Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Afshin, Ashkan and Sur, Patrick John and Fay, Kairsten A. and Cornaby, Leslie and Ferrara, Giannina and Salama, Joseph S and Mullany, Erin C and Abate, Kalkidan Hassen and Abbafati, Cristiana and Abebe, Zegeye and Afarideh, Mohsen and Aggarwal, Anju and Agrawal, Sutapa and Akinyemiju, Tomi and Alahdab, Fares and Bacha, Umar and Bachman, Victoria F and Badali, Hamid and Badawi, Alaa and Bensenor, Isabela M and Bernabe, Eduardo and Biadgilign, Sibhatu Kassa K and Biryukov, Stan H and Cahill, Leah E and Carrero, Juan J and Cercy, Kelly M. and Dandona, Lalit and Dandona, Rakhi and Dang, Anh Kim and Degefa, Meaza Girma and El Sayed Zaki, Maysaa and Esteghamati, Alireza and Esteghamati, Sadaf and Fanzo, Jessica and Farinha, Carla Sofia e Sá and Farvid, Maryam S and Farzadfar, Farshad and Feigin, Valery L. and Fernandes, Joao C and Flor, Luisa Sorio and Foigt, Nataliya A. and Forouzanfar, Mohammad H and Ganji, Morsaleh and Geleijnse, Johanna M. and Gillum, Richard F and Goulart, Alessandra C and Grosso, Giuseppe and Guessous, Idris and Hamidi, Samer and Hankey, Graeme J. and Harikrishnan, Sivadasanpillai and Hassen, Hamid Yimam and Hay, Simon I. and Hoang, Chi Linh and Horino, Masako and Islami, Farhad and Jackson, Maria D. and James, Spencer L. and Johansson, Lars and Jonas, Jost B. and Kasaeian, Amir and Khader, Yousef Saleh and Khalil, Ibrahim A. and Khang, Young-Ho and Kimokoti, Ruth W and Kokubo, Yoshihiro and Kumar, G Anil and Lallukka, Tea and Lopez, Alan D and Lorkowski, Stefan and Lotufo, Paulo A. and Lozano, Rafael and Malekzadeh, Reza and März, Winfried and Meier, Toni and Melaku, Yohannes A and Mendoza, Walter and Mensink, Gert B.M. and Micha, Renata and Miller, Ted R and Mirarefin, Mojde and Mohan, V and Mokdad, Ali H and Mozaffarian, Dariush and Nagel, Gabriele and Naghavi, Mohsen and Nguyen, Cuong Tat and Nixon, Molly R and Ong, Kanyin L and Pereira, David M. and Poustchi, Hossein and Qorbani, Mostafa and Rai, Rajesh Kumar and Razo-García, Christian and Rehm, Colin D and Rivera, Juan A and Rodríguez-Ramírez, Sonia and Roshandel, Gholamreza and Roth, Gregory A and Sanabria, Juan and Sánchez-Pimienta, Tania G and Sartorius, Benn and Schmidhuber, Josef and Schutte, Aletta Elisabeth and Sepanlou, Sadaf G. and Shin, Min-Jeong and Sorensen, Reed J.D. and Springmann, Marco and Szponar, Lucjan and Thorne-Lyman, Andrew L and Thrift, Amanda G and Touvier, Mathilde and Tran, Bach Xuan and Tyrovolas, Stefanos and Ukwaja, Kingsley Nnanna and Ullah, Irfan and Uthman, Olalekan A and Vaezghasemi, Masoud and Vasankari, Tommi Juhani and Vollset, Stein Emil and Vos, Theo and Vu, Giang Thu and Vu, Linh Gia and Weiderpass, Elisabete and Werdecker, Andrea and Wijeratne, Tissa and Willett, Walter C and Wu, Jason H and Xu, Gelin and Yonemoto, Naohiro and Yu, Chuanhua and Murray, Christopher J L (2019) Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet, 393 (10184). p. 1958. ISSN 01406736



Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. METHODS: By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. FINDINGS: In 2017, 11 million (95% uncertainty interval [UI] 10-12) deaths and 255 million (234-274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1-5] deaths and 70 million [34-118] DALYs), low intake of whole grains (3 million [2-4] deaths and 82 million [59-109] DALYs), and low intake of fruits (2 million [1-4] deaths and 65 million [41-92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. INTERPRETATION: This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually.

Item Type:Article
Official URL/DOI:
Uncontrolled Keywords:Global Burden of Disease Study, Dietary Risk
Divisions:Department of Epidemiology
Department of Diabetology
ID Code:1162
Deposited By:surendar radha
Deposited On:04 Feb 2020 11:23
Last Modified:04 Feb 2020 11:23

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