29 June 2009
The Preventable Causes of Death in the United States: Comparative Risk Assessment of Dietary , Lifestyle, and Metabolic Risk Factors
Danaei, G ; Ding, EL ; Mozaffarian, D et al.
PloS Medicine, 6 : 1-23 (2009)
Using data on risk factor exposures in the US population from national health surveys and disease-specific mortality statistics, the authors were able to estimate the relative influence of various lifestyle, metabolic risk factors, and dietary factors (including omega-3 fatty acid intakes) on mortality in the US population.
The largest number of preventable deaths for both sexes combined in the US were due to smoking (premature death due to cancer, respiratory disease, and cardiovascular disease); followed by high blood pressure, obesity, physical inactivity, high blood glucose , and elevated LDL-cholesterol ( all mainly via cardiovascular disease plus diabetes ). Interestingly, the major dietary factors adversely influencing preventable deaths were low dietary omega-3 fatty acid intakes from seafood , high intakes of dietary trans fatty acids from partially hydrogenated vegetable oils, and high salt intakes . The latter three dietary factors had stronger impacts on mortality than low intakes of fruits and vegetables.
Whereas tobacco smoking was considered responsible for 467,000 deaths annually from all causes, high salt, low omega-3 intakes from seafood, and high trans intakes were considered responsible for 102,000, 84,000, and 82,000 deaths, respectively, followed by alcohol use (64,000), low intake of fruits and vegetables (58,000), and low polyunsaturated fat intakes replacing saturates (15,000). With respect to the dietary factors affecting preventable deaths, the authors call for combinations of food industry regulation, pricing, and better information for consumers as vehicles for improving health with a particular emphasis on the risks of various packaged foods and prepared meals.
Dr. Holub's Comments:
While food labeling for dietary fatty acid types has historically been more directed to saturates (Sats) and polyunsaturates (PUFA) including P:S ratios , the present analyses indicate that a much greater emphasis on trans fatty acids (TFA) and omega-3 fatty acids from fish/seafood as DHA/EPA is highly warranted in view of the evidence for low DHA/EPA omega-3 intakes and high TFA intakes being potent dietary factors responsible for much premature death in the US population.