Potential rise in iron deficiency due to future anthropogenic carbon dioxide emissions

Iron deficiency reduces capacity for physical activity, lowers IQ, and increases maternal and child mortality, impacting roughly a billion people worldwide. Recent studies have shown that certain highly consumed crops-C₃ grains (e.g., wheat, rice, and barley), legumes, and maize-have lower iron concentrations of 4-10% when grown under increased atmospheric CO₂ concentrations (550 ppm). We examined diets in 152 countries globally (95.5% of the population) to estimate the percentage of lost dietary iron resulting from anthropogenic CO₂ emissions between now and 2050, specifically among vulnerable age-sex groups: children (1-5 years) and women of childbearing age (15-49 years), holding diets constant. We also cross-referenced these with the current prevalence of anemia to identify most at-risk countries. We found that 1.4 billion children aged 1-5 and women of childbearing age (59% of global total for these groups) live in high-risk countries, where the prevalence of anemia exceeds 20% and modeled loss in dietary iron would be in the most severe tertile (>3.8%). The countries with the highest anemia prevalence also derive their iron from the fewest number of foods, even after excluding countries consuming large amounts of unaccounted wild-harvest foods. The potential risk of increased iron deficiency adds greater incentive for mitigating anthropogenic CO₂ emissions and highlights the need to address anticipated health impacts via improved health delivery systems, dietary behavioral changes, or agricultural innovation. Because these are effects on content rather than yield, it is unlikely that consumers will perceive this health threat and adapt to it without education.