{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:49:22Z","timestamp":1790218162163,"version":"4.1.0"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the burden of dietary iron deficiency in the Middle East and North Africa (MENA) region, focusing on prevalence and years lived with disability (YLD) in 2021 and their changes since 1990.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the Global Burden of Disease (GBD) 2021 study were utilised to report counts and age-standardised rates for prevalence and YLD related to dietary iron deficiency. All estimates were accompanied by 95% uncertainty intervals (UIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2021, the age-standardised prevalence of dietary iron deficiency in the MENA region was 14368.2 per 100,000, representing a 26% decline since 1990. The highest age-standardised prevalence rates were observed in Yemen (30146.5), Sudan (19296.9), and Morocco (15,303) per 100,000 population. Prevalence was notably highest among children under 5\u202fyears old and women of reproductive age, with a gradual decline in older age groups. The greatest reductions in prevalence were seen among older age groups, indicating an age-related downward trend from 1990 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite some improvements, dietary iron deficiency remains a significant public health concern in the MENA region, particularly in countries with lower socio-demographic indices (SDI). Targeted interventions are essential, especially for vulnerable groups such as children and women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2024.1517478","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:43:31Z","timestamp":1737420211000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Burden and trends of dietary iron deficiency in the Middle East and North Africa region, 1990\u20132021"],"prefix":"10.3389","volume":"11","author":[{"given":"Saeid","family":"Safiri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Amiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid","family":"Karamzad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark J. M.","family":"Sullman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali-Asghar","family":"Kolahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morteza","family":"Abdollahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.5114\/aoms\/175467","article-title":"Nutritional burden from the global burden of disease","volume":"20","author":"Wang","year":"2024","journal-title":"Arch Med Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e713","DOI":"10.1016\/S2352-3026(23)00160-6","article-title":"Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990\u20132021: findings from the Global Burden of Disease Study 2021","volume":"10","author":"Gardner","year":"2023","journal-title":"Lancet Haematol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e0136581","DOI":"10.1371\/journal.pone.0136581","article-title":"Social costs of iron deficiency anemia in 6\u201359-month-old children in India","volume":"10","author":"Plessow","year":"2015","journal-title":"PLoS One"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"493","DOI":"10.4324\/9781003228059-39","article-title":"Disability, food insecurity, and health: examining linkages in the Yemeni civil war","volume-title":"The Routledge international handbook of disability and global health","author":"Hollander","year":"2024"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e695","DOI":"10.1016\/S2352-3026(23)00211-9","article-title":"Tackling the enormous global burden of anaemia","volume":"10","author":"The","year":"2023","journal-title":"Lancet Haematol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1097\/MPG.0000000000002059","article-title":"Practices of introduction of complementary feeding and iron deficiency prevention in the Middle East and North Africa","volume":"67","author":"Lifschitz","year":"2018","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/nyas.13336","article-title":"Global and regional trends in the nutritional status of young people: a critical and neglected age group","volume":"1393","author":"Akseer","year":"2017","journal-title":"Ann N Y Acad Sci"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1080\/19320248.2024.2310505","article-title":"Assessing physical, mental, and social factors associated with refugee children food insecurity, food relief barriers, and lessons learned in the Middle East and North Africa (MENA) region: a scoping review","volume":"19","author":"Doumat","year":"2024","journal-title":"J Hunger Environ Nutr"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1038\/sj.ejcn.1602035","article-title":"Prevalence of iron deficiency among schoolchildren of different socio-economic status in urban Turkey","volume":"59","author":"Keskin","year":"2005","journal-title":"Eur J Clin Nutr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/S0140-6736(07)61235-5","article-title":"Nutritional iron deficiency","volume":"370","author":"Zimmermann","year":"2007","journal-title":"Lancet"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"29","DOI":"10.14419\/ijans.v9i1.30456","article-title":"Dietary knowledge, attitude, and practice regarding prevention of iron deficiency anemia among pregnant women in Riyadh, Saudi Arabia","volume":"9","author":"Alosaimi","year":"2020","journal-title":"Int J Adv Nurs Stud"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12937-019-0442-6","article-title":"Gender inequalities in diet quality and their socioeconomic patterning in a nutrition transition context in the Middle East and North Africa: a cross-sectional study in Tunisia","volume":"18","author":"Abassi","year":"2019","journal-title":"Nutr J"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"e1590","DOI":"10.1016\/S2214-109X(22)00367-9","article-title":"Micronutrient deficiencies among preschool-aged children and women of reproductive age worldwide: a pooled analysis of individual-level data from population-representative surveys","volume":"10","author":"Stevens","year":"2022","journal-title":"Lancet Glob Health"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e756","DOI":"10.1016\/S2352-3026(23)00170-9","article-title":"Association between maternal haemoglobin concentrations and maternal and neonatal outcomes: the prospective, observational, multinational, INTERBIO-21st fetal study","volume":"10","author":"Ohuma","year":"2023","journal-title":"Lancet Haematol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2607","DOI":"10.1182\/blood-2012-09-453522","article-title":"Control of iron deficiency anemia in low-and middle-income countries","volume":"121","author":"Pasricha","year":"2013","journal-title":"Blood"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1007\/s10113-017-1144-2","article-title":"Climate change impacts in the Middle East and Northern Africa (MENA) region and their implications for vulnerable population groups","volume":"17","author":"Waha","year":"2017","journal-title":"Reg Environ Change"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"12","DOI":"10.7189\/jogh.12.01003","article-title":"Political economy of health in fragile and conflict-affected regions in the Middle East and North Africa region","volume":"12","author":"Saleh","year":"2022","journal-title":"J Glob Health"},{"key":"ref18","article-title":"Water and food security issues in the MENA region: limits and opportunities for socio-economic development","volume-title":"PhD thesis","author":"Mazzoni","year":"2020"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.whi.2024.03.004","article-title":"Risk of Iron deficiency in women with endometriosis: a population-based prospective cohort study","volume":"34","author":"Gete","year":"2024","journal-title":"Womens Health Issues"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","year":"2024","journal-title":"Lancet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"12799","DOI":"10.3390\/ijerph182312799","article-title":"Prevalence of anaemia, iron deficiency, and iron deficiency anaemia in women of reproductive age and children under 5 years of age in South Africa (1997\u20132021): a systematic review","volume":"18","author":"Turawa","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"17","DOI":"10.32479\/ijefi.11650","article-title":"Economic misery, urbanization and life expectancy in MENA nations: an empirical analysis","volume":"11","author":"Ali","year":"2021","journal-title":"Int. J Econ Financ Issues"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"17086","DOI":"10.3390\/ijerph192417086","article-title":"Climate change and nutrition: implications for the eastern Mediterranean region","volume":"19","author":"Al-Jawaldeh","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref24","first-page":"65","article-title":"Obesity in Middle East","volume-title":"Metabolic syndrome: a comprehensive textbook","author":"Nikoloski","year":"2024"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/978-3-031-60149-1_4","article-title":"Analysis and assessment of the water-food-energy nexus in the MENA region utilizing the index approach and considering the sustainable development goals","volume-title":"Integration of core sustainable development goals in rural areas: current practices of water, energy, food, climate change, and ecosystems","author":"El-Gafy","year":"2024"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/S0140-6736(20)32594-0","article-title":"Iron deficiency","volume":"397","author":"Pasricha","year":"2021","journal-title":"Lancet"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s10708-024-11038-1","article-title":"Socioeconomic determinants of household food security in the Red Sea state of Sudan: insights from a cross-sectional survey","volume":"89","author":"Fadol","year":"2024","journal-title":"GeoJournal"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"101181","DOI":"10.1016\/j.jafr.2024.101181","article-title":"Does climate change affect wheat productivity and water demand in arid regions? Case study of Egypt","volume":"16","author":"Gamal","year":"2024","journal-title":"J Agric Food Res"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1080\/03670240490274101","article-title":"Iron deficiency is an important contributor to anemia among reproductive age women in Lebanon","volume":"43","author":"Hwalla","year":"2004","journal-title":"Ecol Food Nutr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1093\/ajcn\/33.3.570","article-title":"Manifestation of iron deficiency at various levels of dietary iron intake","volume":"33","author":"Siimes","year":"1980","journal-title":"Am J Clin Nutr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1406549","DOI":"10.3389\/fpubh.2024.1406549","article-title":"The global burden of maternal disorders attributable to iron deficiency related sub-disorders in 204 countries and territories: an analysis for the Global Burden of Disease study","volume":"12","author":"Wu","year":"2024","journal-title":"Front Public Health"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"278","DOI":"10.3390\/biomedicines12020278","article-title":"Is it time to alter the standard of care for iron deficiency\/iron deficiency anemia in reproductive-age women?","volume":"12","author":"Bellad","year":"2024","journal-title":"Biomedicines"},{"key":"ref33","article-title":"WHO global anaemia estimates, 2021 edition","year":"2021"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1080\/07399332.2022.2164283","article-title":"Environmental issues, economic growth, and fertility rate in developing regions: from theory to robust empirical policies","volume":"45","author":"Nkalu","year":"2024","journal-title":"Health Care Women Int"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1080\/20009666.2020.1831743","article-title":"Iron deficiency anemia in males: a dosing dilemma?","volume":"11","author":"Sheikh","year":"2021","journal-title":"J Community Hosp Intern Med Perspect"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s12937-024-00945-1","article-title":"Epidemiological study of pediatric nutritional deficiencies: an analysis from the global burden of disease study 2019","volume":"23","author":"Mao","year":"2024","journal-title":"Nutr J"},{"key":"ref37","first-page":"285","article-title":"Iron deficiency anemia in children","volume":"194","author":"Abdikarimov","year":"2024","journal-title":"Sci Collect"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e13601","DOI":"10.1111\/mcn.13601","article-title":"Deteriorating complementary feeding practices and dietary quality in Jordan: trends and challenges","volume":"20","author":"Ghosh","year":"2024","journal-title":"Matern Child Nutr"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"e1561","DOI":"10.1016\/S2214-109X(24)00338-3","article-title":"Addressing global micronutrient inadequacies: enhancing global data representation","volume":"12","author":"Lassale","year":"2024","journal-title":"Lancet Glob Health"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"e627","DOI":"10.1016\/S2214-109X(22)00084-5","article-title":"National, regional, and global estimates of anaemia by severity in women and children for 2000\u201319: a pooled analysis of population-representative data","volume":"10","author":"Stevens","year":"2022","journal-title":"Lancet Glob Health"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"101299","DOI":"10.1016\/j.eclinm.2022.101299","article-title":"Global, regional, and national burdens of common micronutrient deficiencies from 1990 to 2019: a secondary trend analysis based on the Global Burden of Disease 2019 study","volume":"44","author":"Han","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"3587","DOI":"10.3390\/nu6093587","article-title":"Obesity as an emerging risk factor for iron deficiency","volume":"6","author":"Aigner","year":"2014","journal-title":"Nutrients"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1776507","DOI":"10.1080\/16549716.2020.1776507","article-title":"National incidence, prevalence and disability-adjusted life years (DALYs) of common micronutrient deficiencies in Ethiopia from 1990 to 2017: estimates from the global burden of diseases study","volume":"13","author":"Hassen","year":"2020","journal-title":"Glob Health Action"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s12937-022-00771-3","article-title":"Global burden and inequality of iron deficiency: findings from the Global Burden of Disease datasets 1990\u20132017","volume":"21","author":"Wang","year":"2022","journal-title":"Nutr J"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"931","DOI":"10.3390\/nu14050931","article-title":"Evolving patterns of nutritional deficiencies burden in low-and middle-income countries: findings from the 2019 global burden of disease study","volume":"14","author":"Liu","year":"2022","journal-title":"Nutrients"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1958","DOI":"10.1016\/S0140-6736(24)00812-2","article-title":"Global Burden of Disease Study 2021 estimates: implications for health policy and research","volume":"403","author":"Ward","year":"2024","journal-title":"Lancet"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"2678","DOI":"10.1093\/jn\/134.10.2678","article-title":"Iron fortification and iron supplementation are cost-effective interventions to reduce iron deficiency in four subregions of the world","volume":"134","author":"Baltussen","year":"2004","journal-title":"J Nutr"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.3390\/nu16081215","article-title":"The role of social media advertisement and physical activity on eating behaviors among the general population in Saudi Arabia","volume":"16","author":"Aleid","year":"2024","journal-title":"Nutrients"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"97","DOI":"10.4103\/abhs.abhs_60_24","article-title":"Strategies for reducing the burden of cardiovascular diseases in the United Arab Emirates","volume":"3","author":"Shorbagi","year":"2024","journal-title":"Adv Biomed Health Sci"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1517478\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:43:35Z","timestamp":1737420215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2024.1517478\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":49,"alternative-id":["10.3389\/fnut.2024.1517478"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2024.1517478","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]},"article-number":"1517478"}}