ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1681583
A comprehensive analysis of vitamin A deficiency in China from 1990 to 2021, examining temporal trends and demographic influences
Provisionally accepted
- 1Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
- 2Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Background: Vitamin A deficiency (VAD) remains a critical public health burden in China, particularly affecting children and reproductive-age women. A comprehensive analysis of its long-term trends is essential for guiding nutritional interventions. Methods: Utilizing data from the Global Burden of Disease (GBD) 2021 study covering 1990 to 2021, we examined age-standardized incidence, prevalence, disability-adjusted life years (DALYs), and sociodemographic factors influencing VAD in China. Joinpoint regression detected temporal inflection points, and Bayesian age-period-cohort (BAPC) modeling forecasted incidence up to 2040. Frontier analysis correlated burden with the socio-demographic Index (SDI) across 204 countries. Results: In 2021, China reported 23.19 million new VAD cases, with higher age-standardized incidence in females (2,094.3/100,000) versus males (1,821.07/100,000). A bimodal age distribution peaked in children (<14 years, male-predominant DALYs) and young adults (20-34 years, female-predominant incidence). From 1990-2021, age-standardized rates declined by 81.2% (incidence) and 81.2% (prevalence), surpassing global reductions. Critically, a 2013 inflection point reversed sex disparities: male burden exceeded females before 2013, but female rates dominated thereafter. Sub-Saharan Africa experienced the highest burden globally, with a negative correlation between SDI and VAD incidence (R²=0.72, p<0.001). BAPC projections indicate persistent declines through 2040, but males will retain higher incidence than females. Conclusions: Despite substantial progress, VAD persists with evolving sex-age disparities. The 2013 sex burden reversal and dual vulnerability of children/young adults necessitate sex-stratified interventions. Integration of supplementation programs with socioeconomic development is vital for eliminating VAD in China and high-burden regions.
Keywords: Vitamin A Deficiency, Global Burden of Disease study, Age-Period-Cohort analysis, Temporal Trends, Frontier analysis
Received: 07 Aug 2025; Accepted: 25 Sep 2025.
Copyright: © 2025 Du, Jiang, Lei, Juan and Mao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yan Mao, maoyan_0828@163.com
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