Nutritional deficiencies in low-sociodemographic-index countries: a population-based study

Abstract

Background: We aimed to estimate the burden of nutritional deficiency according to sex and age in countries with a low sociodemographic index (SDI). Methods: Following the methods of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, estimated annual percentage changes (EAPCs) were calculated to determine trends in the age-standardized rates of incidence and disability-adjusted life-years (DALYs) of nutritional deficiency and its main subcategories from 1990 to 2019 in low-SDI countries. Findings: From 1990 to 2019, the age-standardized incidence and DALY rates of nutritional deficiency showed decreasing trends, with EAPCs of −0.90 [95% confidence interval (CI), 1.06 to −0.75] and −3.20 (95% CI, −3.29 to −3.10), respectively, in low-SDI countries. In 2019, of the subcategories analyzed, vitamin A deficiency had the highest age-standardized incidence rate and protein–energy malnutrition had the highest age-standardized DALY rate. From 1990 to 2019, the greatest decrease in the age-standardized incidence rate was observed for vitamin A deficiency and the greatest decrease in the age-standardized DALY rate was observed for protein–energy malnutrition. At the national level, from 1990 to 2019, the greatest increase in the age-standardized incidence rate of overall nutritional deficiency was observed in males in Afghanistan (EAPC: 0.28; 95% CI, 0.07 to 0.49). Of the age groups analyzed, the highest incidence and DALY rates of overall nutritional deficiency and dietary iron deficiency were observed in children aged 1–4 years. Interpretation: The age-standardized incidence and DALY rates of nutritional deficiency decreased significantly from 1990 to 2019, especially for vitamin A deficiency and protein–energy malnutrition. Overall nutritional deficiency and dietary iron deficiency occurred primarily in children aged 1–4 years.