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Health Effects of Dietary Risks in 195 Countries, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017 Publisher Pubmed



Afshin A1, 2 ; Sur PJ2, 7 ; Fay KA2 ; Cornaby L2 ; Ferrara G2 ; Salama JS2 ; Mullany EC2 ; Abate KH8 ; Abbafati C9 ; Abebe Z10 ; Afarideh M12 ; Aggarwal A3 ; Agrawal S18, 34 ; Akinyemiju T19 Show All Authors
Authors
  1. Afshin A1, 2
  2. Sur PJ2, 7
  3. Fay KA2
  4. Cornaby L2
  5. Ferrara G2
  6. Salama JS2
  7. Mullany EC2
  8. Abate KH8
  9. Abbafati C9
  10. Abebe Z10
  11. Afarideh M12
  12. Aggarwal A3
  13. Agrawal S18, 34
  14. Akinyemiju T19
  15. Alahdab F20
  16. Bacha U21
  17. Bachman VF4
  18. Badali H22
  19. Badawi A23, 24
  20. Bensenor IM25
  21. Bernabe E28
  22. Biryukov SH2
  23. Biadgilign SKK29
  24. Cahill LE30, 31
  25. Carrero JJ33
  26. Cercy KM2
  27. Dandona L2, 34
  28. Dandona R2
  29. Dang AK35
  30. Degefa MG36
  31. El Sayed Zaki M37
  32. Esteghamati A12
  33. Esteghamati S13
  34. Fanzo J38, 41
  35. Farinha CSES40
  36. Farvid MS31
  37. Farzadfar F14
  38. Feigin VL2, 43
  39. Fernandes JC44
  40. Flor LS45, 46
  41. Foigt NA47
  42. Forouzanfar MH2
  43. Ganji M12
  44. Geleijnse JM48
  45. Gillum RF49
  46. Goulart AC25, 27
  47. Grosso G50
  48. Guessous I51, 52
  49. Hamidi S53
  50. Hankey GJ54, 55
  51. Harikrishnan S56
  52. Hassen HY57, 58
  53. Hay SI1, 2
  54. Hoang CL59
  55. Horino M60
  56. Ikeda N61
  57. Islami F62
  58. Jackson MD63
  59. James SL2
  60. Johansson L64
  61. Jonas JB65, 67
  62. Kasaeian A15, 17
  63. Khader YS68
  64. Khalil IA1, 2
  65. Khang YH69
  66. Kimokoti RW70
  67. Kokubo Y71
  68. Kumar GA34
  69. Lallukka T72, 73
  70. Lopez AD2, 75
  71. Lorkowski S76, 78
  72. Lotufo PA26
  73. Lozano R2
  74. Malekzadeh R16, 79
  75. Marz W66, 80
  76. Meier T77, 81
  77. Melaku YA11, 82
  78. Mendoza W83
  79. Mensink GBM84
  80. Micha R85
  81. Miller TR86, 87
  82. Mirarefin M60
  83. Mohan V88
  84. Mokdad AH1, 2
  85. Mozaffarian D85
  86. Nagel G89
  87. Naghavi M1, 2
  88. Nguyen CT35
  89. Nixon MR2
  90. Ong KL2
  91. Pereira DM90, 91
  92. Poustchi H16
  93. Qorbani M92
  94. Rai RK93, 94
  95. Razogarcia C95
  96. Rehm CD98
  97. Rivera JA96
  98. Rodriguezramirez S96
  99. Roshandel G16, 99
  100. Roth GA2, 5
  101. Sanabria J100, 101
  102. Sanchezpimienta TG97
  103. Sartorius B102
  104. Schmidhuber J42
  105. Schutte AE103, 104
  106. Sepanlou SG16, 79
  107. Shin MJ105
  108. Sorensen RJD2, 6
  109. Springmann M106
  110. Szponar L107
  111. Thornelyman AL32, 39
  112. Thrift AG108
  113. Touvier M109
  114. Tran BX110
  115. Tyrovolas S111, 112
  116. Ukwaja KN113
  117. Ullah I114, 115
  118. Uthman OA116
  119. Vaezghasemi M117
  120. Vasankari TJ118
  121. Vollset SE1, 2
  122. Vos T1, 2
  123. Vu GT59
  124. Vu LG59
  125. Weiderpass E33, 119
  126. Werdecker A120, 121
  127. Wijeratne T74, 122
  128. Willett WC31, 123
  129. Wu JH124
  130. Xu G125
  131. Yonemoto N126
  132. Yu C127
  133. Murray CJL1, 2

Source: The Lancet Published:2019


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. © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
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