An unhealthful diet causes more deaths world-wide than any other risk factor, according to the Global Burden of Disease study reported this month (Lancet, April 3, 2019;393:791-846). Of the 11 million deaths attributed to dietary factors each year, more deaths were associated with inadequate intakes of healthful foods than with eating too much of harmful foods.

In the study year (2017), 22 percent of adult deaths had dietary risk factors. Of these, heart attacks caused the most deaths, followed by cancers and type 2 diabetes. The authors used epidemiological data to show that more than 20 percent of the deaths worldwide might have been prevented by eating more of the healthful anti-inflammatory foods (such as nuts, beans, whole grains and other seeds, fruits and vegetables) and less of the pro-inflammatory foods (such as red meat, processed meats, sugary drinks and sugar added foods). They further state that even though specific dietary factors differed across countries, not taking in enough whole grains, fruits, and vegetables contributed to more than 50 percent of deaths and 66 percent of disability-adjusted-life-years (DALYs) caused by an unhealthful diet.

It is currently felt that pro-inflammatory foods cause inflammation that increases risk for certain diseases and shortens lives, while anti-inflammatory foods dampen down inflammation to help protect you from certain diseases and to prolong your life. For more detail, see my updated report on Anti-Inflammatory and Pro-Inflammatory Foods below. Up to now, much of the popular literature on nutrition has focused on the harmful effects of taking in too much fat, sugar and salt.

Recommendations from the Editors
An editorial in the same issue (Lancet, April 3, 2019) recommends that we should:
• Emphasize that people should eat primarily the foods that are healthful and put less emphasis on restriction of unhealthful foods.
• Recommend eating more plants for their benefits such as anti-oxidants and soluble fiber.
• Stop recommending restriction of specific nutrients or food components because that only confuses most people.

A major problem with recommending a high-plant diet is that many people in poor countries cannot afford to eat the recommended three servings of vegetables and two servings of fruits per day. This would cost 52 percent of household income in low-income countries, 18 percent in low-to-middle income countries, and 16 percent in middle-to-upper income countries, compared to only two percent in high-income countries (Lancet, 2016;4:e695-e703).

Checked 5/2/20