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A Common Problem, A Poor Diet

By Tanya Humphrey BS, NDTR, CLT

· Nutrition Blog

Many people are affected by a poor diet which can contribute to disease and death. Researchers from the Global Burden of Disease Study have found 15 factors that can improve diet1. The study, tracking trends in consumption, estimates one in five deaths is linked with poor diet. That is about 11 million people and some with chronic illnesses could be prevented with better diet. The study explains that in 2017, diets with inadequate amounts of fruit, nuts, whole grains, seeds, and high intakes of trans fat, sugar, red and processed meats were involved in the causes of many deaths. These trends were tracked from the year 1990 to 2017 based on investigations and impact of poor diet leading to death and disease such as cardiovascular, cancer, and diabetes. This type of study is a difficult to complete in nutrition but was done in an effort to find connections between dietary factors and non-communicable diseases.

Past investigations proved difficult due to diet variations and intake across different populations and nations. The study identified several dietary factors. Diets low in fruits, vegetables, legumes, nuts, seeds, whole grains, milk, fiber, calcium, seafood omega-3-fatty acids, and polyunsaturated fats were evaluated. In addition, diets containing high amounts of red meat, processed meat, sugar-sweetened beverages, trans fatty acids and sodium were assessed. The diets that were responsible for half of all diet-related deaths included diets low in whole grains or fruit but also diets high in sodium. A poor diet contributed to cause of death related to Cardiovascular disease in around 10 million. There were 913,000 deaths from cancer and nearly 339,000 deaths from type 2 diabetes. Due to the increase in population and the aging population, deaths due to poor diet grew to 8 million in 1990.

The authors of the study revealed consumption of dietary foods that were not optimal in nearly every region of the world. Some regions did consume dietary foods in correct amounts such as in Asia where consumption of vegetables was optimal. So was seafood rich omega-3-fatty acids in Asia Pacifica due to higher income areas. Legume intake was also in line with health recommendations in the Caribbean, tropical Latin America, South Asia, western sub-Saharan Africa, and eastern sub-Saharan Africa. Poor intake with milk, nuts, seeds, and whole grains was noted. The largest excesses of consumption included sugar-sweetened beverages, processed meat, and sodium. In summary, only 12% of the recommended amount of nuts and seeds were consumed, and 10 times the recommended amount of sugar-sweetened drinks were consumed. Other dietary foods such as milk reached 16% of the recommended intake and whole grains reached 23% of the recommended intake. In addition, there was 90% more of the recommended amount for processed meat and 86% more sodium than recommended.

Intake of specific nutrients varied by region. High intake of sodium was prevalent in China, Japan and Thailand. In the United States, India, Brazil, Pakistan, Nigeria, Russia, Egypt, Germany, Iran and Turkey, intake of whole grains was poor. Low consumption of fruit was prevalent in Bangladesh and in Mexico along with nut and seed intakes which also ranked low. High populated countries had a high intake of red meat, processed meat, trans fat, and sugar-sweetened beverages.

The highest rate of diet-related deaths was in Uzbekistan at 892 deaths per 100,000 people and the country with the lowest was Israel at 89 deaths per 100,000 people in 2017. Other high diet related deaths occurred in France, Spain, Japan and Andorra. The United States ranked 43rd at 171 deaths per 100,000 people which was behind Rwanda and Nigeria. China ranked 140th at 350 deaths per 100,000. India was 118th at 310 deaths per 100,000.


The prevalence of diet-related conditions brings attention to the fact that many diet-improvement programs have not been successful. The study suggests new food interventions to change eating patterns. The authors of the study advocate for changes globally that consider environmental effects of the food system to avoid adverse impact on climate change, loss of biodiversity, degradation of land, and the depletion of freshwater and soil.

The information from this study is important as it can be used to inform the public about the benefits of a sustainable, balanced diet to prevent chronic disease. For example, more nuts or seeds can be used in yogurt, salads, or smoothies to offer similar nutrients in the diet. Seasonal fruits and vegetables can be used to flavor water and may be adequate when trying to reduce consumption of sugar-sweetened beverages. Cucumbers, citrus fruit, melon, and berries offer flavor and important nutrients. Fresh or dried herbs in dishes offers flavor without added sodium. Variety is key and simple solutions are often what is needed to reinforce new diet habits to see long term changes to stay healthy.

Items that should be replaced or limited in the diet include soft drinks, sports drinks, and alcohol. In addition, full-fat dairy, red meat, and processed meats are also poor choices. These include hot dogs, high fat deli meat, bacon, or sausage. High fat and high calorie desserts like pie, cake, doughnuts, ice cream, cookies and candy should be consumed less often. Canned soup, stew, frozen meals, dressings or sauces and fast food should be limited because of their high sodium content. In addition, snack foods should be consumed less frequently such as crackers and chips.

Increasing consumption of whole fruits and vegetables, beans, legumes, nuts, seeds, and low-fat dairy products is recommended. Whole grains such as barley, bulgur, brown rice, cereal, farro, whole wheat couscous, quinoa, and whole grain breads are good choices. 100% whole wheat pasta, bread, shredded wheat, bran cereal and steel cut oatmeal are encouraged to replace refined bagels, cereal, bread, crackers, and other non-nutritious carbohydrates.


1. Ashkan Afshin, Patrick John Sur, Kairsten A. Fay, Leslie Cornaby, Giannina Ferrara, Joseph S. Salama, Erin C. Mullany. Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study, 2017. Published by Elsevier Ltd ©2019