The hidden vulnerability: heavy and persistent burden of dietary iron deficiency among women and children in China, India and globally based on the global burden of disease 2021.

METHODS

A hierarchical analytical framework was adopted to establish the overall landscape across 204 countries and territories, with a focus on China, India, and the global scale from 1990 to 2021. Using the Global Burden of Disease (GBD) database, this study focused on prevalence, disability-adjusted life years (DALYs), age-standardized rates (ASRs) and estimated annual percentage change (EAPC). Bayesian age-period-cohort (BAPC) model was used to project disease burden from 2021-2036 . Health inequality and frontier analyses were incorporated to examine the association between sociodemographic index (SDI) and age-standardized DALY rates (ASDRs).

RESULTS

DID predominantly affects people in low- and middle-income countries, especially women aged 20-54. In 2021, global ASDR was 423.74(95% UI: 285.27-610.83)/100,000, with a decline from 517.98(95% UI: 353.99-730.97)/100,000 in 1990. China's ASDR decreased from 285.82(95% UI: 192.63-407.64) in 1990 to 115.30(95% UI: 76.36-166.42) in 2021. India exhibited increasing burden among younger populations and women, with EAPC of 0.36(95% CI: 0.30-0.41; p < 0.05) for DALY rates in the under-1-year group and higher ASDR in women. The gap between SDI and DALY has narrowed. Age standardized prevalence rates (ASPRs) across the globe, China, and India are predicted to decrease to 2036.

CONCLUSIONS

The study indicates that while global and China's DID burdens have improved since 1990, challenges persist in India. India requires interventions to mitigate DID burden in high-risk groups.