Is Diet Linked to Greater Mortality Rates Than Smoking?

Poor diet is tied to more deaths than any other health risks around the world, including tobacco smoking, with approximately 11 million deaths worldwide attributable to poor diet in 2017, according to new study findings.¹

Interestingly, researchers found that underconsumption of certain foods played a key role in diet-related mortality risk. Consumption of healthy foods including nuts and seeds, milk, and whole grains was found to be “suboptimal” in 2017, while intake of sugar-sweetened beverages, processed meats, and sodium had surpassed optimal levels globally.

Now, researchers are calling for improved dietary policies and comprehensive food system interventions. Although the top contributors to deaths included the overconsumption of sodium and underconsumption of whole grains, fruits, vegetables, and omega-3 fatty acids, the researchers said global efforts and diet policies – including the World Health Organization’s Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCDs) – have focused heavily on taming sodium, sugar, and fat intake.²

“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,” wrote Ashkan Afshin, MD, MPH, MSc, ScD, from the Institute for Health Metrics and Evaluation at the University of Washington, and colleagues, who conducted the study.

They noted that promising interventions including mass media campaigns, food and menu labeling, worksite wellness programs, and policies targeting multiple food system sectors could be helpful in this regard, among other potential efforts.

What the Data Show

For the Global Burden of Disease Study (GBD) 2017, Dr Afshin and colleagues assessed 1990-2017 data on adults aged 25 years and older from 195 countries. Their analysis included estimates of deaths and disability-adjusted life-years (DALYs) attributable to diet for multiple disease outcomes, including cardiovascular disease (CVD).

Of all diet-related deaths around the world, 10 million were due to CVD. Diet-related deaths were also commonly caused by cancers and type 2 diabetes (n = 913,090 and 338,714, respectively).

Among 21 GBD regions, Oceana was found to have the highest age-standardized rates of all diet-related deaths and DALYs (678 deaths per population of 100,000 and 17,804 DALYs per population of 100,000). Diet-related deaths and DALYs were lowest for Asia Pacific and Australasia, respectively.

In the United States, the top dietary risk factor for deaths and DALYs was underconsumption of whole grains. This trend was also observed in countries including India, Pakistan, Russia, and Germany, among others. In other countries, top dietary risk factors for deaths and DALYs included:

• High sodium intake in China, Japan, and Thailand
• Low fruit intake in Bangladesh
• Low consumption of nuts and seeds in Mexico

Of note, for most countries with high populations, high intake of red meat, processed meat, trans fat, and sugar-sweetened beverages ranked lower for deaths and DALYs.

The study findings were published in The Lancet.

—Christina Vogt

References:

1. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 [Published online April 3, 2019]. Lancet. https://doi.org/10.1016/S0140-6736(19)30041-8.

2. Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/94384/9789241506236_eng.pdf;jsessionid=1C21C8B0C4712B9D29BD3A079E9A0F34?sequence=1. Accessed on April 4, 2019.