Poor diet kills more than 500,000 Americans a year and more than 90,000 Brits - eclipsing smoking and hypertension as risk factors for premature death, a staggering new study reveals.
Experts warn the so-called 'Western diet' - heavy in red meat, fats and sugar, and low in fruit and veg - was responsible for one in five deaths globally (10.9 million adults) in 2017, the latest data we have.
The largest number of deaths is recorded in China and India, with millions of diet-related deaths per year (over 3 million and 1 million respectively), then Russia with 550,000.
The US follows with the fourth-highest rate of deaths from diet. The UK has the 18th-highest rate in the world.
Experts say the alarming figures should be a stark reminder of the health risks of overloading on red meat and soda without getting enough greens in.
'Poor diet is an equal opportunity killer,' lead author Dr Ashkan Afshin, an Assistant Professor at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, said.
'We are what we eat and risks affect people across a range of demographics - including age, gender and economic status.'
Cardiovascular disease - such as strokes and heart attacks - was the biggest contributor followed by cancers and type 2 diabetes.
They all fall under the umbrella of non-communicable diseases (NCDs), and they now account for nearly three-quarters of deaths - with a large proportion happening unnecessarily early.
Experts blame a drop in the global consumption of foods such as nuts, seeds, milk and whole grains and increases in processed meat, salt and soda.
Co-author Dr Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, said: 'This study affirms what many have thought for several years – that poor diet is responsible for more deaths than any other risk factor in the world.
'While sodium, sugar and fat have been the focus of policy debates over the past two decades, our assessment suggests the leading dietary risk factors are high intake of sodium, or low intake of healthy foods, such as whole grains, fruit, nuts and seeds, and vegetables.
'The paper also highlights the need for comprehensive interventions to promote the production, distribution and consumption of healthy foods across all nations.'
Dr Afshin, who wrote a global paper on obesity in 2017, said the latest study shows too much fat, sugar and salt causes chronic health problems irrespective of their effect on a person's weight.
More than 130 scientists from nearly 40 countries contributed in the most comprehensive analysis of its kind.
In comparison, tobacco was associated with 8 million deaths, and high blood pressure was linked to 10.4 million deaths.
Diet was behind 9,497,300 deaths from cardiovascular disease, 913,100 from cancer 338,700 from diabetes and 136,600 from kidney diseases.
The study, published in The Lancet, also found low intake of whole grains and fruits and high consumption of salt accounted for more than half.
The others were attributed to high consumption of red and processed meats, sugar-sweetened beverages and trans fatty acids found in packaged foods such as cakes, cookies and spreads.
Dr Afshin said: 'We are highlighting the importance of low consumption of healthy foods as compared to the greater consumption of unhealthy foods.
Dietary policies focusing on promoting healthy eating can have a more beneficial effect than policies advocating against unhealthy foods.'
The largest gaps between current and optimal diets were observed for nuts and seeds, milk, and whole grains. Some of those gaps result from food producers and manufacturers.
Dr Afshin said: 'There is an urgent and compelling need for changes in the various sectors of the food production cycle, such as growing, processing, packaging, and marketing.
'Our research finds the need for a comprehensive food system intervention to promote the production, distribution, and consumption of healthy foods across nations.'
Co-author Dr Walter Willett, of Harvard University, said the findings are consistent with a recent summary of randomized trials.
These documented the benefits on risk factors for cardiovascular disease by replacing red meat with plant sources of protein such as fruit and vegetables.
He said: 'Thus, adoption of diets emphasizing soy foods, beans and other healthy plant sources of protein will have important benefits for both human and planetary health.'
Salt, sugar and fat have been the focus of diet policy debate in recent years. But the study shows the leading risk factors to health are diets high in salt and low in whole grains, fruit, nuts, seeds and vegetables. Each accounts for over 2 percent of all deaths.
On average, the global population only ate 12 percent of the recommended amount of nuts and seeds - around 3g average intake per day, compared with 21g recommended per day.
Meanwhile, the consumption of soda rocketed to 10 times the recommended amount of sugar sweetened beverages - 49g instead of 3g.
The global diet included 16 percent of the recommended amount of milk (71g average intake per day, compared with 435g) and about a quarter (23 percent) of the recommended amount of whole grains (29g compared with 125g).
We also consumed almost double the processed meat (4g compared with 2g) and salt - around 6g compared with 3g).
In 2017, there was a 10-fold difference between the country with the highest rate of diet-related deaths Uzbekistan and the lowest Israel - 892 per 100,000 people and 89.
The study funded by the Bill & Melinda Gates Foundation found the US had 171 deaths per 100,000 compared to 127 in the UK.
The magnitude of diet-related disease highlights that many existing campaigns have not been effective and the authors call for new food system interventions to rebalance diets around the world, said the researchers.
Dr Nita Forouhi, of the Medical Research Council Epidemiology Unit at Cambridge University, who was not involved in the study, said it provides evidence to shift the focus from an emphasis on dietary restriction to promoting healthy food components in a global context.
She added: 'This evidence largely endorses a case for moving from nutrient-based to food based guidelines.
'There are of course considerable challenges in shifting populations' diets in this direction, illustrated by the cost of fruits and vegetables being disproportionately prohibitive.
'Two servings of fruits and three servings of vegetables per day per individual accounted for 52 percent of household income in low-income countries, 18 percent in low to middle-income countries, 16 percent in middle to upper-income countries, and 2 percent in high-income countries.
'A menu of integrated policy interventions across whole food systems, internationally and within countries, is essential to support the radical shift in diets needed to optimize human, and protect planetary health.'
Source: The Daily Mail