Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
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DOI：
10.1016/s0140-6736(19)30041-8
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发表时间：
2019-05-11
期刊：
影响因子：
168.9
通讯作者：
Murray, Christopher J. L.
中科院分区：
文献类型：
--
作者：
Afshin, Ashkan;Sur, Patrick John;Murray, Christopher J. L.
不理想的饮食是非传染性疾病（NCD）的一个重要的可预防风险因素;然而，其对NCD负担的影响尚未得到系统的评估。本研究旨在评估195个国家的主要食物和营养素的消费，并量化其次优摄入对NCD死亡率和发病率的影响。通过使用比较风险评估方法，我们估计了25岁或以上成年人中归因于每个饮食风险因素（也称为人口归因分数）的疾病特异性负担的比例。该分析的主要输入包括每个饮食因素的摄入量，饮食因素对疾病终点的影响大小，以及与最低死亡风险相关的摄入水平。结果2017年，有1100万（95%不确定区间[UI] 10-12）例死亡和2.55亿（234-274）例残疾调整生命年（DADs）可归因于饮食风险因素。高钠摄入（300万[1-5]人死亡，7000万[34-118]人死亡），全谷物摄入量低（300万[2-4]人死亡，8200万[59-109]人死亡），水果摄入量少（200万[1-4]例死亡和6500万[41-92]例糖尿病）是全球和许多国家死亡和糖尿病的主要饮食风险因素。膳食数据来自混合来源，并非所有国家都可获得，增加了我们估计的统计不确定性。解释这项研究提供了一个全面的图片的潜在影响，次优饮食对非传染性疾病的死亡率和发病率，强调需要改善各国的饮食。我们的研究结果将为循证饮食干预措施的实施提供信息，并为每年评估其对人类健康的影响提供平台。
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.