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

Влияние пищевых факторов риска на здоровье в 195 странах, 1990–2017 гг.: систематический анализ в рамках исследования «Глобальное бремя болезней, травм и факторов риска» 2017 года
Walter C. Willett, Ashkan Afshin, Renata Micha, Dariush Mozaffarian, Giuseppe Grosso, Christopher J L Murray, Cristiana Abbafati, Tomi Akinyemiju, Fares Alahdab, Alaa Badawi, Isabela M. Benseñor, Leah E. Cahill, Juan Jesús Carrero, Kelly Cercy, Lalit Dandona, Rakhi Dandona, Alireza Esteghamati, Jessica Fanzo, Farshad Farzadfar, Valery L. Feigin, Giannina Ferrara, Luísa Sório Flor, Nataliya A Foigt, Alessandra C. Goulart, Samer Hamidi, Graeme J. Hankey, Simon I Hay, Nayu Ikeda, Spencer L James, Lars Johansson, Ruth W Kimokoti, G Anil Kumar, Tea Lallukka, Alan D Lopez, Stefan Lorkowski, Paulo A. Lotufo, Reza Malekzadeh, Walter Mendoza, Ted R. Miller, Ali H. Mokdad, Erin C Mullany, Gabriele Nagel, Mohsen Naghavi, Cuong Tat Nguyen, Molly R Nixon, Sok King Ong, David M. Pereira, Juan Á. Rivera, Sonia Rodríguez‐Ramírez, Gholamreza Roshandel, Gregory A. Roth, Tania G Sánchez-Pimienta, Benn Sartorius, Aletta E. Schutte, Sadaf G Sepanlou, Min‐Jeong Shin, Reed J D Sorensen, Dan J. Stein, Mathilde Touvier, Bach Xuan Tran, Tommi Vasankari, Theo Vos, Andrea Werdecker, Gelin Xu, Naohiro Yonemoto, Chuanhua Yu, Elisabete Weiderpass, Marco Springmann, Patrick John Sur, Kairsten Fay, Leslie Cornaby, Joseph S Salama, Kalkidan Hassen Abate, Abebe Zegeye, Mohsen Afarideh, Anju Aggarwal, Sutapa Agrawal, Umar Bacha, Victoria F Bachman, Hamid Badali, Eduardo Bernabé, Sibhatu Biadgilign, Stan Biryukov, Anh Kim Dang, Meaza Girma Degefa, Maysaa El Sayed Zaki, Sadaf Esteghamati, Carla Sofia e Sá Farinha, Maryam S. Farvid, João Carlos Fernandes, Mohammad H. Forouzanfar, Morsaleh Ganji, Johanna M. Geleijnse, Richard F Gillum, Idris Guessous, S Harikrishnan, Hamid Yimam Hassen, Chi Linh Hoang, Masako Horino, Farhad Islami, Maria Jackson, Jost B Jonas, Amir Kasaeian, Yousef Khader, Fakher Rahim, Young‐Ho Khang, Yoshihiro Kokubo, Rafael Lozano, Winfried März, Toni Meier, Yohannes Adama Melaku, Gert Mensink, Renata Micha, Mojde Mirarefin, Viswanathan Mohan, Hossein Poustchi, Mostafa Qorbani, Rajesh Kumar, Christian Razo-García, Colin D. Rehm, Juan Sanabria, Josef Schmidhuber, L Szponar, Andrew Thorne‐Lyman, Amanda G. Thrift, Stefanos Tyrovolas, Kingsley Nnanna Ukwaja, Irfan Ullah, Olalekan A. Uthman, Masoud Vaezghasemi, Giang Thu Vu, Linh Gia Vu, Tissa Wijeratne, Jason Wu, Stein Emil Vollset, Ibrahim A. Khalil
2019-04-03

Global Burden of Disease Study 2017comparative risk assessmentdietary risk factorsdisability-adjusted life-yearspopulation attributable fraction
BACKGROUND: 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. FUNDING: Bill & Melinda Gates Foundation.
1
Dietary data limitations and mixed sources increased the statistical uncertainty of estimates, but the findings support improving diets through evidence-based interventions worldwide.
2
High sodium intake caused an estimated 3 million deaths and 70 million DALYs worldwide in 2017.
3
High sodium intake, low whole-grain intake, and low fruit intake were the leading dietary risks for global deaths and DALYs.
4
In 2017, dietary risk factors accounted for approximately 11 million deaths and 255 million disability-adjusted life-years globally.
5
Low whole-grain intake caused an estimated 3 million deaths and 82 million DALYs, while low fruit intake caused 2 million deaths and 65 million DALYs.

Dietary risks (major food and nutrient intakes) among adults aged 25 years or older across 195 countries, 1990–2017

The impact of suboptimal dietary intake on non-communicable disease mortality, morbidity, and DALYs

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2019-04-03
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Authors
Walter C. Willett
Ashkan Afshin
Renata Micha
Dariush Mozaffarian
Giuseppe Grosso
Christopher J L Murray
Cristiana Abbafati
Tomi Akinyemiju
Fares Alahdab
Alaa Badawi
Isabela M. Benseñor
Leah E. Cahill
Juan Jesús Carrero
Kelly Cercy
Lalit Dandona
Rakhi Dandona
Alireza Esteghamati
Jessica Fanzo
Farshad Farzadfar
Valery L. Feigin
Giannina Ferrara
Luísa Sório Flor
Nataliya A Foigt
Alessandra C. Goulart
Samer Hamidi
Graeme J. Hankey
Simon I Hay
Nayu Ikeda
Spencer L James
Lars Johansson
Ruth W Kimokoti
G Anil Kumar
Tea Lallukka
Alan D Lopez
Stefan Lorkowski
Paulo A. Lotufo
Reza Malekzadeh
Walter Mendoza
Ted R. Miller
Ali H. Mokdad
Erin C Mullany
Gabriele Nagel
Mohsen Naghavi
Cuong Tat Nguyen
Molly R Nixon
Sok King Ong
David M. Pereira
Juan Á. Rivera
Sonia Rodríguez‐Ramírez
Gholamreza Roshandel
Gregory A. Roth
Tania G Sánchez-Pimienta
Benn Sartorius
Aletta E. Schutte
Sadaf G Sepanlou
Min‐Jeong Shin
Reed J D Sorensen
Dan J. Stein
Mathilde Touvier
Bach Xuan Tran
Tommi Vasankari
Theo Vos
Andrea Werdecker
Gelin Xu
Naohiro Yonemoto
Chuanhua Yu
Elisabete Weiderpass
Marco Springmann
Patrick John Sur
Kairsten Fay
Leslie Cornaby
Joseph S Salama
Kalkidan Hassen Abate
Abebe Zegeye
Mohsen Afarideh
Anju Aggarwal
Sutapa Agrawal
Umar Bacha
Victoria F Bachman
Hamid Badali
Eduardo Bernabé
Sibhatu Biadgilign
Stan Biryukov
Anh Kim Dang
Meaza Girma Degefa
Maysaa El Sayed Zaki
Sadaf Esteghamati
Carla Sofia e Sá Farinha
Maryam S. Farvid
João Carlos Fernandes
Mohammad H. Forouzanfar
Morsaleh Ganji
Johanna M. Geleijnse
Richard F Gillum
Idris Guessous
S Harikrishnan
Hamid Yimam Hassen
Chi Linh Hoang
Masako Horino
Farhad Islami
Maria Jackson
Jost B Jonas
Amir Kasaeian
Yousef Khader
Fakher Rahim
Young‐Ho Khang
Yoshihiro Kokubo
Rafael Lozano
Winfried März
Toni Meier
Yohannes Adama Melaku
Gert Mensink
Renata Micha
Mojde Mirarefin
Viswanathan Mohan
Hossein Poustchi
Mostafa Qorbani
Rajesh Kumar
Christian Razo-García
Colin D. Rehm
Juan Sanabria
Josef Schmidhuber
L Szponar
Andrew Thorne‐Lyman
Amanda G. Thrift
Stefanos Tyrovolas
Kingsley Nnanna Ukwaja
Irfan Ullah
Olalekan A. Uthman
Masoud Vaezghasemi
Giang Thu Vu
Linh Gia Vu
Tissa Wijeratne
Jason Wu
Stein Emil Vollset
Ibrahim A. Khalil
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