About 11 million people eat themselves into early graves each year — but the riskiest diet habits may come as a surprise.
The new Global Burden of Disease Study, which analyzed dietary consumption in 195 countries between 1990 and 2017, concluded that poor (or “non-optimal”) diets are responsible for 1 in 5 deaths — more than any other risk factors, including tobacco smoking. (Tobacco kills 8 million people globally, in comparison.) After all, unhealthy diets are associated with cardiovascular disease, type 2 diabetes and many forms of cancer.
But its definition of a “non-optimal” diet may shock consumers who have been fed countless meal-plan fads that call for cutting carbs, sugar or dairy to lose weight and stay healthy as part of the $66 billion weight loss market. Turns out, not getting enough milk, whole grains, fruits, vegetables, nuts and seeds (as well as consuming too much sodium) was associated with more deaths than eating too much unhealthy food, like red meat, processed meat, trans fats and sugar-sweetened drinks, according to the report. And eating insufficient amounts of whole grains and fruits, and taking in too much sodium, accounted for more than half of diet-related deaths across the globe.
“While sodium, sugar and fat have been the focus of policy debates over the past two decades, our assessment suggests the leading dietary risk factors are high intake of sodium, or low intake of healthy foods, such as whole grains, fruit, nuts and seeds, and vegetables,” concluded study author Dr. Christopher Murray from the University of Washington. The study was funded by the Bill & Melinda Gates Foundation.
Kelly Hogan, clinical nutrition and wellness manager at New York’s Mount Sinai Hospital, told MarketWatch that the study supports the healthy guidelines that she and other dietitians have been sharing with their patients. “For a long time, we’ve really been trying to focus on diet quality when it comes to the risk reduction of various chronic disease; focusing on what people should eat more of, as opposed to telling them what not to eat,” she said. “When you tell people what not to do, they’re not necessarily going to know what to do. Sometimes it’s not intuitive for them to eat the ‘right’ thing.” (And if you read Facebook
support groups for diets like keto, which drastically limits carbs, and the Whole 30, which cuts sugar, dairy and legumes early on, the majority of topics center around people asking what they can still eat.)
But this report is more clear about the importance of adding more plants to your diet, as well as milk and whole grains. “And it sends a more positive message,” she added.“When people are told that certain foods are healthy or good for them … it makes them much more likely to try these foods, as opposed to receiving the negative message that your diet is ‘wrong’ and you’re doing ‘bad things’ to your health.”
Uzbekistan saw the highest rate of diet-related deaths — 892 deaths per 100,000 people — among the 195 countries studied in this report, followed by Afghanistan and the Marshall Islands. Israel had the lowest rate of diet-related deaths, with just 89 deaths per 100,000. The U.S. ranked 43rd with 171 deaths per 100,000.
Ten million of 2017’s diet-related deaths were from cardiovascular disease; cancer accounted for 913,000 deaths, and Type 2 diabetes was responsible for 339,000 deaths. But the diet gaps differed by country.
Not getting enough whole grains was the greatest risk factor for mortality in the U.S., India, Brazil, Pakistan, Nigeria, Russia, Egypt, Germany, Iran and Turkey. Indeed, a recent study has linked going low-carb with a higher risk of atrial fibrillation (aka AFib), the most common heart rhythm disorder. And a report published in Lancet last year suggested that both low-carb and high-carb diets were linked with a higher risk of death. Yet Americans are keto-crazy, helping build the low-carb diet into a $9.08 billion industry expected to hit $12.35 billion in 2024, according to Mordor Intelligence.
Residents of China, Japan, Indonesia and Thailand are ingesting too much sodium, according to the report, which could stem from many traditional Asian dishes being made with salty sauces, pastes and rice vinegars. Consuming salt raises blood pressure, which can lead to heart disease.
And not eating enough nuts and seeds (containing essential omega-3 fatty acids that help prevent heart attack, stroke and possibly cancer) was the highest risk factor in Mexico, which was also one of the few countries were unhealthy sugar beverages were high on the risk list. Many Mexican diets are also missing fruits, vegetables and whole grains. Study co-author Dr. Christian Razo told CNN that residents can’t drink tap water, which makes affordable clean water hard to find. “So people have to buy clean water to drink, and if they’re going to have to buy something, they prefer the soda,” she said. “It’s also easier to get processed food than fresh fruits and vegetables.”
Razo also noted that while Mexico produces fresh fruits and vegetables, like avocados, those health crops tend to be distributed more to countries like the U.S. than they are distributed in local cities. The U.S. gets almost 90% of its avocados (essential for guacamole and avocado toast) from Mexico.
The report highlights the need for food system interventions and dietary policies to help individual countries identify which ingredients their residents are missing in order to have a well-balanced diet, and to then produce and distribute these healthy foods in those areas.
But health experts say the main takeaway for most people should be that adding in healthy foods to their diets is more important that cutting “bad” things out.
“We have to look at diet quality as a whole over time. No one food is that bad and terrible that you have to avoid it forever,” said Hogan. “It really is looking at the big picture: Is the majority of your diet plant foods that maybe you’re not eating enough of now? If it’s not, then work toward that, knowing there is still for other things that you might enjoy as well.” Just eat those in moderation.
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