Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: Analysis from the 2010 global burden of disease study

Mohammad Y. Yakoob, Renata Micha, Shahab Khatibzadeh, Gitanjali M. Singh, Peilin Shi, Habibul Ahsan, Nagalla Balakrishna, Ginnela N.V. Brahmam, Yu Chen, Ashkan Afshin, Saman Fahimi, Goodarz Danaei, John W. Powles, Majid Ezzati, Dariush Mozaffarian

Research output: Contribution to journalArticle

Abstract

Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. Methods. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths. Results. Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5countries,withpopulation-attributablefractionsfrom40.7%(95%uncertaintyinterval =37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval =52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet.This was followed inall nations by highfasting plasma glucose, low fruitintake, andlow wholegrainintake.Otherprominentburdensweremorevariable,suchaslowintakeof vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan. Conclusions. Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.

Original languageEnglish (US)
Pages (from-to)2113-2125
Number of pages13
JournalAmerican Journal of Public Health
Volume106
Issue number12
DOIs
StatePublished - Dec 1 2016

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Bangladesh
Pakistan
Mortality
Diet
Nepal
Health Policy
Vegetables
Uncertainty
Meta-Analysis
India
Cardiovascular Diseases
Sodium
Fats
Blood Pressure
Hypertension
Glucose
Population
Global Burden of Disease
Surveys and Questionnaires

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia : Analysis from the 2010 global burden of disease study. / Yakoob, Mohammad Y.; Micha, Renata; Khatibzadeh, Shahab; Singh, Gitanjali M.; Shi, Peilin; Ahsan, Habibul; Balakrishna, Nagalla; Brahmam, Ginnela N.V.; Chen, Yu; Afshin, Ashkan; Fahimi, Saman; Danaei, Goodarz; Powles, John W.; Ezzati, Majid; Mozaffarian, Dariush.

In: American Journal of Public Health, Vol. 106, No. 12, 01.12.2016, p. 2113-2125.

Research output: Contribution to journalArticle

Yakoob, MY, Micha, R, Khatibzadeh, S, Singh, GM, Shi, P, Ahsan, H, Balakrishna, N, Brahmam, GNV, Chen, Y, Afshin, A, Fahimi, S, Danaei, G, Powles, JW, Ezzati, M & Mozaffarian, D 2016, 'Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia: Analysis from the 2010 global burden of disease study', American Journal of Public Health, vol. 106, no. 12, pp. 2113-2125. https://doi.org/10.2105/AJPH.2016.303368
Yakoob, Mohammad Y. ; Micha, Renata ; Khatibzadeh, Shahab ; Singh, Gitanjali M. ; Shi, Peilin ; Ahsan, Habibul ; Balakrishna, Nagalla ; Brahmam, Ginnela N.V. ; Chen, Yu ; Afshin, Ashkan ; Fahimi, Saman ; Danaei, Goodarz ; Powles, John W. ; Ezzati, Majid ; Mozaffarian, Dariush. / Impact of dietary and metabolic risk factors on cardiovascular and diabetes mortality in South Asia : Analysis from the 2010 global burden of disease study. In: American Journal of Public Health. 2016 ; Vol. 106, No. 12. pp. 2113-2125.
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T2 - Analysis from the 2010 global burden of disease study

AU - Yakoob, Mohammad Y.

AU - Micha, Renata

AU - Khatibzadeh, Shahab

AU - Singh, Gitanjali M.

AU - Shi, Peilin

AU - Ahsan, Habibul

AU - Balakrishna, Nagalla

AU - Brahmam, Ginnela N.V.

AU - Chen, Yu

AU - Afshin, Ashkan

AU - Fahimi, Saman

AU - Danaei, Goodarz

AU - Powles, John W.

AU - Ezzati, Majid

AU - Mozaffarian, Dariush

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N2 - Objectives. To quantify cardiovascular disease and diabetes deaths attributable to dietary and metabolic risks by country, age, sex, and time in South Asian countries. Methods. We used the 2010 Global Burden of Disease national surveys to characterize risk factor levels by age and sex. We derived etiological effects of risk factors-disease endpoints, by age, from meta-analyses. We defined optimal levels. We combined these inputs with cause-specific mortality rates to compute population-attributable fractions as a percentage of total cardiometabolic deaths. Results. Suboptimal diet was the leading cause of cardiometabolic mortality in 4 of 5countries,withpopulation-attributablefractionsfrom40.7%(95%uncertaintyinterval =37.4, 44.1) in Bangladesh to 56.9% (95% uncertainty interval =52.4, 61.5) in Pakistan. High systolic blood pressure was the second leading cause, except in Bangladesh, where it superseded suboptimal diet.This was followed inall nations by highfasting plasma glucose, low fruitintake, andlow wholegrainintake.Otherprominentburdensweremorevariable,suchaslowintakeof vegetables, low omega-3 fats, and high sodium intake in India, Nepal, and Pakistan. Conclusions. Important similarities and differences are evident in cardiometabolic mortality burdens of modifiable dietary and metabolic risks across these countries, informing health policy and program priorities.

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