The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: A comparative risk assessment analysis
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BMJ Publishing Group
Abstract
Objective/design: We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality was obtained from clinical trials and observational studies. The number of disease-specific deaths was obtained from the 2010 Global Burden of Disease mortality database. Mortality due to each risk factor was determined using the population attributable fraction and total number of disease-specific deaths. Setting/population: Adult population in the Middle East by age, sex, country and time. Results: Suboptimal diet was the leading risk factor for CMD mortality in 11 countries accounting for 48% (in Morocco) to 72% (in the United Arab Emirates) of CMD deaths. Non-optimal systolic blood pressure was the leading risk factor for CMD deaths in eight countries causing 45% (in Bahrain) to 68% (in Libya) of CMD deaths. Non-optimal body mass index and fasting plasma glucose were the third and fourth leading risk factors for CMD mortality in most countries. Among individual dietary factors, low intake of fruits accounted for 8% (in Jordan) to 21% (in Palestine) of CMD deaths and low intake of whole grains was responsible for 7% (in Palestine) to 22% (in the United Arab Emirates) of CMD deaths. Between 1990 and 2010, the CMD mortality attributable to most risk factors had decreased except for body mass index and trans-fatty acids. Conclusions: Our findings highlight key similarities and differences in the impact of the dietary and metabolic risk factors on CMD mortality in the countries of the Middle East and inform priorities for policy measures to prevent CMD. © 2015, BMJ Publishing Group. All rights reserved.
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Adult, Africa, northern, Aged, Bayes theorem, Blood glucose, Blood pressure, Body mass index, Cardiovascular diseases, Cause of death, Cross-cultural comparison, Diabetes mellitus, Diet, Feeding behavior, Female, Global health, Humans, Male, Middle aged, Middle east, Risk assessment, Risk factors, Young adult, Cholesterol, Glucose, Hydrogenated vegetable oil, Omega 3 fatty acid, Polyunsaturated fatty acid, Saturated fatty acid, Sodium, Trans fatty acid, Glucose blood level, Aorta aneurysm, Article, Bean, Beverage, Body mass, Brain hemorrhage, Brain ischemia, Carbohydrate intake, Cardiometabolic risk, Cardiovascular disease, Cardiovascular mortality, Cholesterol blood level, Diet restriction, Eating habit, Fat intake, Heart disease, Human, Hypertension, Inflammatory disease, Ischemic heart disease, Legume, Maize, Major clinical study, Morocco, Mortality, North africa, Nut, Obesity, Plant seed, Population, Processed meat, Red meat, Rheumatic heart disease, Sea food, Soybean, Systolic blood pressure, United arab emirates, Vegetable, Very elderly, Africa, Comparative study, Cultural factor, Epidemiology, Health, Metabolism, Risk factor, Nutrition