People in almost every region of the world could benefit from rebalancing their diets to eat optimal amounts of various foods and nutrients, according to the Global Burden of Disease study tracking trends in consumption of 15 dietary factors from 1990 to 2017 in 195 countries, published in The Lancet.
The study estimates that one in five deaths globally — equivalent to 11 million deaths — are associated with poor diet, and diet contributes to a range of chronic diseases in people around the world.
In 2017, more deaths were caused by diets with too low amounts of foods such as whole grains, fruit, nuts and seeds than by diets with high levels of foods like trans fats, sugary drinks, and high levels of red and processed meats.
The authors say that their 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.
Overall in 2017, an estimated 11 million deaths were attributable to poor diet. Diets high in sodium, low in whole grains, and low in fruit together accounted for more than half of all diet-related deaths globally in 2017.
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. Deaths related to diet have increased from 8 million in 1990, largely due to increases in the population and population ageing.
The largest shortfalls in optimal intake were seen for nuts and seeds, milk, whole grains, and the largest excesses were seen for sugar sweetened beverages, processed meat and sodium. On an average, the world only ate 12% of the recommended amount of nuts and seeds (around 3g average intake per day, compared with 21g recommended per day), and drank around ten times the recommended amount of sugar sweetened beverages (49g average intake, compared with 3g recommended).
Regionally, high sodium intake (above 3g per day) was the leading dietary risk for death and disease in China, Japan, and Thailand.
In Bangladesh, low intake of fruits (below 250g per day) was the leading dietary risk. High consumption of red meat (above 23g per day), processed meat (above 2g per day), trans fat (above 0.5% 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.
The magnitude of diet-related disease highlights that many existing campaigns have not been effective and the authors call for new food system interventions to rebalance diets around the world.
Importantly, they note 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, depleting freshwater, and soil degradation.