‘Why more Nigerians may die of diet-related diseases’

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Nigeria ranks 42nd out of 195 countries with the highest rate of diet-related deaths, with low intake of whole grains being the leading dietary risk factor for mortality and disease in Nigeria, United States (US), India, Brazil, Pakistan, Russia, Egypt, Germany, Iran, and Turkey.

A study published in The Lancet Thursday by the Global Burden of Disease (GBD) estimates that one in five deaths globally – equivalent to 11 million deaths – are associated with poor diet, and that diet contributes to a range of chronic diseases in people around the world.

The study tracked trends in the consumption of 15 dietary factors from 1990 to 2017 in 195 countries.

The Global Burden of Diseases, Injuries, and Risk Factors Study describes itself as “the single largest and most detailed scientific effort ever conducted to quantify levels and trends in health. Led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, it is truly a global effort, with over 3,600 researchers from more than 145 countries participating in the most recent update.”

According to the study, diets high in sodium, low in whole grains and low in fruits accounted for more than half of all diet-related deaths globally in 2017.

The authors said the causes of these deaths included 10 million deaths from cardiovascular disease; 913,000 cancer deaths; and almost 339,000 deaths from Type 2 diabetes. They disclosed that deaths related to diet swelled from eight million in 1990, largely due to increase in population and population ageing.

They noted that in 2017, more deaths were caused by diets with too low amounts of foods such as whole grains, fruits, nuts and seeds than by diets with high levels of trans fats, sugary drinks, and high levels of red and processed meats.

The researchers said the findings highlight the urgent need for coordinated global efforts to improve diet through collaboration with various sections of the food system and policies that drive balanced diets.

According to the study, “in 2017, there was a 10-fold difference between the country with the highest rate of diet-related deaths (Uzbekistan) and the country with the lowest (Israel).

The countries with the lowest rates of diet-related deaths were Israel (89 deaths per 100,000 people), France, Spain, Japan, and Andorra.

The United Kingdom (UK) ranked 23rd (127 deaths per 100,000) above Ireland (24th) and Sweden (25th), and the United States ranked 43rd (171 deaths per 100,000) after Rwanda and Nigeria (41st and 42nd), China ranked 140th (350 deaths per 100,000 people), and India 118th (310 deaths per 100,000 people).

The countries with the highest rates of diet-related deaths were Uzbekistan (892 deaths per 100,000 people), Afghanistan, Marshall Islands, Papua New Guinea, and Vanuatu.”

The authors said, regionally, high sodium intake (above 3g per day) was the leading dietary risk for death and disease in China, Japan, and Thailand. “Low intake of whole grains (below 125g per day) was the leading dietary risk factor for death and disease in the USA, India, Brazil, Pakistan, Nigeria, Russia, Egypt, Germany, Iran, and Turkey.

In Bangladesh, low intake of fruits (below 250g per day) was the leading dietary risk. And in Mexico, low intake of nuts and seeds (below 21g per day) ranked first.

High consumption of red meat (above 23g per day), processed meat (above 2g per day), trans fat (above 0.5 per cent total daily energy), and sugar-sweetened beverages (above 3g per day) were towards the bottom in ranking of dietary risks for death and disease for highly populated countries,” they noted.

The study evaluated the consumption of major foods and nutrients across 195 countries and quantified the impact of poor diets on death and disease from non-communicable diseases (specifically cancers, cardiovascular diseases and diabetes). It tracked trends between 1990 and 2017.

Previously, population level assessment of the health effects of suboptimal diet has not been possible because of the complexities of characterising dietary consumption across different nations.

The new study combines and analyses data from epidemiological studies – in the absence of long-term randomised trials, which are not always feasible in nutrition – to identify associations between dietary factors and non-communicable diseases.

The study looked at 15 dietary elements – diets low in fruits, vegetables, legumes, whole grains, nuts and seeds, milk, fibre, calcium, seafood omega-3 fatty acids, polyunsaturated fats, and diets high in red meat, processed meat, sugar-sweetened beverages, trans fatty acids, and sodium.

The authors noted that there were varying levels of data available for each dietary factor, which increases the statistical uncertainty of these estimates. For example, while data on how many people ate most dietary factors was available for almost all countries (95 per cent), data for the sodium estimates was only available for around one in four countries.

The researchers said the magnitude of diet-related disease highlights that many existing campaigns have not been effective and called for new food system interventions to rebalance diets around the world.

Importantly, they noted that changes must be sensitive to the environmental effects of the global food system, to avoid adverse effects on climate change, biodiversity loss, land degradation, depletion of freshwater, and soil degradation.

In January 2019, The Lancet published the EAT-Lancet Commission, which provides the first scientific targets for a healthy diet from a sustainable food production system that operates within planetary boundaries for food. This report used 2016 data from the GBD study to estimate how far the world is from the healthy diet proposed.

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