A poor diet remains a leading contributor to ischaemic heart disease, according to an analysis from 204 countries over a 30-year period, published in Nature Medicine. The authors estimate that suboptimal diet associated with this disease was responsible for more than 4 million ischaemic heart disease related deaths and almost 97 million total disability-adjusted life years were lost in 2023. The findings could improve understanding of how specific diets influence ischaemic heart disease patterns and support nutrition-focused strategies to reduce health impacts.
Ischaemic heart disease is a leading cause of death and disability globally, and diet has been identified as one of its most important modifiable risk factors. However, comprehensive studies assessing the global burden of specific dietary components on this disease are limited, and previous research has often focused on single countries or selected diet types.
Min Seo Kim and colleagues analysed global data of key health metrics, including mortality, between 1990 and 2023 from 204 regions to estimate ischaemic heart disease burden deaths attributable to 13 dietary factors. These included fruit, vegetables, whole grains, nuts and seeds, fibre, seafood omega-3 fatty acids, omega-6 polyunsaturated fatty acids, legumes, red meat, processed meat, sugar-sweetened beverages, trans fatty acids, and sodium. In 2023, the authors found that suboptimal diet was associated with 4.06 million ischaemic heart disease related deaths worldwide. Specifically, diets low in whole grains, low in omega-6 polyunsaturated fatty acids, high in sodium, and low in nuts and seeds were leading contributors to its mortality.
The authors also report that in that same year, 96.84 million disability-adjusted life years were associated with diet-related ischaemic heart disease. Regionally, Australasia (-77.32%), western Europe (-69.78%), and high-income North America (−64.41%) saw the greatest declines in diet-attributable ischaemic heart disease deaths since 1990. However, central sub-Saharan Africa saw a 20.86% increase in the same time frame. While developing countries most often face ischaemic heart disease burden related to undernutrition and limited access to protective foods (such as whole grains, fruits, vegetables, omega-3 fatty acids), developed countries are more commonly burdened by overconsumption of harmful dietary components (such as processed meats and sugar-sweetened beverages).
The authors report large differences between regions and population groups and argue that targeted actions are needed to address both low intake of protective foods and high intake of harmful dietary components. They note several limitations of the study, including reliance on observational evidence, uneven data quality, and possible unmeasured factors affecting diet and disease.
Article details
Global, regional and national burden of ischemic heart disease attributable to suboptimal diet, 1990–2023: a Global Burden of Disease study
Corresponding Author:
Min Seo Kim
Massachusetts General Hospital, Boston, MA, USA
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Dong Keon Yon
Kyung Hee University, Seoul, South Korea
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