The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors

作者：Goodarz Danaei, Eric L. Ding, Dariush Mozaffarian, Ben Taylor, Jürgen Rehm, Christopher J L Murray, Majid Ezzati · 发表于：PLoS Medicine · 年份：2009 · DOI：10.1371/journal.pmed.1000058 · 被引用次数：2893 · 研究领域：Nutritional Studies and Diet、Fatty Acid Research and Health、Sodium Intake and Health

BACKGROUND: Knowledge of the number of deaths caused by risk factors is needed for health policy and priority setting. Our aim was to estimate the mortality effects of the following 12 modifiable dietary, lifestyle, and metabolic risk factors in the United States (US) using consistent and comparable methods: high blood glucose, low-density lipoprotein (LDL) cholesterol, and blood pressure; overweight-obesity; high dietary trans fatty acids and salt; low dietary polyunsaturated fatty acids, omega-3 fatty acids (seafood), and fruits and vegetables; physical inactivity; alcohol use; and tobacco smoking. METHODS AND FINDINGS: We used data on risk factor exposures in the US population from nationally representative health surveys and disease-specific mortality statistics from the National Center for Health Statistics. We obtained the etiological effects of risk factors on disease-specific mortality, by age, from systematic reviews and meta-analyses of epidemiological studies that had adjusted (i) for major potential confounders, and (ii) where possible for regression dilution bias. We estimated the number of disease-specific deaths attributable to all non-optimal levels of each risk factor exposure, by age and sex. In 2005, tobacco smoking and high blood pressure were responsible for an estimated 467,000 (95% confidence interval [CI] 436,000-500,000) and 395,000 (372,000-414,000) deaths, accounting for about one in five or six deaths in US adults. Overweight-obesity (216,000; 188,...