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

作者：Ashkan Afshin, Patrick John Sur, Kairsten Fay, Leslie Cornaby, Giannina Ferrara, Joseph S Salama, Erin C Mullany, Kalkidan Hassen Abate, Cristiana Abbafati, Abebe Zegeye, Mohsen Afarideh, Anju Aggarwal, Sutapa Agrawal, Tomi Akinyemiju, Fares Alahdab, Umar Bacha, Victoria F Bachman, Hamid Badali, Alaa Badawi, Isabela M. Benseñor, Eduardo Bernabé, Sibhatu Biadgilign, Stan Biryukov, Leah E. Cahill, Juan Jesús Carrero, Kelly Cercy, Lalit Dandona, Rakhi Dandona, Anh Kim Dang, Meaza Girma Degefa, Maysaa El Sayed Zaki, Alireza Esteghamati, Sadaf Esteghamati, Jessica Fanzo, Carla Sofia e Sá Farinha, Maryam S. Farvid, Farshad Farzadfar, Valery L. Feigin, João Carlos Fernandes, Luísa Sório Flor, Nataliya A Foigt, Mohammad H. Forouzanfar, Morsaleh Ganji, Johanna M. Geleijnse, Richard F Gillum, Alessandra C. Goulart, Giuseppe Grosso, Idris Guessous, Samer Hamidi, Graeme J. Hankey, S Harikrishnan, Hamid Yimam Hassen, Simon I Hay, Chi Linh Hoang, Masako Horino, Nayu Ikeda, Farhad Islami, Maria Jackson, Spencer L James, Lars Johansson, Jost B Jonas, Amir Kasaeian, Yousef Khader, Ibrahim A. Khalil, Young‐Ho Khang, Ruth W Kimokoti, Yoshihiro Kokubo, G Anil Kumar, Tea Lallukka, Alan D Lopez, Stefan Lorkowski, Paulo A. Lotufo, Rafael Lozano, Reza Malekzadeh, Winfried März, Toni Meier, Yohannes Adama Melaku, Walter Mendoza, Gert Mensink, Renata Micha, Ted R. Miller, Mojde Mirarefin, Viswanathan Mohan, Ali H. Mokdad, Dariush Mozaffarian, Gabriele Nagel, Mohsen Naghavi, Cuong Tat Nguyen, Molly R Nixon, Sok King Ong, David M. Pereira, Hossein Poustchi, Mostafa Qorbani, Rajesh Kumar, Christian Razo-García, Colin D. Rehm, Juan Á. Rivera, Sonia Rodríguez‐Ramírez, Gholamreza Roshandel, Gregory A. Roth, Juan Sanabria, Tania G Sánchez-Pimienta, Benn Sartorius, Josef Schmidhuber, Aletta E. Schutte, Sadaf G Sepanlou, Min‐Jeong Shin, Reed J D Sorensen, Marco Springmann, L Szponar, Andrew Thorne‐Lyman, Amanda G. Thrift, Mathilde Touvier, Bach Xuan Tran, Stefanos Tyrovolas, Kingsley Nnanna Ukwaja, Irfan Ullah, Olalekan A. Uthman, Masoud Vaezghasemi, Tommi Vasankari, Stein Emil Vollset, Theo Vos, Giang Thu Vu, Linh Gia Vu, Elisabete Weiderpass, Andrea Werdecker, Tissa Wijeratne, Walter C. Willett, Jason Wu, Gelin Xu, Naohiro Yonemoto, Chuanhua Yu, Christopher J L Murray · 发表于：The Lancet · 年份：2019 · DOI：10.1016/s0140-6736(19)30041-8 · 被引用次数：5910 · 研究领域：Nutritional Studies and Diet、Consumer Attitudes and Food Labeling、Global Public Health Policies and Epidemiology

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...