To analyze the disease burden and changing trends of iron deficiency anemia (IDA) among children and adolescents in China from 1990 to 2021, and to provide evidence for policymakers to formulate prevention and control strategies.

Data from the Global Burden of Disease (GBD) 2021 study were used to extract indicators of iron deficiency anemia (IDA) among Chinese children and adolescents aged 0-19 years, including prevalent case number, prevalence, disability-adjusted life years (DALYs), and DALYs rate. Joinpoint regression models were established using Joinpoint Regression Program 4.9.0.0 to quantify trends in these indicators.

In 2021, the prevalent case number, prevalence, DALYs, and DALYs rate of IDA among Chinese children and adolescents aged 0-19 years were 1 171.77×10⁴,3 505.11/10⁵,28.94×10⁴, and 86.57/10⁵, respectively. Compared with 1990, these values decreased by 71.94%, 62.65%, 75.88%, and 67.88% (all P<0.001). Gender differences revealed that females had significantly higher values than males in all four indicators except DALYs rate (P<0.001), with smaller declines than males. Age distribution of IDA exhibited a “U-shaped” pattern: the group under 5 years had the highest burden (486.69×10⁴ cases, prevalence 6 034.48/10⁵), while the 15-19 years group showed a rebound, particularly in females (184.61×10⁴ cases, prevalence 5 337.18/10⁵), approaching the levels of the group under 5 years.

The disease burden of IDA among Chinese children and adolescents has significantly decreased. However, notable age- and gender-based disparities persist, necessitating focused efforts to sustain gains in IDA prevention and control among children under 5 years of age, while addressing the resurgence of IDA among adolescent females. Further exploration of tailored nutrition strategies and comprehensive measures is essential.