Abstract P360: The Impact of Dietary and Metabolic Risk Factors on the Burden of Cardiovascular Diseases and Diabetes in the Middle East and North Africa; An Analysis from the 2010 Global Burden of Diseases, Injuries, and Risk Factors: Nutrition and Chronic Diseases Expert Group, and Metabolic Risk Factors of Chronic Diseases Collaborating Group

Abstract

BACKGROUND: The burden of CVD and diabetes is rapidly increasing in the Middle East and North Africa. However, the impact of major dietary and metabolic risk factors on CVD and diabetes has not yet been quantified in this region. OBJECTIVE: To quantify the CVD and diabetes mortality attributable to non-optimal diet and metabolic risk factors in the Middle East and North Africa. METHODS: We used a comparative risk assessment framework to estimate the number of disease-specific deaths attributable to 14 dietary and 4 metabolic risk factors by age and sex. The specific inputs we assessed for this analysis included the current national exposure distribution, the etiological effect of risk factor on disease-specific mortality, the alternative exposure distribution associated with the lowest possible disease risk, and the total number of disease-specific deaths in the population. We obtained these inputs as a part of our work in the 2010 GBD study. Using a multi-level hierarchical Bayesian model, we imputed missing exposure data based on non-missing exposure data from other regions and available data on other characteristics in the region or country with the missing data of interest. The first three inputs were used to compute the disease-specific Population Attributable Fraction (PAF) for each dietary and metabolic risk factor. Disease-specific mortality was determined using the PAF and the fourth input. The robustness of the findings was evaluated by their sensitivity to varying assumptions, including likely effect sizes and feasible optimal levels. RESULTS: In 2008, overweight/obesity and high fasting plasma glucose were responsible for 123,000 and 107,000 cardiometabolic deaths, respectively, in the Middle East and North Africa. Other dietary and metabolic risk factors also caused a substantial number of deaths in this region ( Figure ). CONCLUSIONS: Our findings inform priorities for policy measures to improve diet and reduce metabolic risk factors to prevent CVD and diabetes in the Middle East and North Africa.