Trends in dietary iron deficiency in children aged 0-14 years in China, Japan, the USA, and the UK, 1990-2021.

Dietary iron deficiency (DID) remains a critical pediatric health challenge worldwide, with significant cross-national disparities. This study evaluated the disease burden among children aged 0-14 years in China, Japan, the United Kingdom (UK), and United States of America (USA) from 1990 to 2021 to identify targeted interventions. We analyzed age-standardized prevalence, disability-adjusted life years (DALYs), and years lived with disability using Global Burden of Disease 2021 data. Joinpoint regression was used to assess temporal trends stratified by age and sex. All epidemiological indicators of DID burden among children in China significantly trended downward, unlike the low and slowly declining trends observed in Japan and the USA. The prevalence and DALYs in the UK declined steadily but were high in absolute terms, and, recently, the DID ranking as a proportion of all diseases has remained high. Sex disparities persisted in 2021 regarding the DALYs for DID, with females aged 5-14 years being disproportionately affected, particularly in the UK. DALYs for DID attributable to iron deficiency showed the steepest decline in Chinese children (from 2000 to 2010), in contrast to the UK's post-2017 resurgence and USA's rising burden in 5-14-year-olds since 2002, despite decreases post-2015; Japan maintained gradual reductions.

Conclusion

Despite progress, DID remains an issue, particularly in China and the UK. Successful strategies in Japan (school nutrition programs) and the USA (universal screening) underscore the need for age- and sex-targeted interventions, including fortified diets and routine screening, to mitigate these disparities. What is Known: • Dietary iron deficiency disproportionately burdens children in low/middle-income regions despite interventions. • High-income countries (USA, Japan) have reduced burden via universal screening and school nutrition programs. What is New: • The DALYs of dietary iron deficiency rank highest in British children aged 0-14 years among four nations, with significant female disparities. • The DALYs of dietary iron deficiency attributable to iron deficiency showed the steepest decline in Chinese children, contrasting UK's post-2017 resurgence and USA's rising burden in 5-14-year-olds from 2002 to 2014; Japan maintained gradual reductions.