High blood pressure linked to bad diet contributed to most deaths, while smoking and air pollution were also high-ranking risk factors, study finds

Poor diet has emerged as the biggest contributor to early death around the world, according to new analysis from the leading authorities on the global disease, with red meat and sugar-sweetened beverages among the foods implicated in 21% of global deaths.

Smoking cigarettes still carries the highest risk factor of premature death in the UK, followed by high blood pressure and obesity. But the Institute of Health Metrics and Evaluation (IMHE) in the US says that a combination of dietary factors, from eating too few fruit and vegetables, nuts and whole grains to too much sodium and cholesterol, is taking a toll on health in the UK and across the globe.

The IMHE’s study found that the biggest contributor to early death globally is high blood pressure, in which age and family history play a part, but so do obesity, smoking, excessive salt consumption, lack of exercise and drinking large amounts of alcohol. In the UK, alcohol is also one of the top ten risk factors associated with the highest number of deaths for both men and women.

The study looked at 14 dietary risk factors. Cumulatively, unhealthy eating, including diets low in fruit, whole grains, and vegetables, and diets high in red meat and sugar-sweetened beverages contributed to more deaths than any other factor, causing ischemic heart disease, stroke and diabetes.

The first Global Burden of Disease study was published in 2010 and is recognised as the most authoritative work on the causes of ill-health. The latest study, published in the Lancet medical journal, is the first update, taking in data from 108 countries, and expands the number of risk factors for premature death around the world from 67 to 79. The work takes in data from 1990 up to 2013.

The study attributes half of the world’s deaths and more than a third of disabling ill-health to preventable risks, and the authors are calling governments around the world to act on their findings.

“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 IHME director Dr Christopher Murray. “The challenge for policymakers will be to use what we know to guide prevention efforts and health policies.”

The authors call for more to be done to prevent the deaths and ill-health caused by these risk factors. “The comprehensive assessment of risk factors presented in this study provides a clear indication of where prevention programmes aimed at risk factor modification can have major effects on health,” they wrote.

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“The challenge for governments and the health development community more broadly is to heed this knowledge about the comparative effect of health risks more assiduously, and orient health policies towards their mitigation with much greater conviction than that currently observed.”

Environmental pollutants are also a major risk. Air pollution is linked to the seventh highest number of deaths around the world and indoor fumes from cooking is in eighth place, although neither make the top ten in the UK.

The study also looked at preventable risk factors for ill-health. Overall, the leading risk factors were the same as for deaths – high blood pressure, smoking and obesity. But there are big variations around the world.

In Latin America and the Middle East, obesity is the biggest risk for poor health. In south and south-east Asia, household air pollution is a leading risk, and India also grapples with high risks of unsafe water and childhood undernutrition. Alcohol is the number two risk in Russia, and smoking is the number one risk in many high-income countries, including the UK.

Sub-Saharan Africa has a different pattern of risks from the rest of the world, with a toxic combination of childhood undernutrition, unsafe water and sanitation, unsafe sex, and alcohol use.

In the UK, deaths due to all leading risk factors have decreased since 1990, with the exception of deaths due to alcohol use, which have increased by 9.5%, totalling 21,765. High systolic blood pressure and high cholesterol saw the biggest drops, by 55% and 55.2% respectively. Both risk factors remain among the top four leading risks in the UK, however. Low levels of physical activity come in at number five.

“Progress against so many leading risk factors is excellent news and should be celebrated, but these risks still continue to contribute to the disabilities and deaths of thousands of Britons,” said Dr Ivy Shiue, senior researcher at Northumbria University and a co-author of the study.

“We need to focus on minimising risks clustering from childhood to adulthood, such as poor diet and low physical activity, to reduce the burden our health system and ensure that we all live long and healthy lives.”