Diet beats tobacco to the kill
We need to talk about nuts, but not the salted variety. That is one message to emerge from a vast study of the eating habits of adults in 195 countries, which suggests that a poor diet is implicated in a fifth of deaths worldwide. This amounts to 11-million lost lives in 2017, comfortably outstripping the estimated 7-million who died from tobacco-related illnesses.
It is not so much that we are eating badly, although that is undoubtedly true. Rather, according to this contribution to the Global Burden of Disease study, which appeared in the Lancet, we are not eating sufficiently well.
“This study affirms what many have thought for several years, that poor diet is responsible for more deaths than any other risk factor in the world,” said co-author Christopher Murray of the University of Washington.
In a bid to cut down on undesirables such as sodium, fat and sugar, we are neglecting the good stuff. While an estimated 3-million of the 11-million total of diet-related deaths can be blamed on too
much sodium, a further 3-million is due to eating insufficient whole grains, and 2-million down to a lack of fruit. Another egregious omission is nuts and seeds. On average, we munch 3g per day rather than the recommended 21g. Nuts are often shunned as fatfilled morsels dotting the path to an early grave, but they contain fats that protect the heart.
Vegetables are unhealthily absent from the world’s dining tables; sugar drinks worryingly ubiquitous. Murray said the data had encouraged him to increase his own intake of whole grains, fruit, fibre, nuts and seeds.
The Lancet study is an admirable attempt to quantify how diet affects noncommunicable diseases such as cardiovascular disease, cancer and type 2 diabetes. Scientists waded through the medical literature to deduce correlations between different dietary factors and rates of noncommunicable diseases.
Among the 15 factors are diets low in fruit; low in vegetables; low in fibre; low in nuts and seeds; high in red meat; high in sodium; high in sugary drinks and high in unhealthy fats. Academics then tried to pin down, for 21 regions of the world, how many deaths could be laid at the door of each.
This admittedly broad statistical brush has painted a fascinating portrait of the world’s pantries. No region eats the right amount of all 15 dietary factors; and no single factor is eaten in the correct amount by all regions. Too much sodium tops the dietary risk list for China, Japan and Thailand. A low intake of whole grains, found in barley and brown rice, for example, is the main dietary contributor to death and disease in a surprising number of countries, including the US, India, Brazil, and Germany.
It is not all bad news. Central Asia did well on vegetables, while high-income Asia Pacific reached the optimum level of omega-3 fatty acids, in fish, nuts and seeds. The Caribbean and both East Africa and West Africa show a healthy love of legumes, such as lentils and beans.
Overall, Uzbekistan lies at the wrong end of the death-bydinner spectrum, with 892 dietrelated deaths per 100,000 people. That is 10 times worse than Israel, at the preferred end. The UK ranks 23rd, while Rwanda fares better than the US (43). China languishes at 140, with 350 deaths per 100,000.
The study does not include alcohol, the effects of which add 3-million deaths annually. Its findings will feed into future advice on improving diet. This worthy goal will, as scientists recognise, need to take into account other factors, such as poverty, sustainability and the climate risk to crop yields.
Eating well costs more than many can afford. Rebalancing the items on a dinner plate is only a dream for the estimated 821-million who, according to UN estimates of world hunger, have no plate at all.