Burden of Nutritional Deficiencies: A Systematic Analysis for the GBD 2021

Background and Aims: Nutritional deficiencies (ND) remain a major global health challenge, significantly affecting population well-being. As part of the Global Burden of Disease (GBD) study, we conducted a comprehensive assessment of the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) attributed to ND from 1990 to 2021. Methods: This study analyzed temporal trends in nutritional deficiencies by estimating the estimated annual percentage change (EAPC) over the study period. We examined age-standardized prevalence rates (ASPR), incidence rates (ASIR), death rates (ASDR), and DALYs (ASDALYs) across various demographic and geographic dimensions. Data were stratified by sex, 20 age groups, 21 GBD regions, 204 countries and territories, and five socio-demographic index (SDI) quintiles. To project future trends, we applied the Bayesian age-period-cohort (BAPC) model. Results: In 2021, nutritional deficiencies continued to impose a substantial global health burden, with approximately 1.85 billion cases (95% UI: 1.81-1.88 billion) and an ASPR of 23,859 per 100,000 population (95% UI: 23,446-24,321). The ASIR was 7725 per 100,000 (95% UI: 7404-8109). The ASDR was 3.0 per 100,000 (95% UI: 2.7-3.4), and the ASDALY rate reached 657.6 per 100,000 (95% UI: 489.9-869.6). Marked regional disparities were observed: low SDI regions exhibited the highest ASPR, ASIR, ASDR, and ASDALYs, while high SDI regions had the lowest ASDR. Central Sub-Saharan Africa recorded the highest rates across most indicators, whereas Western Europe had the lowest ASDR. Projections indicate a significant decline in the global burden of nutritional deficiencies from 2021 to 2040. Conclusion: These findings underscore the urgent need for targeted public health strategies to address the persistent and disproportionate burden of nutritional deficiencies in low SDI regions.