Poor Diet and High Blood Pressure Highest Risk Factors for Early Death

The Global Burden of Disease Study 2013, conducted by an international consortium of researchers led by the Institute for Health Metrics and Evaluation (IHME; Seattle, WA, USA) at the University of Washington (Seattle, USA) and the University of Melbourne (Australia), was designed to examine the global, regional, and national comparative risk assessment of 79 behavioral, environmental, occupational, and metabolic clusters of risks in 188 countries between 1990 and 2013.

The results revealed that since 1990, a profound change occurred in risk factors for death. While 25 years ago child and maternal malnutrition, unsafe water and sanitation, and lack of hand washing were the leading risks for death globally, they have been replaced by dietary risks and high systolic blood pressure. The other leading causes are child and maternal malnutrition, tobacco smoke, air pollution and high body mass index (BMI). When broken down geographically, in much of the Middle East and Latin America high BMI is the number-one risk associated with health loss. In South and Southeast Asia, household air pollution is a leading risk.

India continues to grapple with the high risks of unsafe water and childhood under-nutrition, while smoking is the number-one risk in many high-income countries, including the United Kingdom; alcohol is the number-two risk in Russia. The most marked differences are found in sub-Saharan Africa, which, unlike other regions, is dominated by a combination of childhood malnutrition, unsafe water and lack of sanitation, unsafe sex, and alcohol use. Wasting (low weight) accounts for one in five deaths of children under five-years-old, highlighting the importance of child malnutrition as a risk factor.

When broken down by sex, for women in nearly all countries in the Americas, North Africa, and the Middle East, as well as in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and South and East Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in North Africa and the Middle East, Europe, and Asia.

Unsafe sex continues to take a massive toll on global health, contributing to 82% of HIV/AIDS deaths overall and 94% among 15- to 19-year-olds; this has a greater impact in a geographical corridor running from Kenya to South Africa, where 38% of deaths were attributed to unsafe sex. Another risk factor that is growing in prominence worldwide is drug use. The systematic analysis of death burden resulting from the Global Burden of Disease Study 2013 was published online on September 10, 2015, in the Lancet.

“There's great potential to improve health by avoiding certain risks like smoking and poor diet, as well as tackling environmental risks like air pollution,” said Christopher Murray, MD, director of the IHME. “The challenge for policymakers will be to use what we know to guide prevention efforts and health policies.”

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