Diet and lifestyle diseases – the global burden

Very generally, as a global population, we are living in the healthiest age since in known human history. Though much disparity remains across the world, we are certainly lengthening the lifespan! But are we living well?

Communicable diseases have been on the decline. Which is brilliant news! Through factors such as immunization and sanitization, overall the global population is living longer.¹

But maybe not better.

The incidence of diet and lifestyle-related illness and disease are on the rise, impeding everyday quality of life, and becoming an increasing burden on the healthcare system.

The Global Burden of Disease, Injuries and Risk Factors (GBD) 2015 report was recently published over several papers in The Lancet. This edition measured for social development, including income per capita, level of education and fertility rate – and interestingly, the study collaborators found the disparity between these markers and health outcomes.

“Development drives, but does not determine health,” says Dr Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle, the coordinating center for the GBD collaboration. “We see countries that have improved far faster than can be explained by income, education, or fertility. And we also continue to see countries – including the United States – that are far less healthy than they should be given their resources.”

As mentioned, incidence and death by communicable disease are reported to have gone down, which has largely contributed to the increase in lifespan of 10 years for both men and women since 1980!²

Yet 70% of deaths are now due to non-communicable diseases, such as ischemic heart disease, stroke, dementia, Alzheimer’s disease, type 2 diabetes, chronic kidney disease and drug-use disorders.²

However, that increase in lifespan is not reflected in more years living healthy, and the aging population are being burdened with hearing and vision loss, and osteoarthritis, for example, which can have massive implications for any healthcare system.

Overfed and undernourished

The report found more of the global population is gaining access to clean water and sanitation, reducing the incidence of many diseases. Yet simultaneously, high blood glucose, high blood pressure, obesity and childhood malnutrition were leading factors for premature death in 2015 – all non-communicable and preventable conditions. With the addition of smoking and increased exposure to occupational carcinogens like diesel exhaust, conditions like type 2 diabetes, cardiovascular disease, and cancer are becoming more common.³

Consider also the impact on quality of life these conditions have. And the risk for developing each can be influenced by what we choose to eat.

Since our food system got all large-scale industrialised, we have seen food portions go up and quality of food go down. According to another recent 2016 report, South Asian countries are simultaneously being overfed, yet malnourishment is rife.⁴

The GBD notes a diet low in vegetables, fruit, nuts, seeds, seafood and whole grains (as opposed to the super refined alternative) are big contributors to the incidence of the non-communicable and preventable conditions that are now leading causes of premature death.³

Consider all the goodness consuming these real, whole foods can offer – vitamins, minerals, phytochemicals, fibre and healthy fats, offering a steady stream of essential nutrition for the millions of bodily functions, as well as anti-inflammatory and antioxidant activity, and food for the microbiome.

In light of this, perhaps focus on education and access to good, whole food needs to become a healthcare priority.

Food as medicine

As mentioned earlier, development doesn’t necessarily translate to better heath outcomes. It is believed that urbanisation and shifts to a more ‘Western’ diet and lifestyle are contributing to health issues.

Whilst factors like sanitation, micronutrient deficiencies and household pollution improve as countries develop, there is a simultaneous shift in other factors that worsen health status, such as poor diet, low physical activity, and high body mass index.³

And no surprise that the increased consumption of sugar-sweetened beverages is a key contributor to ill-health and increased burden on the health care systems. Measuring amount of total added sugars in the diet is being considered for future GBD reporting and analysis.³

The report makes a good point that instead of public health initiatives focusing on what we should limit in our diet, perhaps more effective interventions would be promoting ways to eat well, through education and subsidies. An act with the aim to stop poor diet-related health outcomes before they happen, using food as preventative medicine.

Nutrition and good food are cornerstones for good health, that can support not only a longer life, but a brighter, happier, healthier one too.

By Angela Johnson (BHSc Nut. Med.)

References:

1. United Nations 2016, ‘The Sustainable Development Goals Report 2016’, New York, viewed 11 October 2016, <http://unstats.un.org/sdgs/report/2016/The%20Sustainable%20Development%20Goals%20Report%202016.pdf>
2. Wang, H et al. 2016, ‘Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015’, The Lancet, vol. 388 , no.10053, pp. 1459-1544.
3. Forouzanfar, MH et al. 2016, ‘Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015’, The Lancet, vol. 388, no. 10053 , 1659-1724.
4. Global Panel on Agriculture and Food Systems for Nutrition 2016, ‘Food systems and diets: Facing the challenges of the 21st century’, London, UK, viewed 11 October 2016, <http://glopan.org/sites/default/files/ForesightReport.pdf>