Abstract P241: The Impact of Dietary and Metabolic Risk Factors on Cardiovascular Diseases and Type 2 Diabetes in Brazil
Background: Brazil, the 5th largest country in the world, is undergoing a nutrition transition toward unhealthy diets and greater incidence of cardiometabolic diseases (CM). However, little is known about the quantitative impact of major dietary and metabolic risk factors on current burdens of CVD and diabetes in Brazil.
Aims: To quantify using consistent and comparable methods the CVD and diabetes mortality attributable to suboptimal diet and metabolic factors in Brazil.
Methods: Based on data from 2010 Global Burden of Disease Study, we used a comparative risk assessment framework to develop consistent and comparable methods to identify dietary and metabolic risk factors with evidence for etiologic effects on CVD and diabetes; estimate current national intake levels and their uncertainty, by age and sex; quantify etiologic effects of each diet-disease relationship, by age; and characterize optimal consumption levels. We combined these inputs with national data on disease-specific deaths to estimate overall burdens attributable to each dietary factor, and by age, sex, and disease. We quantified uncertainty using probabilistic simulation analyses, incorporating uncertainty in dietary exposure data and etiologic effects by age, and sex. Missing exposure data was imputed using a multi-level hierarchical Bayesian model based on non-missing exposure data from other regions. Robustness of findings was evaluated by sensitivity to varying inputs including effect sizes and feasible optimal levels.
Results: Among dietary factors, low intake of fruits and whole grains had highest impacts on CM mortality, each responsible for ~12% of total CM deaths (62,800 and 61,400 deaths, respectively) (Figure). Hypertension and high fasting plasma glucose were responsible for 32% (163,000) and 28% (141,700) of CM deaths respectively. Other dietary and metabolic risk factors also caused substantial numbers of deaths among Brazilians.
Conclusion: Our findings inform priorities for policy measures to reduce CVD and diabetes in Brazil.
Author Disclosures: M.C. de Oliveira Otto: B. Research Grant; Modest; Dr. Otto was supported by an unrestricted educational grant from Bunge LLC.. R. Micha: None. S. Khatibzadeh: None. G. Singh: None. A. Afshin: None. S. Fahimi: None. G. Danaei: None. D. Mozaffarian: B. Research Grant; Significant; Research grants from GlaxoSmithKline, Sigma Tau, Pronova, and the National Institutes of Health for a completed investigator-initiated, not-for-profit, randomized clinical trial of fish oil supplement. E. Honoraria; Modest; Ad hoc travel reimbursement and/or honoraria for one-time scientific presentations or reviews on diet and cardiometabolic diseases from Quaker Oats, Life Sciences Research Organization, Ad hoc travel reimbursement and/or honoraria for one-time scientific presentations or reviews on diet and cardiometabolic diseases from Pollock Institute and Bunge LLC. G. Consultant/Advisory Board; Modest; Ad hoc consulting fees from McKinsey Health Systems Institute (11/11), Foodminds (1/12), Nutrition Impact (10/12), Amarin (9/13), Omthera (9/13), and Winston and Strawn LLP (9/13), Advisory board: Unilever North America Scientific Advisory Board. H. Other; Modest; Royalties from UpToDate, for an online chapter on fish oil, Harvard University has filed a provisional patent application listing Dr. Mozaffarian as a co-inventor to the US Patent and Trademark Office for use of trans-palmitoleic acid to prevent diabetes.
- © 2014 by American Heart Association, Inc.