The burden of dietary risk factors in the Nordic and Baltic countries

Abstract

Abstract Background The Nordic Nutrition Recommendations (NNR) gives the scientific basis for national dietary guidelines for the Nordic and Baltic countries. The Global Burden of Diseases, Injuries, and Risk Factors study (GBD) provides comparative estimates of the disease burden related to suboptimal diet in 195 countries. The aim of the study was to employ data from GBD 2021 to improve the knowledge base for NNR. Methods A comparative risk assessment approach was used to estimate the proportion of disease-specific burden that could be attributed to fifteen dietary risk factors in the population aged 25 and older in the Nordic and Baltic countries. The analyses included four steps: (1) estimating dietary intake on a population level; (2) determining the relative risks of dietary factors on disease endpoints; (3) determining the level of exposure with minimum risk; and (4) estimating the final disease burden, defined as disability-adjusted life-years (DALYs), attributed to each dietary risk. Results A suboptimal intake was found for all dietary risk factors in all countries. A total of 60 350 deaths and 1 079 087 DALYs were attributed to dietary factors. The highest age standardised mortality rates attributed to diet were found in Lithuania (371 per 100 000), and lowest in Norway (101 per 100 000). Low intake of whole grains was the largest dietary risk factor for mortality and DALYs in all countries except Estonia. Other highly-ranked factors in all countries included a diet high in processed meat and low in fruit. The results are preliminary, with final GBD 2021 estimates expected to be published medio 2023. Conclusions GBD offers a powerful resource to model trends in diet-related burden of diseases in the Nordic and Baltic countries. Estimates from GBD can provide countries with insight into the potential of reducing disease burden by targeting specific dietary risks. Key messages • Suboptimal diet leads to a substantial and avoidable mortality and disease burden in the Nordic and Baltic countries. • Detailed and comparative estimates from GBD can help countries identify their most important dietary risk factors.