The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary, Lifestyle, and Metabolic Risk Factors
Goodarz Danaei,Eric L. Ding,Dariush Mozaffarian,Bruce Taylor,Bruce Taylor,Jürgen Rehm,Jürgen Rehm,Jürgen Rehm,Christopher J L Murray,Majid Ezzati +9 more
Reads0
Chats0
TLDR
Examination of US data on risk factor exposures and disease-specific mortality finds that smoking and hypertension, which both have effective interventions, are responsible for the largest number of deaths.Abstract:
Background: Knowledge of the number of deaths caused by risk factors is needed for health policy and priority setting. Our aim was to estimate the mortality effects of the following 12 modifiable dietary, lifestyle, and metabolic risk factors in the United States (US) using consistent and comparable methods: high blood glucose, low-density lipoprotein (LDL) cholesterol, and blood pressure; overweight–obesity; high dietary trans fatty acids and salt; low dietary polyunsaturated fatty acids, omega-3 fatty acids (seafood), and fruits and vegetables; physical inactivity; alcohol use; and tobacco smoking. Methods and Findings: We used data on risk factor exposures in the US population from nationally representative health surveys and disease-specific mortality statistics from the National Center for Health Statistics. We obtained the etiological effects of risk factors on disease-specific mortality, by age, from systematic reviews and meta-analyses of epidemiological studies that had adjusted (i) for major potential confounders, and (ii) where possible for regression dilution bias. We estimated the number of disease-specific deaths attributable to all non-optimal levels of each risk factor exposure, by age and sex. In 2005, tobacco smoking and high blood pressure were responsible for an estimated 467,000 (95% confidence interval [CI] 436,000–500,000) and 395,000 (372,000–414,000) deaths, accounting for about one in five or six deaths in US adults. Overweight–obesity (216,000; 188,000–237,000) and physical inactivity (191,000; 164,000–222,000) were each responsible for nearly 1 in 10 deaths. High dietary salt (102,000; 97,000–107,000), low dietary omega-3 fatty acids (84,000; 72,000–96,000), and high dietary trans fatty acids (82,000; 63,000–97,000) were the dietary risks with the largest mortality effects. Although 26,000 (23,000–40,000) deaths from ischemic heart disease, ischemic stroke, and diabetes were averted by current alcohol use, they were outweighed by 90,000 (88,000–94,000) deaths from other cardiovascular diseases, cancers, liver cirrhosis, pancreatitis, alcohol use disorders, road traffic and other injuries, and violence. Conclusions: Smoking and high blood pressure, which both have effective interventions, are responsible for the largest number of deaths in the US. Other dietary, lifestyle, and metabolic risk factors for chronic diseases also cause a substantial number of deaths in the US. Please see later in the article for the Editors’ Summary.read more
Citations
More filters
Journal ArticleDOI
Why and How to Improve Physical Activity Promotion: Lessons from Behavioral Science and Related Fields
Abby C. King,James F. Sallis +1 more
TL;DR: This commentary highlights the importance of regular physical activity to the nation's health and discusses some of the major challenges and opportunities currently facing the field.
Journal ArticleDOI
Mercury exposure and risk of hypertension in US men and women in 2 prospective cohorts.
Dariush Mozaffarian,Peilin Shi,J. Steven Morris,Philippe Grandjean,David S. Siscovick,Donna Spiegelman,Walter C. Willett,Eric B. Rimm,Gary C. Curhan,John P. Forman +9 more
TL;DR: Findings from 2 separate large prospective cohort studies do not support any clinically apparent adverse effects of methylmercury exposure on the risk of hypertension in men or women, including at levels ⩽2.5-fold higher than the reference dose.
Journal ArticleDOI
Impedimetric detection of influenza A (H1N1) DNA sequence using carbon nanotubes platform and gold nanoparticles amplification
TL;DR: The use of an impedimetric genosensor for the model detection of H1N1 swine flu correlated DNA sequence and a comparison between impedance and microscopy was performed in terms of viability and feasibility of the techniques.
Journal ArticleDOI
Concurrent lifestyle risk factors: Clusters and determinants in an Australian sample.
TL;DR: The tendency for lifestyle risk factors to aggregate in different subgroups has meaningful implications for health promotion strategies and better insight in the more vulnerable subpopulations that are at higher risk of displaying multiple lifestyle risk Factors is of importance if the population propensity for chronic disease is reduced.
Journal ArticleDOI
Selenium supplementation for Hashimoto's thyroiditis
TL;DR: Although the changes from baseline were statistically significant in these three studies, their clinical relevance is unclear, and randomised controlled clinical trials that assessed the effects of selenium supplementation for adults diagnosed with Hashimoto's thyroiditis appear to have a statistically significant impact on the incidence of adverse events.
References
More filters
Journal ArticleDOI
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,Jackson T. Wright,Edward J. Roccella +10 more
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Journal ArticleDOI
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin.
William C. Knowler,Elizabeth Barrett-Connor,Sarah E. Fowler,Richard F. Hamman,John M. Lachin,Elizabeth A. Walker,David M. Nathan +6 more
TL;DR: In this paper, the authors compared a lifestyle intervention with metformin to prevent or delay the development of Type 2 diabetes in nondiabetic individuals. And they found that the lifestyle intervention was significantly more effective than the medication.
Journal Article
Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)
R C Turner,Rury R. Holman,Carole A. Cull,Irene M Stratton,David R Matthews,V Frighi,Susan E. Manley,Andrew Neil,K McElroy,D Wright,E. M. Kohner,Caroline S. Fox,D R Hadden,Z Mehta,Albert V. Smith,Z Nugent,Richard Peto,A I Adlel,Jim Mann,P A Bassett,S. Oakes,Tim Dornan,Stephen J Aldington,H Lipinski,R Collum,K Harrison,C MacIntyre,S Skinner,A Mortemore,D Nelson,S Cockley,S Levien,L Bodsworth,R Willox,T Biggs,S Dove,E Beattie,M Gradwell,S Staples,R Lam,F Taylor,L Leung,R D Carter,S M Brownlee,K E Fisher,K Islam,R. Jelfs,P A Williams,F A Williams,P J Sutton,A Ayres,Lisa Logie,C Lovatt,M A Evans,L A Stowell,I Ross,I A Kennedy,D. J. Croft,A H Keen,C Rose,M Raikou,A E Fletcher,Christopher J. Bulpitt,Clare Battersby,J S Yudkin,Richard Stevens,M R Stearn,S L Palmer,M S Hammersley,S L Franklin,R S Spivey,Jonathan C. Levy,C R Tidy,N J Bell,J Steemson,B A Barrow,R Coster,K Waring,L Nolan,E Truscott,N Walravens,L Cook,H Lampard,C Merle,P Parker,J McVittie,I Draisey,L E Murchison,Brunt Ahe.,M J Williams,D W Pearson,Petrie Xmp.,Lean Mej.,D Walmsley,F Lyall,E Christie,J Church,E Thomson,A Farrow,J M Stowers,M Stowers,K McHardy,N Patterson,Alex D. Wright,N A Levi,Shearer Aci.,Thompson Rjw.,G Taylor,S Rayton,M Bradbury,A Glover,A Smyth-Osbourne,C Parkes,J Graham,P England,S Gyde,C Eagle,B Chakrabarti,Josh Smith,J Sherwell,N. W. Oakley,M. Whitehead,G P Hollier,T. Pilkington,J Simpson,Michael W. Anderson,S Martin,J Kean,B Rice,A Rolland,J Nisbet,E M Kohner,A Dornhorst,M C Doddridge,M Dumskyij,S Walji,P Sharp,M Sleightholm,G Vanterpool,G Frost,M Roseblade,S Elliott,S Forrester,Meredith C. Foster,K Myers,R Chapman,J R Hayes,R W Henry,M S Featherston,Archbold Gpr.,M Copeland,R Harper,I Richardson,H A Davison,L Alexander,Scarpello Jhb.,D E Shiers,R J Tucker,Worthington Jrh.,S Angris,A Bates,J Walton,M Teasdale,J Browne,S Stanley,B A Davis,R C Strange,Hadden,L Kennedy,A B Atkinson,P M Bell,D R McCance,J Rutherford,A M Culbert,C Hegan,H Tennet,N Webb,I Robinson,J Holmes,S Nesbitt,A S Spathis,S Hyer,M E Nanson,L M James,J M Tyrell,C Davis,P Strugnell,M Booth,H Petrie,D Clark,S Hulland,J L Barron,B C Gould,J Singer,A Badenoch,M McGregor,L Isenberg,M Eckert,K Alibhai,E Marriot,Christopher E. Cox,R Price,M Fernandez,A Ryle,S Clarke,G Wallace,E Mehmed,J A Lankester,E Howard,A Waite,S MacFarlane,R H Greenwood,J Wilson,M J Denholm,R C Temple,K Whitfield,F Johnson,C Munroe,S Gorick,E Duckworth,M Fatman,S Rainbow,L J Borthwick,D J Wheatcroft,R J Seaman,R A Christie,W Wheatcroft,P Musk,Jennifer White,S McDougal,M Bond,P Raniga,J L Day,M J Doshi,James G. Wilson,J. Howard-Williams,H Humphreys,A Graham,K Hicks,S Hexman,P Bayliss,D Pledger,R W Newton,R T Jung,C Roxburgh,B Kilgallon,L Dick,N Waugh,S Kilby,A Ellingford,J Burns,C Fox,M C Holloway,H M Coghill,N Hein,A J Fox,W Cowan,M Richard,K Quested,S J Evans,Richard B Paisey,Brown Npr.,A J Tucker,R Paisey,F Garrett,J Hogg,P Park,K Williams,P Harvey,R Wilcocks,S Mason,J. C. Frost,C Warren,P Rocket,L Bower,J M Roland,D J Brown,J Youens,K Stanton-King,H Mungall,V Ball,W Maddison,D Donnelly,S King,P Griffin,Sidney C. Smith,S Church,Graham Dunn,Andrew D. Wilson,K Palmer,P M Brown,D Humphriss,Davidson Ajm.,Richard Rose,L Armistead,S Townsend,P Poon,Peacock Ida.,Culverwell Njc.,M H Charlton,Connolly Bps.,J Peacock,J Barrett,J Wain,W Beeston,George L. King,P G Hill,Boulton Ajm.,A M Robertson,V Katoulis,A Olukoga,H McDonald,S Kumar,F Abouaesha,B Abuaisha,E A Knowles,S Higgins,J Booker,J Sunter,K Breislin,R Parker,P Raval,J Curwell,H Davenport,G Shawcross,A Prest,J Grey,H Cole,C Sereviratne,R J Young,J R Clyne,M Gibson,I O'Connell,L M Wong,S J Wilson,K L Wright,Chris Wallace,D McDowell,A C Burden,E M Sellen,R Gregory,M Roshan,N Vaghela,M Burden,C Sherriff,S Mansingh,J Clarke,J Grenfell,Je Tooke,K. M. MacLeod,C Seamark,M Rammell,C Pym,J Stockman,C Yeo,J Piper,L Leighton,Ellen Green,M Hoyle,K Jones,A Hudson,A J James,Angela C. Shore,A Higham,B Martin,Neil Haw.,Butterfield Wjh.,Doll Wrs.,R Eastman,F R Ferris,N Kurinij,K McPherson,R F Mahler,Tom W. Meade,G Shafer,P J Watkins,H Keen,D Siegel,D J Betteridge,R D Cohen,D Currie,Julie L Darbyshire,J V Forrester,T Guppy,D G Johnston,Alistair McGuire,Mike Murphy,A M el-Nahas,B Pentecost,D Spiegelhalter,Alberti Kgmm.,R Denton,Philip Home,S Howell,Jarrett,V Marks,Michael Marmot,J D Ward,Grp Ukpds. +398 more
TL;DR: In this article, the effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
Journal ArticleDOI
Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study
Salim Yusuf,Steven Hawken,Stephanie Ôunpuu,Tony Dans,Alvaro Avezum,Fernando Lanas,Matthew J. McQueen,Andrzej Budaj,Prem Pais,John Varigos,Liu Lisheng +10 more
TL;DR: Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psychosocial factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions.
Journal ArticleDOI
Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies.
TL;DR: Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.
Related Papers (5)
Measuring inconsistency in meta-analyses
A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010
Stephen S Lim,Theo Vos,Abraham D. Flaxman,Goodarz Danaei,Kenji Shibuya,Heather Adair-Rohani,Mohammad A. AlMazroa,Markus Amann,H. Ross Anderson,Kathryn G. Andrews,Martin J. Aryee,Charles Atkinson,Loraine J. Bacchus,Adil N. Bahalim,Kalpana Balakrishnan,John R. Balmes,Suzanne Barker-Collo,Amanda J Baxter,Michelle L. Bell,Jed D. Blore,Fiona M. Blyth,Carissa Bonner,Guilherme Borges,Rupert R A Bourne,Michel Boussinesq,Michael Brauer,Peter Brooks,Nigel Bruce,Bert Brunekreef,Claire Bryan-Hancock,Chiara Bucello,Rachelle Buchbinder,Fiona Bull,Richard T. Burnett,Tim Byers,Bianca Calabria,Jonathan R. Carapetis,Emily Carnahan,Zoë Chafe,Fiona J Charlson,Honglei Chen,Jian Shen Chen,Andrew T. A. Cheng,Jennifer C. Child,Aaron Cohen,K. Ellicott Colson,Benjamin C Cowie,Sarah C. Darby,Susan Darling,Adrian Davis,Louisa Degenhardt,Frank Dentener,Don C. Des Jarlais,Karen Devries,Mukesh Dherani,Eric L. Ding,E. Ray Dorsey,Tim Driscoll,Karen Edmond,S. Ali,Rebecca E. Engell,Patricia J. Erwin,Saman Fahimi,Gail Falder,Farshad Farzadfar,Alize J. Ferrari,Mariel M. Finucane,Seth Flaxman,F.G.R. Fowkes,Greg Freedman,Michael Freeman,Emmanuela Gakidou,Santu Ghosh,Edward Giovannucci,Gerhard Gmel,Kathryn Graham,Rebecca Grainger,Rebecca Grainger,Bridget F. Grant,David Gunnell,Hialy R. Gutierrez,Wayne Hall,Hans W. Hoek,Anthony Hogan,H. Dean Hosgood,Damian G Hoy,Howard Hu,Bryan Hubbell,Sally Hutchings,Sydney E. Ibeanusi,Gemma Jacklyn,Rashmi Jasrasaria,Jost B. Jonas,Haidong Kan,John A. Kanis,Nicholas J Kassebaum,Norito Kawakami,Young-Ho Khang,Shahab Khatibzadeh,Jon-Paul Khoo,Cindy Kok,Francine Laden,Ratilal Lalloo,Qing Lan,Tim Lathlean,Janet L Leasher,James Leigh,Yang Li,John K Lin,Steven E. Lipshultz,Stephanie J. London,Rafael Lozano,Yuan Lu,Joelle Mak,Reza Malekzadeh,Leslie Mallinger,Wagner Marcenes,Lyn March,Robin Marks,Randall V. Martin,Paul McGale,John J. McGrath,Sumi Mehta,Ziad A. Memish,George A. Mensah,Tony R. Merriman,Renata Micha,Renata Micha,Catherine Michaud,Vinod Mishra,Khayriyyah Mohd Hanafiah,Ali A. Mokdad,Lidia Morawska,Dariush Mozaffarian,Tasha B. Murphy,Mohsen Naghavi,Bruce Neal,Paul K. Nelson,Joan M. Nolla,Rosana E. Norman,Casey Olives,Saad B. Omer,Jessica Orchard,Richard H. Osborne,Bart Ostro,Andrew Page,Kiran Pandey,Charles D. H. Parry,Erin Passmore,Jayadeep Patra,Neil Pearce,Pamela M. Pelizzari,Max Petzold,Michael Phillips,Daniel Pope,C. Arden Pope,John Powles,Mayuree Rao,Homie Razavi,Eva Rehfuess,Jürgen Rehm,Beate Ritz,Frederick P. Rivara,Thomas Roberts,Carolyn Robinson,Jose Adolfo Rodriguez-Portales,Isabelle Romieu,Robin Room,Lisa C. Rosenfeld,Ananya Roy,Lesley Rushton,Joshua A. Salomon,Uchechukwu Sampson,Lidia Sanchez-Riera,Ella Sanman,Amir Sapkota,Soraya Seedat,Peilin Shi,Kevin D. Shield,Rupak Shivakoti,Gitanjali M Singh,David A. Sleet,Emma Smith,Kirk R. Smith,Nicolas J. C. Stapelberg,Kyle Steenland,Heidi Stöckl,Lars Jacob Stovner,Kurt Straif,Lahn Straney,George D. Thurston,Jimmy H. Tran,Rita Van Dingenen,Aaron van Donkelaar,J. Lennert Veerman,Lakshmi Vijayakumar,Robert G. Weintraub,Myrna M. Weissman,Richard A. White,Harvey Whiteford,Steven T. Wiersma,James D. Wilkinson,Hywel C Williams,Warwick Williams,Nick Wilson,Anthony D. Woolf,Paul S. F. Yip,Jan M Zielinski,Alan D. Lopez,Christopher J L Murray,Majid Ezzati +210 more