Repositioning of the global epicentre of non-optimal cholesterol
Taddei, Cristina ; Zhou, Bin ; Bixby, Honor ; Carrillo-Larco, Rodrigo M. ; Danaei, Goodarz ; Jackson, Rod T. ; Farzadfar, Farshad ; Sophiea, Marisa K. ; Cesare, Mariachiara Di; Iurilli, Maria Laura Caminia ; Martinez, Andrea Rodriguez ; Asghari, Golaleh ; Dhana, Klodian ; Gulayin, Pablo ; Kakarmath, Sujay ; Santero, Marilina ; Voortman, Trudy ; Riley, Leanne M. ; Cowan, Melanie J. ; Savin, Stefan ; Bennett, James E. ; Stevens, Gretchen A. ; Paciorek, Christopher J. ; Aekplakorn, Wichai ; Cifkova, Renata ; Giampaoli, Simona ; Kengne, Andre Pascal ; Khang, Young Ho ; Kuulasmaa, Kari ; Laxmaiah, Avula ; Margozzini, Paula ; Mathur, Prashant ; Nordestgaard, Børge G. ; Zhao, Dong ; Aadahl, Mette ; Abarca-Gómez, Leandra ; Rahim, Hanan Abdul ; Abu-Rmeileh, Niveen M. ; Acosta-Cazares, Benjamin ; Adams, Robert J. ; Ferrieres, Jean ; Geleijnse, Johanna M. ; He, Yuna ; Jacobs, Jeremy M. ; Kromhout, Daan ; Ma, Guansheng ; Dam, Rob M. van; Wang, Qian ; Wang, Ya Xing ; Wang, Ying Wei - \ 2020
Nature 582 (2020)7810. - ISSN 0028-0836 - p. 73 - 77.
High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017
Afshin, Ashkan ; Sur, Patrick John ; Fay, Kairsten A. ; Cornaby, Leslie ; Ferrara, Giannina ; Salama, Joseph S. ; Mullany, Erin C. ; Abate, Kalkidan Hassen ; Abbafati, Cristiana ; Abebe, Zegeye ; Afarideh, Mohsen ; Aggarwal, Anju ; Agrawal, Sutapa ; Akinyemiju, Tomi ; Alahdab, Fares ; Bacha, Umar ; Bachman, Victoria F. ; Badali, Hamid ; Badawi, Alaa ; Bensenor, Isabela M. ; Bernabe, Eduardo ; Biadgilign, Sibhatu Kassa K. ; Biryukov, Stan H. ; Cahill, Leah E. ; Carrero, Juan J. ; Cercy, Kelly M. ; Dandona, Lalit ; Dandona, Rakhi ; Dang, Anh Kim ; Degefa, Meaza Girma ; Sayed Zaki, Maysaa El; Esteghamati, Alireza ; Esteghamati, Sadaf ; Fanzo, Jessica ; Sá Farinha, Carla Sofia e; Farvid, Maryam S. ; Farzadfar, Farshad ; Feigin, Valery L. ; Fernandes, Joao C. ; Flor, Luisa Sorio ; Foigt, Nataliya A. ; Forouzanfar, Mohammad H. ; Ganji, Morsaleh ; Geleijnse, Johanna M. ; Gillum, Richard F. ; Goulart, Alessandra C. ; Grosso, Giuseppe ; Guessous, Idris ; Hamidi, Samer ; Nguyen, Cuong Tat - \ 2019
The Lancet 393 (2019)10184. - ISSN 0140-6736 - p. 1958 - 1972.
Background: Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. Methods: By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction)among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. Findings: In 2017, 11 million (95% uncertainty interval [UI]10–12)deaths and 255 million (234–274)DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1–5]deaths and 70 million [34–118]DALYs), low intake of whole grains (3 million [2–4]deaths and 82 million [59–109]DALYs), and low intake of fruits (2 million [1–4]deaths and 65 million [41–92]DALYs)were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. Interpretation: This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually. Funding: Bill & Melinda Gates Foundation.
Burden of diarrhea in the eastern mediterranean region, 1990-2013 : Findings from the global burden of disease study 2013
Khalil, Ibrahim ; Colombara, Danny V. ; Forouzanfar, Mohammad Hossein ; Troeger, Christopher ; Daoud, Farah ; Moradi-Lakeh, Maziar ; Bcheraoui, Charbel El; Rao, Puja C. ; Afshin, Ashkan ; Charara, Raghid ; Abate, Kalkidan Hassen ; Abd El Razek, Mohammed Magdy ; Abd-Allah, Foad ; Abu-Elyazeed, Remon ; Kiadaliri, Aliasghar Ahmad ; Akanda, Ali Shafqat ; Akseer, Nadia ; Alam, Khurshid ; Alasfoor, Deena ; Ali, Raghib ; AlMazroa, Mohammad A. ; Alomari, Mahmoud A. ; Salem Al-Raddadi, Rajaa Mohammad ; Alsharif, Ubai ; Alsowaidi, Shirina ; Altirkawi, Khalid A. ; Alvis-Guzman, Nelson ; Ammar, Walid ; Antonio, Carl Abelardo T. ; Asayesh, Hamid ; Asghar, Rana Jawad ; Atique, Suleman ; Awasthi, Ashish ; Bacha, Umar ; Badawi, Alaa ; Barac, Aleksandra ; Bedi, Neeraj ; Bekele, Tolesa ; Bensenor, Isabela M. ; Betsu, Balem Demtsu ; Bhutta, Zulfiqar ; Abdulhak, Aref A. Bin; Butt, Zahid A. ; Danawi, Hadi ; Dubey, Manisha ; Endries, Aman Yesuf ; Faghmous, Imad M.D.A. ; Farid, Talha ; Farvid, Maryam S. ; Farzadfar, Farshad ; Fereshtehnejad, Seyed Mohammad ; Fischer, Florian ; Anderson Fitchett, Joseph Robert ; Gibney, Katherine B. ; Mohamed Ginawi, Ibrahim Abdelmageem ; Gishu, Melkamu Dedefo ; Gugnani, Harish Chander ; Gupta, Rahul ; Hailu, Gessessew Bugssa ; Hamadeh, Randah Ribhi ; Hamidi, Samer ; Harb, Hilda L. ; Hedayati, Mohammad T. ; Hsairi, Mohamed ; Husseini, Abdullatif ; Jahanmehr, Nader ; Javanbakht, Mehdi ; Beyene, Tariku ; Jonas, Jost B. ; Kasaeian, Amir ; Khader, Yousef Saleh ; Khan, Abdur Rahman ; Khan, Ejaz Ahmad ; Khan, Gulfaraz ; Khoja, Tawfik Ahmed Muthafer ; Kinfu, Yohannes ; Kissoon, Niranjan ; Koyanagi, Ai ; Lal, Aparna ; Abdul Latif, Asma Abdul ; Lunevicius, Raimundas ; Abd El Razek, Hassan Magdy ; Majeed, Azeem ; Malekzadeh, Reza ; Mehari, Alem ; Mekonnen, Alemayehu B. ; Melaku, Yohannes Adama ; Memish, Ziad A. ; Mendoza, Walter ; Misganaw, Awoke ; Ibrahim Mohamed, Layla Abdalla ; Nachega, Jean B. ; Nguyen, Quyen Le ; Nisar, Muhammad Imran ; Peprah, Emmanuel Kwame ; Platts-Mills, James A. ; Pourmalek, Farshad ; Qorbani, Mostafa ; Rafay, Anwar ; Rahimi-Movaghar, Vafa ; Ur Rahman, Sajjad ; Rai, Rajesh Kumar ; Rana, Saleem M. ; Ranabhat, Chhabi L. ; Rao, Sowmya R. ; Refaat, Amany H. ; Riddle, Mark ; Roshandel, Gholamreza ; Ruhago, George Mugambage ; Saleh, Muhammad Muhammad ; Sanabria, Juan R. ; Sawhney, Monika ; Sepanlou, Sadaf G. ; Setegn, Tesfaye ; Sliwa, Karen ; Sreeramareddy, Chandrashekhar T. ; Sykes, Bryan L. ; Tavakkoli, Mohammad ; Tedla, Bemnet Amare ; Terkawi, Abdullah S. ; Ukwaja, Kingsley ; Uthman, Olalekan A. ; Westerman, Ronny ; Wubshet, Mamo ; Yenesew, Muluken A. ; Yonemoto, Naohiro ; Younis, Mustafa Z. ; Zaidi, Zoubida ; Sayed Zaki, Maysaa El; Rabeeah, Abdullah A. Al; Wang, Haidong ; Naghavi, Mohsen ; Vos, Theo ; Lopez, Alan D. ; Murray, Christopher J.L. ; Mokdad, Ali H. - \ 2016
American Journal of Tropical Medicine and Hygiene 95 (2016)6. - ISSN 0002-9637 - p. 1319 - 1329.
Diarrheal diseases (DD) are leading causes of disease burden, death, and disability, especially in children in low-income settings. DD can also impact a child's potential livelihood through stunted physical growth, cognitive impairment, and other sequelae. As part of the Global Burden of Disease Study, we estimated DD burden, and the burden attributable to specific risk factors and particular etiologies, in the Eastern Mediterranean Region (EMR) between 1990 and 2013. For both sexes and all ages, we calculated disability-adjusted life years (DALYs), which are the sum of years of life lost and years lived with disability. We estimate that over 125,000 deaths (3.6% of total deaths) were due to DD in the EMR in 2013, with a greater burden of DD in low-and middle-income countries. Diarrhea deaths per 100,000 children under 5 years of age ranged from one (95% uncertainty interval [UI] = 0-1) in Bahrain and Oman to 471 (95% UI = 245-763) in Somalia. The pattern for diarrhea DALYs among those under 5 years of age closely followed that for diarrheal deaths. DALYs per 100,000 ranged from 739 (95% UI = 520-989) in Syria to 40,869 (95% UI = 21,540-65,823) in Somalia. Our results highlighted a highly inequitable burden of DD in EMR, mainly driven by the lack of access to proper resources such as water and sanitation. Our findings will guide preventive and treatment interventions which are based on evidence and which follow the ultimate goal of reducing the DD burden.