Poster Topical Area: Global Nutrition

Location: Hall D

Poster Board Number: 605

P12-125 - Impact of Diet Quality on Cardiometabolic Disease: Application of the Global Dietary Index (GDI)

Monday, Jun 11
8:00 AM – 3:00 PM

Objective: Diet quality has large effects on population health, but benefits or harms from any individual risk factor may be affected by exposure to other risks. This study introduces a novel Global Dietary Index (GDI) to account for differences in competing risks, measuring overall diet quality impacts on DALYs lost in 2010 by age and sex across 186 countries.


Methods:
GDI measures the impact of overall diet quality on DALYs lost as the weighted sum of each risk factor for the population of interest. GDIs were calculated using the formula in Fig. 1, based on intake of 8 dietary factors from the Global Dietary Database, weighted by that factor's relative risk for 1 of 4 cardiometabolic diseases from systematic reviews, and by that disease's attributable fraction of DALYs lost from the Global Burden of Disease database. GDIprotective measures risk reduction from 5 beneficial factors (fruits, vegetables, nuts, whole grains, PUFAs substituting carbohydrates, and PUFAs substituting saturated fat). GDIharmful measures risk increase from 3 harmful factors (processed meat, red meat, and saturated fat). Outcomes are ischemic heart disease and stroke, hemorrhagic stroke, and diabetes. GDI values are measured in log points of relative risk for loss of DALYs.


Results:
GDIprotective varied from 102.35 to 3.56, GDIharmful ranged from -0.47 to -34.78. East and Southeast Asian countries had the most protection from beneficial foods (GDIprotective = 33.97±17.19) while South Asian countries had the least risk from harmful foods (GDIharmful = - 2.70±1.50). Canada and the U.S. had the least protection and also the greatest harms (GDIprotective = 20.56±7.44, GDIharmful = -13.48±6.54). Higher national income is associated with significantly less protection from beneficial foods and more DALYs lost from harmful foods (GDIprotective: F= 3.48, p= 0.015; GDIharmful: F= 75.65, p< 0.001). Higher age is significantly associated with a smaller magnitude of both effects (p


Conclusion:
Health effects of dietary intake are modified by competing risks in systematic ways. Diet quality impacts on DALYs rise with national income and decline with age, with significant differences by country and region. Measuring overall diet quality can help tailor interventions to the dietary needs of each population.



Funding Source: Bill & Melinda Gates Foundation (OPP1099505)
NHLBI (R00HL124321)
Figure

CoAuthors: William Masters, PhD – Tufts University; Dariush Mozaffarian, MD, DrPh – Tufts University; Elena Naumova, PhD – Tufts University; Gitanjali Singh, PhD, MPH – Tufts University

Jifan Wang

Graduate Student
Friedman School of Nutrition Science and Policy, Tufts University
Malden, Massachusetts