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

被引：3426

作者：

Afshin, Ashkan ^{[1
,2
]}

Sur, Patrick John ^{[2
,7
]}

Fay, Kairsten A. ^{[2
]}

Cornaby, Leslie ^{[2
]}

Ferrara, Giannina ^{[2
]}

Salama, Joseph S. ^{[2
]}

Mullany, Erin C. ^{[2
]}

Abate, Kalkidan Hassen ^{[8
]}

Abbafati, Cristiana ^{[9
]}

Abebe, Zegeye ^{[10
]}

Afarideh, Mohsen ^{[12
]}

Aggarwal, Anju ^{[3
]}

Agrawal, Sutapa ^{[18
,33
]}

Akinyemiju, Tomi ^{[19
]}

Alahdab, Fares ^{[20
]}

Bacha, Umar ^{[21
]}

Bachman, Victoria F. ^{[4
]}

Badali, Hamid ^{[22
]}

Badawi, Alaa ^{[23
,24
]}

Bensenor, Isabela M. ^{[25
]}

Bernabe, Eduardo ^{[28
]}

Biryukov, Stan H. ^{[2
]}

Biadgilign, Sibhatu Kassa K.

Cahill, Leah E. ^{[29
,30
]}

Carrero, Juan J. ^{[32
]}

Cercy, Kelly M. ^{[2
]}

Dandona, Lalit ^{[2
,33
]}

Dandona, Rakhi ^{[2
,33
]}

Anh Kim Dang ^{[34
]}

Degefa, Meaza Girma ^{[35
]}

Zaki, Maysaa El Sayed ^{[36
]}

Esteghamati, Alireza ^{[12
]}

Esteghamati, Sadaf ^{[13
]}

Fanzo, Jessica ^{[37
,40
]}

Farinha, Carla Sofia E. Sa ^{[39
]}

Farvid, Maryam S. ^{[30
]}

Farzadfar, Farshad ^{[14
]}

Feigin, Valery L. ^{[2
,42
]}

Fernandes, Joao C. ^{[43
]}

Flor, Luisa Sorio ^{[44
,45
]}

Foigt, Nataliya A. ^{[46
]}

Forouzanfar, Mohammad H. ^{[2
]}

Ganji, Morsaleh ^{[12
]}

Geleijnse, Johanna M. ^{[47
]}

Gillum, Richard F. ^{[48
]}

Goulart, Alessandra C. ^{[25
,27
]}

Grosso, Giuseppe ^{[49
]}

Guessous, Idris ^{[50
,51
]}

Hamidi, Samer ^{[52
]}

Hankey, Graeme J. ^{[53
,54
]}

机构：

[1] Univ Washington, Dept Hlth Metr Sci, Seattle, WA 98195 USA

[2] Univ Washington, Inst Hlth Metr Evaluat, Seattle, WA 98195 USA

[3] Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA

[4] Univ Washington, Sch Med, Seattle, WA 98195 USA

[5] Univ Washington, Div Cardiol, Seattle, WA 98195 USA

[6] Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA

[7] Univ Calif Riverside, Sch Med, Riverside, CA 92521 USA

[8] Jimma Univ, Dept Populat & Family Hlth, Jimma, Ethiopia

[9] Univ Roma La Sapienza, Dept Law Philosophy & Econ Studies, Rome, Italy

[10] Univ Gondar, Dept Human Nutr, Gondar, Ethiopia

[11] Univ Gondar, Inst Publ Hlth, Gondar, Ethiopia

[12] Univ Tehran Med Sci, Endocrinol & Metab Res Ctr, Tehran, Iran

[13] Univ Tehran Med Sci, Endocrine Res Ctr, Tehran, Iran

[14] Univ Tehran Med Sci, Noncommunicable Dis Res Ctr, Tehran, Iran

[15] Univ Tehran Med Sci, Hematol Malignancies Res Ctr, Tehran, Iran

[16] Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran

[17] Univ Tehran Med Sci, Hematol Oncol & Stem Cell Transplantat Res Ctr, Tehran, Iran

[18] Vital Strategies, Gurugram, India

[19] Univ Kentucky, Dept Epidemiol, Lexington, KY USA

[20] Mayo Clin, Fdn Med Educ & Res, Evidence Based Practice Ctr, Rochester, MN USA

[21] Univ Management & Technol, Sch Hlth Sci, Lahore, Pakistan

[22] Mazandaran Univ Med Sci, Dept Med Mycol, Sari, Iran

[23] Publ Hlth Agcy Canada, Publ Hlth Risk Sci Div, Toronto, ON, Canada

[24] Univ Toronto, Dept Nutr Sci, Toronto, ON, Canada

[25] Univ Sao Paulo, Dept Internal Med, Sao Paulo, Brazil

[26] Univ Sao Paulo, Dept Med, Sao Paulo, Brazil

[27] Univ Sao Paulo, Ctr Clin & Epidemiol Res, Sao Paulo, Brazil

[28] Kings Coll London, Inst Dent, London, England

[29] Dalhousie Univ, Dept Med, Halifax, NS, Canada

[30] Harvard Univ, TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA

[31] Harvard Univ, TH Chan Sch Publ Hlth, Boston, MA 02115 USA

[32] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden

[33] Publ Hlth Fdn India, Gurugram, India

[34] Duy Tan Univ, Inst Global Hlth Innovat, Hanoi, Vietnam

[35] Mekelle Univ, Dept Nutr & Dietet, Mekelle, Ethiopia

[36] Mansoura Univ, Dept Clin Pathol, Mansoura, Egypt

[37] Johns Hopkins Univ, Berman Inst Bioeth, Baltimore, MD USA

[38] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA

[39] Natl Stat Off, Lisbon, Portugal

[40] Food & Agr Org United Nations, Nutr & Food Syst Div, Rome, Italy

[41] Food & Agr Org United Nations, Trade & Markets Div, Rome, Italy

[42] Auckland Univ Technol, Natl Inst Stroke & Appl Neurosci, Auckland, New Zealand

[43] Catholic Univ Portugal, Ctr Biotechnol & Fine Chem, Porto, Portugal

[44] Sergio Arouca Natl Sch Publ Hlth, Rio De Janeiro, Brazil

[45] Univ Fed Espirito Santo, Vitoria, Brazil

[46] Natl Acad Med Sci Ukraine, Inst Gerontol, Kiev, Ukraine

[47] Wageningen Univ & Res, Div Human Nutr & Hlth, Wageningen, Netherlands

[48] Howard Univ, Dept Community & Family Med, Div Gen Internal Med, Washington, DC 20059 USA

[49] Vittorio Emanuele Univ Hosp Polyclin, Registro Tumori Integrato, Catania, Italy

[50] Geneva Univ Hosp, Dept Community Med Primary Care & Emergency Med, Unit Populat Epidemiol, Geneva, Switzerland

来源：

LANCET | 2019年 / 393卷 / 10184期

关键词：

COST-EFFECTIVENESS; ENVIRONMENTAL SUSTAINABILITY; CARDIOVASCULAR-DISEASE; SODIUM-INTAKE; CONSUMPTION; IMPACT; ASSOCIATIONS; NUTRITION; REGIONS; US;

D O I：

10.1016/S0140-6736(19)30041-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 diseasespecific 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.

引用

页码：1958 / 1972

页数：15

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