The Dietary Risk Factors We Need to Understand

Ashkan Afshin, an assistant professor at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, is the lead author of a 27-year global diet study, which found that contrary to popular belief, it’s just as important to avoid unhealthy foods as it is to eat more healthy foods and to avoid high levels of salt.

"While traditionally all the conversation about healthy diet has been focused on lowering the intake of unhealthy food, in this study we have shown that, at the population level, a low intake of healthy foods is the more important factor rather than the high intake of unhealthy foods," he said.

One in 5 deaths globally—that's about 11 million people—in 2017 occurred because of too much sodium and a lack of whole grains, fruit and nuts and seeds, the study found, rather than from diets packed with trans fats, sugar-sweetened drinks and high levels of red and processed meats.

In the study, which was funded by the Bill & Melinda Gates Foundation, Afshin and his colleagues looked at 15 dietary risk factors and their impact on death and disability. High levels of unhealthy red and processed meats, sugar-sweetened beverages, trans fatty acids and salt—all known to be health risks—were compared with the effects of a diet low in many healthy foods. Those healthy items included fruits, vegetables, whole grains, milk, calcium, nuts and seeds, fiber, legumes or beans, omega-3 fatty acids from seafood and polyunsaturated fats, the good-for-you fats found in salmon, vegetable oils and some nuts and seeds.

Except for salt, which was a key risk factor in most countries, the study found red and processed meats, trans fats and sugary drinks toward the bottom of the risk chart for most countries.

In fact, more than half of all global diet-related deaths in 2017 were due to just three risk factors: eating too much salt, not enough whole grains and not enough fruit. Those risks held true regardless of socioeconomic level of most nations.  

The new study is part of the yearly Global Burden of Disease report, prepared by a consortium of thousands of researchers that tracks premature death and disability from more than 350 diseases and injuries in 195 countries.