Mortality attributable to diets low in whole grains, fruits, and vegetables in brazil: estimates from the global burden of disease study 2019

Background

Although it is known that adequate consumption of whole grains, fruits, and vegetables is essential for health and to prevent disease, this consumption is suboptimal and its impact on mortality is not well characterized for the Brazilian population. The study aimed to describe the mortality due to non-communicable diseases (NCDs) attributable to diets low in whole grains, fruits, and vegetables in Brazil in 2019.

Methods

Descriptive analysis according to secondary data publicly available in the Global Burden of Disease (GBD) Study 2019. Using a comparative risk assessment, GBD 2019 estimated the mortality attributable to diets low in whole grains, fruits, and vegetables in the Brazilian adult population aged 25 years or older. We estimated the mortality burden for each risk factor in the country as the absolute number of deaths, age and cause specific-standardized rates per 100,000 population, and rates per 100,000 population by sex and age group, with a 95% uncertainty interval (95%UI).

Results

In 2019, 62,439.7 deaths were attributed to diets low in whole grains, fruits, and vegetables in Brazil. The largest number of deaths was attributable to low whole grains intake (33,250.3 deaths;17,844.6–42,606.1) followed by low vegetables intake (17,701.2 deaths; 11,123.6–24,031.4) and low fruits intake (11,488.2 deaths; 7,366.3–16,086.2). Age-standardized mortality rates per 100,000 population in Brazil attributable to diets low in whole grains, vegetables, and fruits were 14.4 (7.8–18.4), 7.6 (4.8–10.3), and 5.0 (3.2–7.0), respectively. When considering the cause-specific mortality attributable to these three risk factors, ischemic heart disease was the leading cause of death in 2019 in Brazil, with low whole grains intake accounting for an age-standardized rate of 10.3/100,00 (3.9–14.1), low vegetables intake 4.9/100,000 (2.6–7.1), and low fruits intake 1.8/100,000 (0.6–3.0). In general, the age-standardized mortality rates due to NCDs attributable to the three dietary risks were similar for males and females. Regarding age groups, the highest age-standardized rates were observed for the population aged 60 years or older.

Conclusion

Suboptimal consumption of whole grains, fruits, and vegetables contributed substantially to NCDs mortality in Brazil in 2019, mainly to ischemic heart disease. Strategies regarding these three dietary risks should target earlier stages of life to prevent NCDs in the elderly population. Policy initiatives to improve the consumption of whole grains, fruits, and vegetables, such as subsidies and food and nutrition education, are feasible solutions to reduce the mortality attributable to these dietary risks.