Abstract

Abstract Background modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention of chronic non-communicable diseases (NCD). Among various risk factors, poor nutrition quality has been identified as a leading determinant of NCD. Methods The Global Burden of Diseases (GBD) Study provided a comprehensive comparative risk assessment (CRA) of risk factor for NCD, quantifying the impact of behavioural, environmental and occupational, and metabolic risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. Special focus on nutritional risk factors will be dedicated, discussing the proportion of disease-specific burden attributable to each dietary risk factor and the level of intake associated with the lowest risk of mortality. Results In 2017, over 30 million deaths were attributable to risk factors. When ranked, high systolic blood pressure was the leading risk factor, accounting for more than 10 million deaths, followed by, high fasting plasma glucose, and high body-mass index. A total of 11 million deaths were attributable to dietary risk factors. High intake of sodium, low intake of whole grains, and low intake of fruits were the leading dietary risk factors for deaths globally. However, important differences between regions and outcome (i.e., cardiovascular disease vs. cancer) have been registered. Besides the major aforementioned factors, underrated dietary risk factors, such as low calcium intake, have been found important contributors to cancer burden in certain developed countries. Interpretation The combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in NCD at the global level. These data provide a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations.

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