Impact of Dietary and Metabolic Risk Factors on Cardiovascular and Diabetes Mortality in South Asia: Analysis From the 2010 Global Burden of Disease Study
Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. Methods. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived et...
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| Published in | American journal of public health (1971) Vol. 106; no. 12; pp. 2113 - 2125 |
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| Main Authors | , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
American Public Health Association
01.12.2016
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0090-0036 1541-0048 1541-0048 |
| DOI | 10.2105/AJPH.2016.303368 |
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| Abstract | Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries.
Methods. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors–disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths.
Results. Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan.
Conclusions. Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities. |
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| AbstractList | To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths. Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5countries, with population-attributable fractionsfrom40.7%(95%uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan. Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities. Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. Methods. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors–disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths. Results. Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan. Conclusions. Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries.OBJECTIVESTo quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries.We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths.METHODSWe used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths.Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan.RESULTSSuboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan.Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.CONCLUSIONSImportant similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths. Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan. Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities. Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. Methods. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors–disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths. Results. Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5 countries, with population-attributable fractions from 40.7% (95% uncertainty interval = 37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval = 52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet. This was followed in all nations by high fasting plasma glucose, low fruit intake, and low whole grain intake. Other prominent burdens were more variable, such as low intake of vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan. Conclusions. Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities. |
| Author | Micha, Renata Khatibzadeh, Shahab Danaei, Goodarz Shi, Peilin Balakrishna, Nagalla Chen, Yu Ezzati, Majid Powles, John W. Singh, Gitanjali M. Yakoob, Mohammad Y. Fahimi, Saman Ahsan, Habibul Afshin, Ashkan Mozaffarian, Dariush Brahmam, Ginnela N. V. |
| AuthorAffiliation | Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, In |
| AuthorAffiliation_xml | – name: Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the Department of Health Studies, University of Chicago, IL. Nagalla Balakrishna and Ginnela N. V. Brahmam are with the National Institute of Nutrition, Hyderabad, Andhra Pradesh, India. Yu Chen is with the Department of Population Health (Epidemiology) and Environmental Medicine, New York University School of Medicine, New York, NY. Ashkan Afshin is with the Institute for Health Metrics and Evaluation, Seattle, WA. John W. Powles is with the Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, UK. Majid Ezzati is with the Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, UK |
| Author_xml | – sequence: 1 givenname: Mohammad Y. surname: Yakoob fullname: Yakoob, Mohammad Y. organization: Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the – sequence: 2 givenname: Renata surname: Micha fullname: Micha, Renata organization: Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the – sequence: 3 givenname: Shahab surname: Khatibzadeh fullname: Khatibzadeh, Shahab organization: Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the – sequence: 4 givenname: Gitanjali M. surname: Singh fullname: Singh, Gitanjali M. organization: Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the – sequence: 5 givenname: Peilin surname: Shi fullname: Shi, Peilin organization: Mohammad Y. Yakoob is with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. 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Saman Fahimi is with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Renata Micha, Gitanjali M. Singh, Peilin Shi, and Dariush Mozaffarian are with Tufts Friedman School of Nutrition Science and Policy, Boston. Shahab Khatibzadeh and Goodarz Danaei are with the Department of Global Health and Population, Harvard School of Public Health. Habibul Ahsan is with the |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27736219$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | Copyright American Public Health Association Dec 2016 American Public Health Association 2016 2016 |
| Copyright_xml | – notice: Copyright American Public Health Association Dec 2016 – notice: American Public Health Association 2016 2016 |
| CorporateAuthor | on behalf of Global Burden of Diseases, Injuries, and Risk Factors: Nutrition and Chronic Diseases Expert Group, and Metabolic Risk Factors of Chronic Diseases Collaborating Group Global Burden of Diseases, Injuries, and Risk Factors: Nutrition and Chronic Diseases Expert Group, and Metabolic Risk Factors of Chronic Diseases Collaborating Group |
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| DOI | 10.2105/AJPH.2016.303368 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Peer Reviewed M. Y. Yakoob, R. Micha, S. Khatibzadeh, S. Fahimi, J. W. Powles, M. Ezzati, and D. Mozaffarian conceptualized the idea of the study. R. Micha, S. Khatibzadeh, P. Shi, and S. Fahimi were involved in data collection. H. Ahsan, N. Balakrishna, G. N. V. Brahmam, and Y. Chen provided the raw survey data for South Asian countries. M. Y. Yakoob, R. Micha, S. Khatibzadeh, A. Afshin, S. Fahimi, and J. W. Powles collected other inputs for analysis such as etiological effects, optimal risk factor levels, and mortality data. M. Y. Yakoob, G. M. Singh, and A. Afshin conducted the analyses for the study. G. Danaei, J. W. Powles, M. Ezzati, and D. Mozaffarian were the faculty guiding and reviewing the overall process. All authors have read the final article, reviewed it, and approved it to be submitted. M. Y. Yakoob is the overall guarantor of the honesty, integrity, and authenticity of the work. CONTRIBUTORS |
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| Snippet | Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian... To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. We... To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. We... To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian... Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian... |
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| SubjectTerms | Adult Age Aged Aged, 80 and over AJPH Special Section Asia - epidemiology Blood pressure Cardiovascular Disease Cardiovascular diseases Cardiovascular Diseases - mortality Chronic illnesses Diabetes Diabetes Mellitus - mortality Diet Disease Epidemiology Etiology Fasting Female Global Burden of Disease Glucose Health care policy Health Policy Health risk assessment Humans Ischemia Male Metabolic Syndrome Metabolism Middle Aged Mortality Mortality rates Nutrition/Food Population Prevention Public health Risk Assessment - statistics & numerical data Risk Factors Stroke Uncertainty |
| Title | Impact of Dietary and Metabolic Risk Factors on Cardiovascular and Diabetes Mortality in South Asia: Analysis From the 2010 Global Burden of Disease Study |
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