Eating badly, either for a little of some foods or for a lot of others, is related to 11 million deaths in the world per year, according to a study published today. The Lancet. This figure represents practically one fifth of the 57 million deaths that occur on the planet annually, and is higher than the deaths attributed to tobacco (7 million, according to the World Health Organization, WHO), cancer (8.2 million), heart attacks (5.5 million) and obesity (2.8 million). These 11 million are distributed among deaths due to cardiovascular diseases (10 million), cancers related to food such as colon (900,000) and diabetes (300,000). Of course, all these aspects are related, and there are deaths related to nutrition that manifest as cancer.
The work has been financed by the Bill and Melinda Gates Foundation and it is based on collecting data on the intake of 15 nutrients in 195 countries. Specifically, it was established that a diet low in fruits, vegetables, legumes, is bad, whole grains, nuts and seeds, milk, fiber, calcium, omega-3 fatty acids from marine foods, polyunsaturated fats or high in red meat, processed meat, sugary drinks, trans fats and sodium (whose main source is salt).
Within this complicated balance (ingest less of one thing and more of another) the authors affirm that the study confirms "what many thought": "That a poor diet [en los alimentos que deben estar presentes] is responsible for more deaths than any other risk factor in the world ", in the words of the main author of the article, Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME) of the University of Washington: That's why Murray goes further, and points to the need to redefine campaigns for good practices in nutrition. "While sodium [la sal], the sugar and fat have been the focus of debate in the last two decades, our work suggests that the main risk factors in diets are the high sodium intake, but also the low intake of healthy foods, such as whole grains, fruit , Nuts and seeds [frutos secos] and vegetables. "Excess salt and inadequate whole grains and fruits are responsible for half of those 11 million deaths, according to the study.
The group of experts, in which there are also representatives of Harvard University, had already evaluated the situation in 1990, and since then the deaths associated with imbalances in the diet have increased by eight million, although they attribute it more to the increase in population than to other factors.
The work offers a classification of the 195 countries studied. Israel, France and Spain are, in this order, the three whose dietary habits cause fewer deaths, with less than 90 deaths per 100,000 inhabitants (about 40,000 deaths for the Spanish case, 10% of the total). They are followed by Japan and Andorra. The first American country is Peru (ranked 9), followed by Bermuda (18), Puerto Rico (20) and Canada (22). The first African is Rwanda (41) followed by Nigeria (42), just before the United States (43). Of the great powers, Russia is 171st of 195; Italy, the 10th; United Kingdom, the 23rd; Germany, the 38; China, 140; Mexico is ranked 57; Argentina, in 62 and Brazil in 50. Close the list three countries of the Pacific, Vanuatu, Papua New Guinea and Marshall Islands, and then Afghanistan and Uzbekistan.
Regarding the specific components, Spain occupies the 155th place in terms of mortality associated with the consumption of processed meats (the higher the position, more mortality), the 168 for red meat, the first in terms of sodium [sal], 83 in sugary drinks, the second with the lowest mortality associated with the consumption of trans fatty acids, 151 for milk consumption, 37 for fiber, 14 for fruit and 43 for legumes.
Felipe Casanueva, from Center for Biomedical Research in the Network of the Pathophysiology of Obesity and Nutrition (Ciberobn), believes that the work "corroborates" what they have been "preaching for many years" about the benefits of the Mediterranean diet and the one called Atlantic, which has the same base (products of proximity, many vegetables and fish and little meat) but with the products of the area. "The diet has to be sensible and balanced, any food can be incorporated if you use your head and you have a very varied diet."
He is only shocked by the little damage attributed to salt abuse, when Spain doubles the consumption recommended by WHO (9.8 grams a day against the 5 advised). "We have a problematic consumption that has even altered the perception of consumers," who do not notice how salty they eat, Casanueva says. But, in return, it highlights that important measures have been taken, such as "the reduction in salt by 25% in bread flour". And he affirms that "many pathologies are counteracted by very aggressive treatments", such as the intensive use of antihypertensive drugs to combat the effect of salt. "Here the mortality is very low because we do everything."
Fruit. 250 grams.
Other vegetables 360 grams.
Vegetables. 60 grams.
Whole grains. 125 grams.
Nuts and seeds. 21 grams.
Red meat. 23 grams.
Processed meat 2 grams.
Sugary drinks. 3 grams of sugar per day.
Fiber. 24 grams.
Calcium. 1.25 grams.
Omega 3. 250 milligrams
Polyunsaturated fatty acids. 11% of total energy.
Trans fatty acids. 0.5% of the energy.
Sodium. 3 grams expelled in the urine.
On average, the world population ate only 12% of the 21 grams of walnuts and seeds recommended per day and took 10 times the recommended amount of sugary drinks (49 grams compared to the 3 stipulated). Only 16% of the milk considered necessary was consumed (71 real grams compared to 435); about a quarter of the whole grains (29 of 125 grams), and almost double the processed meat (4 grams versus 2 recommended) and 86% more sodium.
By zones, an elevated sodium intake (more than three grams per day) was the main cause of death associated with the diet of Japan, China and Thailand; taking a few whole grains (less than 125 grams a day) was in the United States, India, Brazil, Pakistan, Nigeria, Russia, Egypt, Germany, Iran and Turkey. Taking little fruit (the minimum is 250 grams per day) is in Bangladesh; the low intake of nuts and seeds, it is in Mexico. Finally, eat a lot of red meat (more than 23 grams per day), processed meat (more than two grams per day), trans fat (more than 0.5% of the energy consumed) and sugary drinks (more than three grams of sugar). day) are the least concerns of the most populated countries.
Miguel Ángel Rubio, Head of Endocrinology and Nutrition of the Hospital Clínico de Madrid and member of the Spanish society of that specialty (SEN) assesses the general conclusions, but warns that the authors themselves warn that the data are incomplete (can not get that detail of all the countries). Criticizes not even mentioning olive oil, and summarizes that "it is an observational work that, therefore, does not establish causality, if not as much association, between the consumption of certain nutritional factors and mortality in 195 countries." "Adherence to these healthier patterns could be associated with lower mortality, and certain national policies could improve that individual behavior by favoring accessibility and control of prices for healthy products and / or rates for the most harmful ones."
The president of the SEN, Francisco Tinahones, highlights that the indicators of the study "are closely related to the Mediterranean diet". "Although Spain has dropped in the score on the matter [hay una escala de 17 puntos que mide la adherencia a los patrones tradicionales], still at a great distance from the rest. Not in vain we are from the countries with more life expectancy and studies as the Predimed, that has measured how cardiovascular risk decreases with the Mediterranean diet, they go in that line ".
Rubio points out that "in some economically more unfavorable countries the accessibility to reach a desirable consumption of some of those nutrients is almost impossible", and adds that "perhaps the improvement of environmental health and socio-health conditions occupy a preferential place in the improvement of the quality and quantity of life, that countries like Asia consume a high amount of sodium (soy sauce, salted meats and fish, pickles and other salted products) is understandable. "
Javier Aranceta, nutrition specialist, highlights that two months ago Bloomberg cataloged Spain as the healthiest country in the world, "And in 40% that's because of the diet." "Although the Mediterranean is losing something, it still remains, and also its effect is not lost suddenly, what matters is the general pattern, not to look at a specific food".
Rubio looks at another aspect: in 1990 Spain also occupied third place. "From the abundance of pastries in breakfasts in the coffee shops of a decade or two ago, we have clearly passed to healthy breakfasts (where a majority consumes bread toast with virgin olive oil with or without tomato) and more than 50% of the soft drinks that are consumed are Light or zero We have learned something in this period. "