COMMENTARY

Global Nutrition Crisis: What in the World Is Going On?

William F. Balistreri, MD

Disclosures

September 10, 2019

In This Article

When it comes to global nutrition, the problems we face are undeniably complex, yet a 2019 Lancet editorial[1] found a way to succinctly encapsulate them in its opening sentence: "Civilization is in crisis."

These words may read as alarming, but as outlined in a series of recent reports appearing in the Lancet,[2,3,4] they are also accurate. Collectively, these reports outline the overlapping health risks of undernutrition, obesity, climate change, and threats to the sustainability of our food sources. However, they also offer a plan for improving diets across nations, and it is therefore worth delving into each of these reports individually, to better understand how we can tackle these problems head on.

The Effects of Unhealthy Diets on Noncommunicable Diseases

The first of these reports—the Global Burden of Diseases, Injuries, and Risk Factors (GBD) study[2]—evaluated the consumption of major foods and nutrients across 195 countries.

Researchers quantified the impact of suboptimal diets (ie, low intake of fresh fruit and vegetables, seeds, and nuts, coupled with high consumption of sugar, sodium, and trans fats) on mortality and morbidity.[2] They concluded that in 2017, 22% of deaths among adults worldwide were associated with poor diets. Most of these 11 million deaths were due to cardiovascular disease, followed by cancer and type 2 diabetes. Unhealthy diets were larger determinants of ill health than either tobacco or high blood pressure. In addition, 255 million disability-adjusted life-years (DALYs) were attributable to suboptimal diets.

The study further estimated the proportion of disease burden attributable to each specific dietary risk factor. High intake of sodium (3 million deaths and 70 million DALYs), low intake of whole grains (3 million deaths and 82 million DALYs), and low intake of fruits (2 million deaths and 65 million DALYs) were the leading dietary risk factors.

The lowest proportion of diet-related deaths occurred in France, Spain, and Peru; the United States ranked 43rd. The countries that had the lowest number of diet-related deaths most closely followed the Mediterranean diet, with its high intake of fruits, vegetables, nuts, olive oil, and omega-3 fatty acids from fish.

This GBD study will form the basis of evidence-based dietary interventions to reduce mortality and provide a platform for evaluation of their impact on human health annually.

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