Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
- PMID: 30954305
- PMCID: PMC6899507
- DOI: 10.1016/S0140-6736(19)30041-8
Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
Erratum in
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Department of Error.Lancet. 2021 Jun 26;397(10293):2466. doi: 10.1016/S0140-6736(21)01342-8. Lancet. 2021. PMID: 34175088 Free PMC article. No abstract available.
Abstract
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.
Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
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Comment in
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Global diet and health: old questions, fresh evidence, and new horizons.Lancet. 2019 May 11;393(10184):1916-1918. doi: 10.1016/S0140-6736(19)30500-8. Epub 2019 Apr 4. Lancet. 2019. PMID: 30954306 No abstract available.
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Uncertainties in the GBD 2017 estimates on diet and health.Lancet. 2019 Nov 16;394(10211):1801-1802. doi: 10.1016/S0140-6736(19)32502-4. Lancet. 2019. PMID: 31741448 No abstract available.
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Uncertainties in the GBD 2017 estimates on diet and health.Lancet. 2019 Nov 16;394(10211):1802. doi: 10.1016/S0140-6736(19)32477-8. Lancet. 2019. PMID: 31741449 No abstract available.
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Uncertainties in the GBD 2017 estimates on diet and health - Authors' reply.Lancet. 2019 Nov 16;394(10211):1802-1803. doi: 10.1016/S0140-6736(19)32629-7. Lancet. 2019. PMID: 31741450 No abstract available.
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Differences in modelled estimates of global dietary intake.Lancet. 2021 May 8;397(10286):1708-1709. doi: 10.1016/S0140-6736(21)00714-5. Lancet. 2021. PMID: 33965084 No abstract available.
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