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07-03-2017 | Public health | Highlight | Article

Editor's pick

Diet associated with ‘substantial proportion’ of cardiometabolic deaths

medwireNews: Research published in JAMAsuggests that suboptimal intake of specific dietary factors is associated with almost half of deaths from heart disease, stroke, or type 2 diabetes in the USA.

“These results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health,” say the study authors.

Renata Micha (Tufts Friedman School of Nutrition Science and Policy, Boston, Massachusetts, USA) and colleagues developed a comparative risk assessment model that incorporated data from National Health and Nutrition Examination Surveys, estimated associations between diet and disease from meta-analyses and clinical trials, and estimated disease-specific national mortality from the National Center for Health Statistics.

They found that suboptimal intake of 10 dietary factors was associated with 45.4% of a total 702,308 cardiometabolic deaths occurring in the USA in 2012.

Among individual dietary factors, the highest proportion of cardiometabolic deaths was attributed to excess sodium consumption (9.5%), followed by low intake of nuts and seeds, high processed meats, low seafood omega-3 fats, low vegetables, low fruits, high sugar-sweetened beverages (SSBs), low whole grains (each between 5.9 and 8.5%), and lastly low polyunsaturated fats (2.3%) and high unprocessed red meats (0.4%).

These findings suggest that “sodium is a key target” among unhealthy dietary components, report the authors.

However, they observe that the number of deaths linked to insufficient intake of healthier foods was “at least as substantial” as the number of deaths related to excess consumption of unhealthy foods, providing support for positive messaging to “emphasize maximizing the good (rather than simply reducing the harmful) food choices.”

In subgroup analyses, Micha and team found that cardiometabolic mortality associated with each dietary factor was “modestly higher” among men than women, with the greatest gender difference observed for processed meats.

There were also higher rates of diet-associated cardiometabolic deaths among Black and Hispanic compared with White people, at younger versus older ages, and among participants with low compared with high education.

“Income-related disparities in current levels and trends over time of national consumption of nuts/seeds, fruits, and SSBs […] likely contribute to these disparities in diet-associated mortality by race and education,” explain the researchers.

In an accompanying editorial, Noel Mueller and Lawrence Appel (both from Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland, USA) note that “the precision of the estimates reported by Micha et al should be interpreted cautiously given that the excess fraction of [cardiometabolic disease] deaths related to suboptimal diet relies on the strong assumption of causality.”

However, they conclude that: “Whether the authors overestimated or underestimated the potential effects of improved diet, the likely benefits are substantial and justify policies designed to improve diet quality.”

By Claire Barnard

medwireNews is an independent medical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2017

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