Abstract
BackgroundThe burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia. The contribution of dietary behaviours to the NCD burden in Ethiopia has not been evaluated. This study, therefore, aimed to assess diet-related burden of disease in Ethiopia between 1990 and 2013.MethodWe used the 2013 Global Burden of Disease (GBD) data to estimate deaths, years of life lost (YLLs) and disability-adjusted life years (DALYs) related to eight food types, five nutrients and fibre intake. Dietary exposure was estimated using a Bayesian hierarchical meta-regression. The effect size of each diet-disease pair was obtained based on meta-analyses of prospective observational studies and randomized controlled trials. A comparative risk assessment approach was used to quantify the proportion of NCD burden associated with dietary risk factors.ResultsIn 2013, dietary factors were responsible for 60,402 deaths (95% Uncertainty Interval [UI]: 44,943-74,898) in Ethiopia—almost a quarter (23.0%) of all NCD deaths. Nearly nine in every ten diet-related deaths (88.0%) were from cardiovascular diseases (CVD) and 44.0% of all CVD deaths were related to poor diet. Suboptimal diet accounted for 1,353,407 DALYs (95% UI: 1,010,433-1,672,828) and 1,291,703 YLLs (95% UI: 961,915-1,599,985). Low intake of fruits and vegetables and high intake of sodium were the most important dietary factors. The proportion of NCD deaths associated with low fruit consumption slightly increased (11.3% in 1990 and 11.9% in 2013). In these years, the rate of burden of disease related to poor diet slightly decreased; however, their contribution to NCDs remained stable.ConclusionsDietary behaviour contributes significantly to the NCD burden in Ethiopia. Intakes of diet low in fruits and vegetables and high in sodium are the leading dietary risks. To effectively mitigate the oncoming NCD burden in Ethiopia, multisectoral interventions are required; and nutrition policies and dietary guidelines should be developed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0447-x) contains supplementary material, which is available to authorized users.
Highlights
The burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia
Burden of disease associated with dietary risks in 2013 Dietary risks of chronic diseases were responsible for 60,402 deaths (95% UI: 44,943-74,898), 8.1% and 23.0% of all and NCD deaths, respectively
The number of disability-adjusted life years (DALYs) caused by poor diet quality was 1,353,407 (95% UI: 1,010,433-1,672,828) DALYs (3.0 and 9.8% of DALYs of all causes and NCDs, respectively)
Summary
The burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia. The burden of non-communicable diseases (NCDs) in sub-Saharan Africa has increased significantly over the past two decades [1,2,3]. In Ethiopia, despite the prevailing high burden of communicable diseases, the proportion of deaths due to NCDs has increased by 73.7% in these years [1,2,3, 5] and in 2013, more than a third (35.1%) of all deaths were caused by NCDs. CVD was the second most common causes of death behind specific infectious diseases (diarrhoea, lower respiratory and other infectious diseases together), accounting for 121,211 deaths (16.2% of all deaths) in the country [3]. In sub-Sahara Africa, in addition to problems of undernutrition, dietary factors were responsible for 5.8% of all deaths and 2.2% of all disability-adjusted life years (DALYs) in 2013 [8]
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