingan Ukur Tarigan; Jacques Lukenze Tamuzi; Mircea Tampa; Iman M. Talaat; Jabeen Taiba; Celine Tabche; Seyed Amir Tabatabaeizadeh; Seyyed Mohammad Tabatabaei; T. Y. Sree Sudha; Mindy D. Szeto; Lukasz Szarpak; Chandan Kumar Swain; Hani Susianti; Vetriselvan Subramaniyan; Suresh Kumar Srinivasamurthy; Reed J.D. Sorensen; Soroush Soraneh; Shipra Solanki; Ranjan Solanki; Farrukh Sobia; Surjit Singh; Puneetpal Singh; Paramdeep Singh; Narinder Pal Singh; Jasvinder A. Singh; Jasbir Singh; Harmanjit Singh; Baljinder Singh; Luís Manuel Lopes Rodrigues Silva; Emmanuel Edwar Siddig; Sunil Shrestha; Velizar Shivarov; Aminu Shittu; Rahman Shiri; Shiran Shetty; Premalatha K. Shetty; Pavanchand H. Shetty; Mahabalesh Shetty; Rekha Raghuveer Shenoy; Rahim Ali Sheikhi; Maryam Shayan; Vishal Sharma; Anupam Sharma; Javad Sharifi Rad; Amin Sharifan; Medha Sharath; Mohammed Shannawaz; Mohd Shanawaz; Alfiya Shamsutdinova; Anas Shamsi; Mehran Shams-Beyranvand; Muhammad Aaqib Shamim; Sunder Sham; Alireza Shakeri; Masood Ali Shaikh; Moyad Jamal Shahwan; Wajeehah Shahid; Samiah Shahid; Mahan Shafie; Christianus Heru Setiawan; Yashendra Sethi; Sadaf G. Sepanlou; Pallav Sengupta; Mohammad H. Semreen; Siddharthan Selvaraj; Art Schuermans; Abu Sayeed; Monika Sawhney; Maheswar Satpathy; Anudeep Sathyanarayan; Brijesh Sathian; Sachin C. Sarode; Gargi Sachin Sarode; Tanmay Sarkar; Aswini Saravanan; Sivan Yegnanarayana Iyer Saraswathy; Itamar S. Santos; Rama Krishna Sanjeev; Abdallah M. Samy; Vijaya Paul Samuel; Yoseph Leonardo Samodra; Marwa Rashad Salem; Samreen Saleem; Luciane B. Salaroli; Afeez Abolarinwa Salami; S. Mohammad Sajadi; Soumya Swaroop Sahoo; Pragyan Monalisa Sahoo; Amirhossein Sahebkar; Narjes Saheb Sharif-Askari; Fatemeh Saheb Sharif-Askari; Umar Saeed; Basema Ahmad Saddik; Mamta Sachdeva Dhingra; Siamak Sabour; Cameron John Sabet; Aly M.A. Saad; Godfrey M. Rwegerera; Guilherme de Andrade Ruela; Bedanta Roy; Himanshu Sekhar Rout; Moustaq Karim Khan Rony; Luca Ronfani; Ravi Rohilla; Leonardo Roever; Hermano Alexandre Lima Rocha; Jennifer Rickard; Muhammad Riaz; Mohsen Rezaeian; Nazila Rezaei; Kannan R.R. Rengasamy; Giuseppe Remuzzi; Elrashdy M. Moustafa Mohamed Redwan; Christian Razo; Rabail Zehra Raza; Salman Rawaf; Devarajan Rathish; Ashkan Rasouli-Saravani; Mohammad Mahdi Rashidi; Sowmya J. Rao; Mithun Rao; Chythra R. Rao; Amey Rane; Rishabh Kumar Rana; Kritika Rana; Shakthi Kumaran Ramasamy; Mahmoud Mohammed Ramadan; Koushik Ramachandra; Prashant Rajput; Vinoth Rajendran; Sandesh Raja; Adarsh Raja; Setyaningrum Rahmawaty; Vahid Rahmanian; Mohammad Rahmanian; Amir Masoud Rahmani; Muhammad Aziz Rahman; Mosiur Rahman; Mohammad Hifz Ur Rahman; Md Mosfequr Rahman; Vafa Rahimi-Movaghar; Fakher Rahim; Pankaja Raghav; Venkatraman Radhakrishnan; R. Deepthi; Asma Saleem Qazi; Ibrahim Qattea; Nameer Hashim Qasim; Jagadeesh Puvvula; Bharathi M. Purohit; Manya Prasad; Jalandhar Pradhan; Pranil Man Singh Pradhan; Naeimeh Pourtaheri; Ramesh Poluru; Dimitri Poddighe; Zahra Zahid Piracha; Anil K. Philip; Norberto Perico; Arokiasamy Perianayagam; Gavin Pereira; Prince Peprah; Minjin Peng; Shrikant Pawar; Dimitrios Patoulias; Shankargouda Patil; Siddhartha Pati; Jay Patel; Roberto Passera; Seoyeon Park; Romil R. Parikh; Pragyan Paramita Parija; Sheikh Mohammed Shariful Islam; Md Rabiul Islam; Nasser Bagheri; Mohammed Usman Ali

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, Sooji Lee, Yejun Son, Jiyoung Hwang, Min Seo Kim, Susan A. McLaughlin, Victor Vilchis-Tella, Leo Zoeckler, Nandita Perumal, Sa’ed H. Zyoud, Ghazal Zoghi, Hafsa Zia, Abzal Zhumagaliuly, Claire Chenwen Zhong, Liqun Zhang, Haijun Zhang, Naod Gebrekrstos Zeru, Mohammed G.M. Zeariya, Iman Zare, Nelson ZamoraBurhan Abdullah Zaman, Chuanhua Yu, Naohiro Yonemoto, Dehui Yin, Muluken Yigezu, Subah Abderehim Yesuf, Sanni Yaya, Amir Yarahmadi, Vikas Yadav, Xiaoyue Xu, Yihun Miskir Wubie, Abay Tadesse Woday, Peter Willeit, Holly Wild, Kosala Gayan Weerakoon, Yanzhong Wang, Yasir Waheed, Simona Ruxandra Volovat, Manish Vinayak, Dominique Vervoort, Georgios Ioannis Verras, Balachandar Vellingiri, Tommi Juhani Vasankari, Joe Varghese, Jef Van den Eynde, Rohollah Valizadeh, Asokan Govindaraj Vaithinathan, Sanaz Vahdati, Seyed Mohammad Vahabi, Tolassa Wakayo Ushula, Bhaskaran Unnikrishnan, Muhammad Umar, Shahid Ullah, Saeed Ullah, Aniefiok John Udoakang, Munkhtuya Tumurkhuu, Abdul Rohim Tualeka, Thien Tan Tri Tai Truyen, Domenico Trico, Thang Huu Tran, Ngoc Ha Tran, Nghia Minh Tran, Marcos Roberto Tovani-Palone, Krishna Tiwari, Mariya Vladimirovna Titova, Jansje Henny Vera Ticoalu, Nikhil Kenny Thomas, Sathish Thirunavukkarasu, Samar Tharwat, Rekha Thapar, Mohamad Hani Temsah, Yibekal Manaye Tefera, Birhan Tsegaw Taye, Nathan Y. Tat, Md Tariqujjaman, Ingan Ukur Tarigan, Jacques Lukenze Tamuzi, Mircea Tampa, Iman M. Talaat, Jabeen Taiba, Celine Tabche, Seyed Amir Tabatabaeizadeh, Seyyed Mohammad Tabatabaei, T. Y. Sree Sudha, Mindy D. Szeto, Lukasz Szarpak, Chandan Kumar Swain, Hani Susianti, Vetriselvan Subramaniyan, Suresh Kumar Srinivasamurthy, Reed J.D. Sorensen, Soroush Soraneh, Shipra Solanki, Ranjan Solanki, Farrukh Sobia, Surjit Singh, Puneetpal Singh, Paramdeep Singh, Narinder Pal Singh, Jasvinder A. Singh, Jasbir Singh, Harmanjit Singh, Baljinder Singh, Luís Manuel Lopes Rodrigues Silva, Emmanuel Edwar Siddig, Sunil Shrestha, Velizar Shivarov, Aminu Shittu, Rahman Shiri, Shiran Shetty, Premalatha K. Shetty, Pavanchand H. Shetty, Mahabalesh Shetty, Rekha Raghuveer Shenoy, Rahim Ali Sheikhi, Maryam Shayan, Vishal Sharma, Anupam Sharma, Javad Sharifi Rad, Amin Sharifan, Medha Sharath, Mohammed Shannawaz, Mohd Shanawaz, Alfiya Shamsutdinova, Anas Shamsi, Mehran Shams-Beyranvand, Muhammad Aaqib Shamim, Sunder Sham, Alireza Shakeri, Masood Ali Shaikh, Moyad Jamal Shahwan, Wajeehah Shahid, Samiah Shahid, Mahan Shafie, Christianus Heru Setiawan, Yashendra Sethi, Sadaf G. Sepanlou, Pallav Sengupta, Mohammad H. Semreen, Siddharthan Selvaraj, Art Schuermans, Abu Sayeed, Monika Sawhney, Maheswar Satpathy, Anudeep Sathyanarayan, Brijesh Sathian, Sachin C. Sarode, Gargi Sachin Sarode, Tanmay Sarkar, Aswini Saravanan, Sivan Yegnanarayana Iyer Saraswathy, Itamar S. Santos, Rama Krishna Sanjeev, Abdallah M. Samy, Vijaya Paul Samuel, Yoseph Leonardo Samodra, Marwa Rashad Salem, Samreen Saleem, Luciane B. Salaroli, Afeez Abolarinwa Salami, S. Mohammad Sajadi, Soumya Swaroop Sahoo, Pragyan Monalisa Sahoo, Amirhossein Sahebkar, Narjes Saheb Sharif-Askari, Fatemeh Saheb Sharif-Askari, Umar Saeed, Basema Ahmad Saddik, Mamta Sachdeva Dhingra, Siamak Sabour, Cameron John Sabet, Aly M.A. Saad, Godfrey M. Rwegerera, Guilherme de Andrade Ruela, Bedanta Roy, Himanshu Sekhar Rout, Moustaq Karim Khan Rony, Luca Ronfani, Ravi Rohilla, Leonardo Roever, Hermano Alexandre Lima Rocha, Jennifer Rickard, Muhammad Riaz, Mohsen Rezaeian, Nazila Rezaei, Kannan R.R. Rengasamy, Giuseppe Remuzzi, Elrashdy M. Moustafa Mohamed Redwan, Christian Razo, Rabail Zehra Raza, Salman Rawaf, Devarajan Rathish, Ashkan Rasouli-Saravani, Mohammad Mahdi Rashidi, Sowmya J. Rao, Mithun Rao, Chythra R. Rao, Amey Rane, Rishabh Kumar Rana, Kritika Rana, Shakthi Kumaran Ramasamy, Mahmoud Mohammed Ramadan, Koushik Ramachandra, Prashant Rajput, Vinoth Rajendran, Sandesh Raja, Adarsh Raja, Setyaningrum Rahmawaty, Vahid Rahmanian, Mohammad Rahmanian, Amir Masoud Rahmani, Muhammad Aziz Rahman, Mosiur Rahman, Mohammad Hifz Ur Rahman, Md Mosfequr Rahman, Vafa Rahimi-Movaghar, Fakher Rahim, Pankaja Raghav, Venkatraman Radhakrishnan, R. Deepthi, Asma Saleem Qazi, Ibrahim Qattea, Nameer Hashim Qasim, Jagadeesh Puvvula, Bharathi M. Purohit, Manya Prasad, Jalandhar Pradhan, Pranil Man Singh Pradhan, Naeimeh Pourtaheri, Ramesh Poluru, Dimitri Poddighe, Zahra Zahid Piracha, Anil K. Philip, Norberto Perico, Arokiasamy Perianayagam, Gavin Pereira, Prince Peprah, Minjin Peng, Shrikant Pawar, Dimitrios Patoulias, Shankargouda Patil, Siddhartha Pati, Jay Patel, Roberto Passera, Seoyeon Park, Romil R. Parikh, Pragyan Paramita Parija, Sheikh Mohammed Shariful Islam, Md Rabiul Islam, Nasser Bagheri, Mohammed Usman Ali

Health Research Institute

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

12 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
DOIs	https://doi.org/10.1038/s41591-025-03624-8
Publication status	Published - Jun 2025

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10.1038/s41591-025-03624-8

Cite this

GBD 2021 Dietary Iron Deficiency Collaborators, Lee, S., Son, Y., Hwang, J., Kim, M. S., McLaughlin, S. A., Vilchis-Tella, V., Zoeckler, L., Perumal, N., Zyoud, S. H., Zoghi, G., Zia, H., Zhumagaliuly, A., Zhong, C. C., Zhang, L., Zhang, H., Zeru, N. G., Zeariya, M. G. M., Zare, I., ... Ali, M. U. (2025). Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study. Nature Medicine, 31(6), 1809-1829. https://doi.org/10.1038/s41591-025-03624-8

@article{c87da15f90624ba2b1f024cd2b21ec35,

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 Ushula, {Tolassa Wakayo} and Bhaskaran Unnikrishnan and Muhammad Umar and Shahid Ullah and Saeed Ullah and Udoakang, {Aniefiok John} and Munkhtuya Tumurkhuu and Tualeka, {Abdul Rohim} and {Tri Tai Truyen}, {Thien Tan} and Domenico Trico and Tran, {Thang Huu} and Tran, {Ngoc Ha} and Tran, {Nghia Minh} and Tovani-Palone, {Marcos Roberto} and Krishna Tiwari and Titova, {Mariya Vladimirovna} and Ticoalu, {Jansje Henny Vera} and Thomas, {Nikhil Kenny} and Sathish Thirunavukkarasu and Samar Tharwat and Rekha Thapar and Temsah, {Mohamad Hani} and Tefera, {Yibekal Manaye} and Taye, {Birhan Tsegaw} and Tat, {Nathan Y.} and Md Tariqujjaman and Tarigan, {Ingan Ukur} and Tamuzi, {Jacques Lukenze} and Mircea Tampa and Talaat, {Iman M.} and Jabeen Taiba and Celine Tabche and Tabatabaeizadeh, {Seyed Amir} and Tabatabaei, {Seyyed Mohammad} and {Sree Sudha}, {T. Y.} and Szeto, {Mindy D.} and Lukasz Szarpak and Swain, {Chandan Kumar} and Hani Susianti and Vetriselvan Subramaniyan and Srinivasamurthy, {Suresh Kumar} and Sorensen, {Reed J.D.} and Soroush Soraneh and Shipra Solanki and Ranjan Solanki and Farrukh Sobia and Surjit Singh and Puneetpal Singh and Paramdeep Singh and Singh, {Narinder Pal} and Singh, {Jasvinder A.} and Jasbir Singh and Harmanjit Singh and Baljinder Singh and {Lopes Rodrigues Silva}, {Lu{\'i}s Manuel} and Siddig, {Emmanuel Edwar} and Sunil Shrestha and Velizar Shivarov and Aminu Shittu and Rahman Shiri and Shiran Shetty and Shetty, {Premalatha K.} and Shetty, {Pavanchand H.} and Mahabalesh Shetty and Shenoy, {Rekha Raghuveer} and Sheikhi, {Rahim Ali} and Maryam Shayan and Vishal Sharma and Anupam Sharma and Rad, {Javad Sharifi} and Amin Sharifan and Medha Sharath and Mohammed Shannawaz and Mohd Shanawaz and Alfiya Shamsutdinova and Anas Shamsi and Mehran Shams-Beyranvand and Shamim, {Muhammad Aaqib} and Sunder Sham and Alireza Shakeri and Shaikh, {Masood Ali} and Shahwan, {Moyad Jamal} and Wajeehah Shahid and Samiah Shahid and Mahan Shafie and Setiawan, {Christianus Heru} and Yashendra Sethi and Sepanlou, {Sadaf G.} and Pallav Sengupta and Semreen, {Mohammad H.} and Siddharthan Selvaraj and Art Schuermans and Abu Sayeed and Monika Sawhney and Maheswar Satpathy and Anudeep Sathyanarayan and Brijesh Sathian and Sarode, {Sachin C.} and Sarode, {Gargi Sachin} and Tanmay Sarkar and Aswini Saravanan and Saraswathy, {Sivan Yegnanarayana Iyer} and Santos, {Itamar S.} and Sanjeev, {Rama Krishna} and Samy, {Abdallah M.} and Samuel, {Vijaya Paul} and Samodra, {Yoseph Leonardo} and Salem, {Marwa Rashad} and Samreen Saleem and Salaroli, {Luciane B.} and Salami, {Afeez Abolarinwa} and Sajadi, {S. Mohammad} and Sahoo, {Soumya Swaroop} and Sahoo, {Pragyan Monalisa} and Amirhossein Sahebkar and Sharif-Askari, {Narjes Saheb} and Sharif-Askari, {Fatemeh Saheb} and Umar Saeed and Saddik, {Basema Ahmad} and Dhingra, {Mamta Sachdeva} and Siamak Sabour and Sabet, {Cameron John} and Saad, {Aly M.A.} and Rwegerera, {Godfrey M.} and {de Andrade Ruela}, Guilherme and Bedanta Roy and Rout, {Himanshu Sekhar} and Rony, {Moustaq Karim Khan} and Luca Ronfani and Ravi Rohilla and Leonardo Roever and Rocha, {Hermano Alexandre Lima} and Jennifer Rickard and Muhammad Riaz and Mohsen Rezaeian and Nazila Rezaei and Rengasamy, {Kannan R.R.} and Giuseppe Remuzzi and {Moustafa Mohamed Redwan}, {Elrashdy M.} and Christian Razo and Raza, {Rabail Zehra} and Salman Rawaf and Devarajan Rathish and Ashkan Rasouli-Saravani and Rashidi, {Mohammad Mahdi} and Rao, {Sowmya J.} and Mithun Rao and Rao, {Chythra R.} and Amey Rane and Rana, {Rishabh Kumar} and Kritika Rana and Ramasamy, {Shakthi Kumaran} and Ramadan, {Mahmoud Mohammed} and Koushik Ramachandra and Prashant Rajput and Vinoth Rajendran and Sandesh Raja and Adarsh Raja and Setyaningrum Rahmawaty and Vahid Rahmanian and Mohammad Rahmanian and Rahmani, {Amir Masoud} and Rahman, {Muhammad Aziz} and Mosiur Rahman and Rahman, {Mohammad Hifz Ur} and Rahman, {Md Mosfequr} and Vafa Rahimi-Movaghar and Fakher Rahim and Pankaja Raghav and Venkatraman Radhakrishnan and R. Deepthi and Qazi, {Asma Saleem} and Ibrahim Qattea and Qasim, {Nameer Hashim} and Jagadeesh Puvvula and Purohit, {Bharathi M.} and Manya Prasad and Jalandhar Pradhan and Pradhan, {Pranil Man Singh} and Naeimeh Pourtaheri and Ramesh Poluru and Dimitri Poddighe and Piracha, {Zahra Zahid} and Philip, {Anil K.} and Norberto Perico and Arokiasamy Perianayagam and Gavin Pereira and Prince Peprah and Minjin Peng and Shrikant Pawar and Dimitrios Patoulias and Shankargouda Patil and Siddhartha Pati and Jay Patel and Roberto Passera and Seoyeon Park and Parikh, {Romil R.} and Parija, {Pragyan Paramita} and Islam, {Sheikh Mohammed Shariful} and Islam, {Md Rabiul} and Nasser Bagheri and Ali, {Mohammed Usman}",

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",

pages = "1809--1829",

journal = "Nature Medicine",

issn = "1078-8956",

publisher = "Nature Publishing Group",

number = "6",

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GBD 2021 Dietary Iron Deficiency Collaborators, Lee, S, Son, Y, Hwang, J, Kim, MS, McLaughlin, SA, Vilchis-Tella, V, Zoeckler, L, Perumal, N, Zyoud, SH, Zoghi, G, Zia, H, Zhumagaliuly, A, Zhong, CC, Zhang, L, Zhang, H, Zeru, NG, Zeariya, MGM, Zare, I, Zamora, N, Zaman, BA, Yu, C, Yonemoto, N, Yin, D, Yigezu, M, Yesuf, SA, Yaya, S, Yarahmadi, A, Yadav, V, Xu, X, Wubie, YM, Woday, AT, Willeit, P, Wild, H, Weerakoon, KG, Wang, Y, Waheed, Y, Volovat, SR, Vinayak, M, Vervoort, D, Verras, GI, Vellingiri, B, Vasankari, TJ, Varghese, J, Van den Eynde, J, Valizadeh, R, Vaithinathan, AG, Vahdati, S, Vahabi, SM, Ushula, TW, Unnikrishnan, B, Umar, M, Ullah, S, Ullah, S, Udoakang, AJ, Tumurkhuu, M, Tualeka, AR, Tri Tai Truyen, TT, Trico, D, Tran, TH, Tran, NH, Tran, NM, Tovani-Palone, MR, Tiwari, K, Titova, MV, Ticoalu, JHV, Thomas, NK, Thirunavukkarasu, S, Tharwat, S, Thapar, R, Temsah, MH, Tefera, YM, Taye, BT, Tat, NY, Tariqujjaman, M, Tarigan, IU, Tamuzi, JL, Tampa, M, Talaat, IM, Taiba, J, Tabche, C, Tabatabaeizadeh, SA, Tabatabaei, SM, Sree Sudha, TY, Szeto, MD, Szarpak, L, Swain, CK, Susianti, H, Subramaniyan, V, Srinivasamurthy, SK, Sorensen, RJD, Soraneh, S, Solanki, S, Solanki, R, Sobia, F, Singh, S, Singh, P, Singh, P, Singh, NP, Singh, JA, Singh, J, Singh, H, Singh, B, Lopes Rodrigues Silva, LM, Siddig, EE, Shrestha, S, Shivarov, V, Shittu, A, Shiri, R, Shetty, S, Shetty, PK, Shetty, PH, Shetty, M, Shenoy, RR, Sheikhi, RA, Shayan, M, Sharma, V, Sharma, A, Rad, JS, Sharifan, A, Sharath, M, Shannawaz, M, Shanawaz, M, Shamsutdinova, A, Shamsi, A, Shams-Beyranvand, M, Shamim, MA, Sham, S, Shakeri, A, Shaikh, MA, Shahwan, MJ, Shahid, W, Shahid, S, Shafie, M, Setiawan, CH, Sethi, Y, Sepanlou, SG, Sengupta, P, Semreen, MH, Selvaraj, S, Schuermans, A, Sayeed, A, Sawhney, M, Satpathy, M, Sathyanarayan, A, Sathian, B, Sarode, SC, Sarode, GS, Sarkar, T, Saravanan, A, Saraswathy, SYI, Santos, IS, Sanjeev, RK, Samy, AM, Samuel, VP, Samodra, YL, Salem, MR, Saleem, S, Salaroli, LB, Salami, AA, Sajadi, SM, Sahoo, SS, Sahoo, PM, Sahebkar, A, Sharif-Askari, NS, Sharif-Askari, FS, Saeed, U, Saddik, BA, Dhingra, MS, Sabour, S, Sabet, CJ, Saad, AMA, Rwegerera, GM, de Andrade Ruela, G, Roy, B, Rout, HS, Rony, MKK, Ronfani, L, Rohilla, R, Roever, L, Rocha, HAL, Rickard, J, Riaz, M, Rezaeian, M, Rezaei, N, Rengasamy, KRR, Remuzzi, G, Moustafa Mohamed Redwan, EM, Razo, C, Raza, RZ, Rawaf, S, Rathish, D, Rasouli-Saravani, A, Rashidi, MM, Rao, SJ, Rao, M, Rao, CR, Rane, A, Rana, RK, Rana, K, Ramasamy, SK, Ramadan, MM, Ramachandra, K, Rajput, P, Rajendran, V, Raja, S, Raja, A, Rahmawaty, S, Rahmanian, V, Rahmanian, M, Rahmani, AM, Rahman, MA, Rahman, M, Rahman, MHU, Rahman, MM, Rahimi-Movaghar, V, Rahim, F, Raghav, P, Radhakrishnan, V, Deepthi, R, Qazi, AS, Qattea, I, Qasim, NH, Puvvula, J, Purohit, BM, Prasad, M, Pradhan, J, Pradhan, PMS, Pourtaheri, N, Poluru, R, Poddighe, D, Piracha, ZZ, Philip, AK, Perico, N, Perianayagam, A, Pereira, G, Peprah, P, Peng, M, Pawar, S, Patoulias, D, Patil, S, Pati, S, Patel, J, Passera, R, Park, S, Parikh, RR, Parija, PP, Islam, SMS, Islam, MR, Bagheri, N & Ali, MU 2025, 'Global, regional and national burden of dietary iron deficiency from 1990 to 2021: a Global Burden of Disease study', Nature Medicine, vol. 31, no. 6, pp. 1809-1829. https://doi.org/10.1038/s41591-025-03624-8

TY - JOUR

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

T2 - a Global Burden of Disease study

AU - GBD 2021 Dietary Iron Deficiency Collaborators

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 - Ushula, Tolassa Wakayo

AU - Unnikrishnan, Bhaskaran

AU - Umar, Muhammad

AU - Ullah, Shahid

AU - Ullah, Saeed

AU - Udoakang, Aniefiok John

AU - Tumurkhuu, Munkhtuya

AU - Tualeka, Abdul Rohim

AU - Tri Tai Truyen, Thien Tan

AU - Trico, Domenico

AU - Tran, Thang Huu

AU - Tran, Ngoc Ha

AU - Tran, Nghia Minh

AU - Tovani-Palone, Marcos Roberto

AU - Tiwari, Krishna

AU - Titova, Mariya Vladimirovna

AU - Ticoalu, Jansje Henny Vera

AU - Thomas, Nikhil Kenny

AU - Thirunavukkarasu, Sathish

AU - Tharwat, Samar

AU - Thapar, Rekha

AU - Temsah, Mohamad Hani

AU - Tefera, Yibekal Manaye

AU - Taye, Birhan Tsegaw

AU - Tat, Nathan Y.

AU - Tariqujjaman, Md

AU - Tarigan, Ingan Ukur

AU - Tamuzi, Jacques Lukenze

AU - Tampa, Mircea

AU - Talaat, Iman M.

AU - Taiba, Jabeen

AU - Tabche, Celine

AU - Tabatabaeizadeh, Seyed Amir

AU - Tabatabaei, Seyyed Mohammad

AU - Sree Sudha, T. Y.

AU - Szeto, Mindy D.

AU - Szarpak, Lukasz

AU - Swain, Chandan Kumar

AU - Susianti, Hani

AU - Subramaniyan, Vetriselvan

AU - Srinivasamurthy, Suresh Kumar

AU - Sorensen, Reed J.D.

AU - Soraneh, Soroush

AU - Solanki, Shipra

AU - Solanki, Ranjan

AU - Sobia, Farrukh

AU - Singh, Surjit

AU - Singh, Puneetpal

AU - Singh, Paramdeep

AU - Singh, Narinder Pal

AU - Singh, Jasvinder A.

AU - Singh, Jasbir

AU - Singh, Harmanjit

AU - Singh, Baljinder

AU - Lopes Rodrigues Silva, Luís Manuel

AU - Siddig, Emmanuel Edwar

AU - Shrestha, Sunil

AU - Shivarov, Velizar

AU - Shittu, Aminu

AU - Shiri, Rahman

AU - Shetty, Shiran

AU - Shetty, Premalatha K.

AU - Shetty, Pavanchand H.

AU - Shetty, Mahabalesh

AU - Shenoy, Rekha Raghuveer

AU - Sheikhi, Rahim Ali

AU - Shayan, Maryam

AU - Sharma, Vishal

AU - Sharma, Anupam

AU - Rad, Javad Sharifi

AU - Sharifan, Amin

AU - Sharath, Medha

AU - Shannawaz, Mohammed

AU - Shanawaz, Mohd

AU - Shamsutdinova, Alfiya

AU - Shamsi, Anas

AU - Shams-Beyranvand, Mehran

AU - Shamim, Muhammad Aaqib

AU - Sham, Sunder

AU - Shakeri, Alireza

AU - Shaikh, Masood Ali

AU - Shahwan, Moyad Jamal

AU - Shahid, Wajeehah

AU - Shahid, Samiah

AU - Shafie, Mahan

AU - Setiawan, Christianus Heru

AU - Sethi, Yashendra

AU - Sepanlou, Sadaf G.

AU - Sengupta, Pallav

AU - Semreen, Mohammad H.

AU - Selvaraj, Siddharthan

AU - Schuermans, Art

AU - Sayeed, Abu

AU - Sawhney, Monika

AU - Satpathy, Maheswar

AU - Sathyanarayan, Anudeep

AU - Sathian, Brijesh

AU - Sarode, Sachin C.

AU - Sarode, Gargi Sachin

AU - Sarkar, Tanmay

AU - Saravanan, Aswini

AU - Saraswathy, Sivan Yegnanarayana Iyer

AU - Santos, Itamar S.

AU - Sanjeev, Rama Krishna

AU - Samy, Abdallah M.

AU - Samuel, Vijaya Paul

AU - Samodra, Yoseph Leonardo

AU - Salem, Marwa Rashad

AU - Saleem, Samreen

AU - Salaroli, Luciane B.

AU - Salami, Afeez Abolarinwa

AU - Sajadi, S. Mohammad

AU - Sahoo, Soumya Swaroop

AU - Sahoo, Pragyan Monalisa

AU - Sahebkar, Amirhossein

AU - Sharif-Askari, Narjes Saheb

AU - Sharif-Askari, Fatemeh Saheb

AU - Saeed, Umar

AU - Saddik, Basema Ahmad

AU - Dhingra, Mamta Sachdeva

AU - Sabour, Siamak

AU - Sabet, Cameron John

AU - Saad, Aly M.A.

AU - Rwegerera, Godfrey M.

AU - de Andrade Ruela, Guilherme

AU - Roy, Bedanta

AU - Rout, Himanshu Sekhar

AU - Rony, Moustaq Karim Khan

AU - Ronfani, Luca

AU - Rohilla, Ravi

AU - Roever, Leonardo

AU - Rocha, Hermano Alexandre Lima

AU - Rickard, Jennifer

AU - Riaz, Muhammad

AU - Rezaeian, Mohsen

AU - Rezaei, Nazila

AU - Rengasamy, Kannan R.R.

AU - Remuzzi, Giuseppe

AU - Moustafa Mohamed Redwan, Elrashdy M.

AU - Razo, Christian

AU - Raza, Rabail Zehra

AU - Rawaf, Salman

AU - Rathish, Devarajan

AU - Rasouli-Saravani, Ashkan

AU - Rashidi, Mohammad Mahdi

AU - Rao, Sowmya J.

AU - Rao, Mithun

AU - Rao, Chythra R.

AU - Rane, Amey

AU - Rana, Rishabh Kumar

AU - Rana, Kritika

AU - Ramasamy, Shakthi Kumaran

AU - Ramadan, Mahmoud Mohammed

AU - Ramachandra, Koushik

AU - Rajput, Prashant

AU - Rajendran, Vinoth

AU - Raja, Sandesh

AU - Raja, Adarsh

AU - Rahmawaty, Setyaningrum

AU - Rahmanian, Vahid

AU - Rahmanian, Mohammad

AU - Rahmani, Amir Masoud

AU - Rahman, Muhammad Aziz

AU - Rahman, Mosiur

AU - Rahman, Mohammad Hifz Ur

AU - Rahman, Md Mosfequr

AU - Rahimi-Movaghar, Vafa

AU - Rahim, Fakher

AU - Raghav, Pankaja

AU - Radhakrishnan, Venkatraman

AU - Deepthi, R.

AU - Qazi, Asma Saleem

AU - Qattea, Ibrahim

AU - Qasim, Nameer Hashim

AU - Puvvula, Jagadeesh

AU - Purohit, Bharathi M.

AU - Prasad, Manya

AU - Pradhan, Jalandhar

AU - Pradhan, Pranil Man Singh

AU - Pourtaheri, Naeimeh

AU - Poluru, Ramesh

AU - Poddighe, Dimitri

AU - Piracha, Zahra Zahid

AU - Philip, Anil K.

AU - Perico, Norberto

AU - Perianayagam, Arokiasamy

AU - Pereira, Gavin

AU - Peprah, Prince

AU - Peng, Minjin

AU - Pawar, Shrikant

AU - Patoulias, Dimitrios

AU - Patil, Shankargouda

AU - Pati, Siddhartha

AU - Patel, Jay

AU - Passera, Roberto

AU - Park, Seoyeon

AU - Parikh, Romil R.

AU - Parija, Pragyan Paramita

AU - Islam, Sheikh Mohammed Shariful

AU - Islam, Md Rabiul

AU - Bagheri, Nasser

AU - Ali, Mohammed Usman

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.

UR - http://www.scopus.com/inward/record.url?scp=105008398095&partnerID=8YFLogxK

U2 - 10.1038/s41591-025-03624-8

DO - 10.1038/s41591-025-03624-8

M3 - Article

C2 - 40263631

AN - SCOPUS:105008398095

SN - 1078-8956

VL - 31

SP - 1809

EP - 1829

JO - Nature Medicine

JF - Nature Medicine

IS - 6

ER -

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

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