Image Credit: RitaE @ Pixabay
If you also look with suspicion at inflammatory headlines stamped in tabloids these days, be assured you are not alone. This time, a scientific paper in the journal Lancet presents a meta-analysis - which is just a scientific jargon for a large-scale compilation and analyses of other studies - of nutritional data from 195 countries; and it is likely to create the common hubbub. Sadly, this time the study does not bring cheerful news to fast-food lovers and salty snacks fanatics of our world.
Scientists from the GBD 2017 Diet Collaborators - a large consortium of academics across the globe - were able to link 15 nutritional factors of everyday life to diseases and premature death. What were the biggest risk factors? Well, this time the three main "villains" were high sodium consumption - yes, the common rock salt, which is added to nearly every single dish in Western diets -, low consumption of vegetables and fruits, and the lack of more whole grains in our diets; which were all pointed out as important risk factors. Together, just these three dietary habits were related to "more than 50% of deaths and 66% of DALYs (disability-adjusted life-years)."¹
You might be surprised not to see the common sugar and fat duo amongst these nutrients, but the authors reinforce:¹
Although sodium, sugar, and fat have been the main focus of diet policy debate in the past two decades, our assessment shows that the leading dietary risk factors for mortality are diets high in sodium, low in whole grains, low in fruit, low in nuts and seeds, low in vegetables, and low in omega-3 fatty acids; each accounting for more than 2% of global deaths.
There is more... If you are young and think this study is just about the older folks, just take a look at what the authors have to say:¹
Our findings show that, unlike many other risk factors, dietary risks affected people regardless of age, sex, and sociodemographic development of their place of residence.
That is right. According to this latest study, there is no escaping from the healthy food train. As for the recommended dietary changes? The authors suggest eating more fruits, vegetables, whole grains, milk, and seafood as replacements for red meat and processed foods.¹ According to their analysis, which was mostly based on observational studies - implying the authors can only point to important correlations between diet and disease, but are unable to find causal relationships -, the leading causes of death due to poor nutritional habits were cardiovascular disease (10 million deaths), cancers (913,090 deaths), and type 2 diabetes (338,714 deaths).¹
Perhaps contrary to our expectations, the Eastern diets were actually the ones which led to more diet-related deaths and disabilities across the globe. What is the danger hidden in these delicious Asiatic meals? Too much salt! The authors point to the excessive intake of sodium, commonly added to Eastern recipes in the form of soy sauce, as the leading factor for the high incidence of diet-related causalities in this region. However, it was Egypt that took the trophy - though not one to proudly add to the collection - as the country with the highest age-standardised rate of all diet related deaths (552 per 100,000 people).¹ This latter metric was used by the authors to compare different countries and regions of the world.
Amongst the most populous countries, China comes as a leading cause for concern. Their population experienced the highest standardised rates for both cardiovascular disease deaths (299 per 100,000 people), and cancers (42 per 100,000 people); whilst Mexico took the lead in rates for deaths caused by type 2 diabetes (35 per 100,000 people).¹ It seems that diets high in sugar and starch - a simple form of carbohydrate which is plentiful in baking potatoes, corn, and white rice² - are not good for anyone's health either.
With all these not-so-cheerful news, you might be considering drastic changes to your diet... But before you go ahead and finally stick to your long forgotten New Year's resolution - yes, that one to eat healthily and go to the gym; after all, we all know it is the one most of us make, yet... - you should take these findings with a pinch of salt, pun intended. This study was solely based on correlations between diet and diseases, which means they are unable to pin down the physical effect each nutrient has in our bodies. On top of that, human biology is complicated. There are several other factors that influence long term health: age, metabolism and (epi-)genetics - a topic that deserves an entire discussion on its own - are just three examples.
It is not like the authors are shy of pointing out these limitations in their paper,¹ but is always good to remind you to explore news reporting studies on diet and health with skepticism. They also recognise that without changing the way we grow, advertise and price our food, it will be very difficult to promote the much needed switch in our dietary habits.
In the end, it looks like your parents have been right all this time: "eat your veggies and finish that cold piece of broccoli you thought we didn't notice" is still a good advice. Yes, and it also goes without saying that too much sugar, fat (specially saturated and trans-fats); and processed meat continue to be bad for your health - sorry if it took me so long to destroy your hopes and dreams.
Up until the writing of this post, there were only three news reports covering these findings: in The Guardian,³ Time - Health,⁴ and BBC News;⁵ all well written and far away from the sensationalism we normally see in articles about nutrition and health. I only hope the remaining coverage stays like that, without hubbub and avoiding misinformation...
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¹ Afshin, A. et al., Lancet 2019, Ahead of Print, doi:10.1016/S0140-6736(19)30041-8
² Carbohydrates in 100 g of vegetables: potatoes, baked - 21.55 g; yellow corn, cooked - 20.98 g; white rice, cooked - 28.17 g. Data retrieved from the National Nutrient Database for Standard Reference Legacy Release of the United States Department of Agriculture - USDA, available at https://ndb.nal.usda.gov/ndb/search/list, accessed on 05/04/2019.
³ Boseley, S., "Bad diets killing more people globally than tobacco, study finds" in: The Guardian, https://www.theguardian.com/society/2019/apr/03/bad-diets-killing-more-people-globally-than-tobacco-study-finds; accessed on 04/04/2019.
⁴ Ducharme, J., "Poor Diets Are Linked to 20% of All Deaths Worldwide, Study Says. But These Foods Could Help" in: Time - Health, http://time.com/5562994/diet-disease-mortality/; accessed on 04/04/2019.
⁵ Gallagher, J., "The diets cutting one in five lives short every year" in: BBC News, https://www.bbc.com/news/health-47734296; accessed on 04/04/2019.
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