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
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
TL;DR: In this paper, the authors estimated deaths and disability-adjusted life years (DALYs; sum of years lived with disability [YLD] and years of life lost [YLL]) attributable to the independent effects of 67 risk factors and clusters of risk factors for 21 regions in 1990 and 2010.
Journal ArticleDOI
Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Emelia J. Benjamin,Michael J. Blaha,Stephanie E. Chiuve,Mary Cushman,Sandeep R Das,Rajat Deo,Sarah D. de Ferranti,James S. Floyd,Myriam Fornage,Cathleen Gillespie,Carmen R. Isasi,Monik C. Jim'nez,Lori Chaffn Jordan,Suzanne E. Judd,Daniel T. Lackland,Judith H. Lichtman,Lynda D. Lisabeth,Simin Liu,Chris T. Longenecker,Rachel H. Mackey,Kunihiro Matsushita,Dariush Mozaffarian,Michael E. Mussolino,Khurram Nasir,Robert W. Neumar,Latha Palaniappan,Dilip K. Pandey,Ravi R. Thiagarajan,Mathew J. Reeves,Matthew D. Ritchey,Carlos J. Rodriguez,Gregory A. Roth,Wayne D. Rosamond,Comilla Sasson,Amytis Towfghi,Connie W. Tsao,Melanie B. Turner,Salim S. Virani,Jenifer H. Voeks,Joshua Z. Willey,John T. Wilkins,Jason H Y Wu,Heather M. Alger,Sally S. Wong,Paul Muntner +44 more
TL;DR: WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Jiménez, ScD, SM Lori Chaffin Jordan,MD, PhD Suzanne E. Judd, PhD
Journal ArticleDOI
Interventions for latent autoimmune diabetes (LADA) in adults.
TL;DR: Two studies show SU leading to earlier insulin dependence and a meta-analysis of four studies with considerable heterogeneity showed poorer metabolic control if SU is prescribed for patients with LADA compared to insulin.
Journal ArticleDOI
Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association
Dariush Mozaffarian,Emelia J. Benjamin,Alan S. Go,Donna K. Arnett,Michael J. Blaha,Mary Cushman,Sandeep R Das,Sarah D. de Ferranti,Jean-Pierre Després,Heather J. Fullerton,Virginia J. Howard,Mark D. Huffman,Carmen R. Isasi,Monik C. Jiménez,Suzanne E. Judd,Brett M. Kissela,Judith H. Lichtman,Lynda D. Lisabeth,Simin Liu,Rachel H. Mackey,David J. Magid,Darren K. McGuire,Emile R. Mohler,Claudia S. Moy,Paul Muntner,Michael E. Mussolino,Khurram Nasir,Robert W. Neumar,Graham Nichol,Latha Palaniappan,Dilip K. Pandey,Mathew J. Reeves,Carlos J. Rodriguez,Wayne D. Rosamond,Paul D. Sorlie,Joel M. Stein,Amytis Towfighi,Tanya N. Turan,Salim S. Virani,Daniel Woo,Robert W. Yeh,Melanie B. Turner +41 more
TL;DR: Author(s): Writing Group Members; Mozaffarian, Dariush; Benjamin, Emelia J; Go, Alan S; Arnett, Donna K; Blaha, Michael J; Cushman, Mary; Das, Sandeep R; de Ferranti, Sarah; Despres, Jean-Pierre; Fullerton, Heather J; Howard, Virginia J; Huffman, Mark D; Isasi, Carmen R; Jimenez, Monik C; Judd, Suzanne
Journal ArticleDOI
Heart Disease and Stroke Statistics—2010 Update A Report From the American Heart Association
Donald M. Lloyd-Jones,Robert J. Adams,Todd M. Brown,Mercedes R. Carnethon,Shifan Dai,Giovanni de Simone,T. Bruce Ferguson,Earl S. Ford,Karen L. Furie,Cathleen Gillespie,Alan S. Go,Kurt J. Greenlund,Nancy Haase,Susan M. Hailpern,P. Michael Ho,Virginia J. Howard,Brett M. Kissela,Steven J. Kittner,Daniel T. Lackland,Lynda D. Lisabeth,Ariane Marelli,Mary M. McDermott,James B. Meigs,Dariush Mozaffarian,Michael E. Mussolino,Graham Nichol,Véronique L. Roger,Wayne D. Rosamond,Ralph L. Sacco,Paul D. Sorlie,Randall S. Stafford,Thomas Thom,Sylvia Wasserthiel-Smoller,Nathan D. Wong,Judith Wylie-Rosett +34 more
TL;DR: The Statistical Update brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update each year.
References
More filters
Journal ArticleDOI
Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis.
TL;DR: Statins can lower LDL cholesterol concentration by an average of 1.8 mmol/l which reduces the risk of IHD events by about 60% and stroke by 17% and is corroborated by results from the nine cohort studies.
Journal Article
Comparative Quantification of Health Risks. Global and Regional Burden of Disease Attributable to Selected Major Risk Factors
Journal ArticleDOI
Trans Fatty Acids and Cardiovascular Disease
TL;DR: The authors consider the feasibility and potential implications of reducing or eliminating the consumption of trans fatty acids from partially hydrogenated vegetable oils in the United States.
Journal ArticleDOI
Cause-Specific Excess Deaths Associated With Underweight, Overweight, and Obesity
TL;DR: The results help to clarify the associations of BMI with all-cause mortality and suggest a decrease in the association of obesity with CVD mortality over time.
Journal ArticleDOI
Mortality from tobacco in developed countries: Indirect estimation from national vital statistics
TL;DR: Application of such methods indicates that on current smoking patterns just over 20% of those now living in developed countries will eventually be killed by tobacco (ie, about a quarter of a billion, out of a current total population of just under one and a quarter billion).
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