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WHO Global Burden of Disease Study 2017

About the study:

This study looked at dietary data across 195 countries, with the aim of assessing the impact of suboptimal intake of 15 key foods and nutrients against incidences of mortality and disease risk factors. A large team of researchers, known collectively as the Global Burden of Disease (GBD) 2017 Diet Collaborators, provide a comprehensive overview of mortality and disease risk factors caused by suboptimal diets at the population level. The study published in the Lancet can be found here.

Key findings:

  • Poor diets caused 1 in 5 (11 million) deaths globally in 2017
  • Cardiovascular disease was the biggest cause, followed by cancers and type 2 diabetes
  • The top three dietary risk factors accounting for 50% of deaths and 66% of DALYs (Disability Adjusted Life Years) were:
    1. high intake of sodium
    2. low intake of whole grains
    3. low intake of fruits

Across all 15 dietary factors, more deaths were associated with not eating enough healthy foods such as wholegrains, fruit, nuts and seeds than by diets with high levels of trans fats, sugary drinks and high levels of red and processed meats. The largest shortfalls in global consumption were for healthy foods such as nuts, seeds, milk and whole grains.


This study was a systematic review of data for adults aged 25 years and over. It examined 15 dietary elements: diets low in fruits, vegetables, legumes, whole grains, nuts and seeds, milk, fibre, calcium, seafood omega-3 fatty acids, polyunsaturated fats; and diets high in red meat, processed meat, sugar-sweetened beverages, trans fatty acids, and sodium. In this study, an optimal level of intake was defined as “the level of risk exposure that minimises the risk from all causes of death”.

Dietary intake data was obtained from nationally representative nutrition surveys, Euromonitor national sales data and United Nations Food and Agriculture Organisation balance sheets. Nutrient data was drawn from the Global Nutrient Database, while sodium intake came from 24-hour urinary sodium measures. 

Data from Australasia:

Healthy foods that were consumed at or above optimal levels in Australasia were:

  • Fruits (>250g/day)
  • Nuts and seeds (>21g/day)
  • Milk (>435g/day)
  • Calcium (>500mg/day)
  • Omega-3 fats (>250mg/day)

Unhealthy foods/nutrients that were consumed in excess of optimal levels were:

  • Sodium (>3g/day)
  • Red meat (>23g/day)
  • Processed meat (>2g/day)
  • Sugar-sweetened beverages (>3g/day)
  • Trans fats (>0.5% total Energy)

Healthy foods/nutrients consumed in sub-optimal amounts were:

  • Vegetables (
  • Legumes (
  • Wholegrains (
  • Fibre (
  • Polyunsaturated fatty acids (PUFA) (

Low intakes of whole grains, nuts and seeds, fruits and vegetables were the top four dietary risk factors.


Based on this study, suboptimal diet was found to be the leading cause of death globally, superseding other lifestyle factors such as smoking.  Poor diet was also non-discriminant of age, gender and socio-demographic factors as a cause of death.

Authors emphasise the potentially greater effect of promoting inadequate intake of healthy foods rather than just targeting sugar and fat. Dietary policies should work with multiple sectors of the food system and focus on promoting the production, distribution and consumption of healthy foods across nations. This will require active collaboration of a variety of actors within the food system.

Importantly, they note that changes must be sensitive to the environmental effects of the global food system to avoid adverse effects on climate change, biodiversity loss, land degradation, depleting freshwater, and soil degradation.

Effective health policies have failed to be implemented globally and coordinated global efforts to improve the quality of the human diet are urgently needed.

Read more about global nutrition policy at WHO’s Global Nutrition Policy Review 2016-2017- Country progress in creating enabling policy environments for promoting healthy diets and nutrition

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