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Prioritizing Preventable Causes of US Deaths
Modifiable risk factors responsible for many
premature or preventable deaths fall into three main categories:
Lifestyle factors such as smoking and physical inactivity; Dietary
risk factors such as a high salt intake and a low intake of fruits
and vegetables; And "metabolic" risk factors, such as obesity
and hypertension, which shorten life expectancy by increasing
the odds of developing CVD and diabetes.
With health care costs skyrocketing, it's
important to know how many deaths are caused by each risk factor
before developing policies and programs to improve the nation's
health. Although previous studies have provided some information,
they have not used consistent and comparable methods to estimate
the number of deaths attributable to different risk factors. In
addition, previous studies have rarely considered dietary and
metabolic risk factors.
In a new study, jointly funded by the CDC
and the Association of Schools of Public Health, Harvard researchers
estimated the number of deaths due to 12 different modifiable
Study Methods and Findings
The researchers used a method called "comparative
risk assessment." They retrieved data on exposures to the 12 selected
risk factors from US national health surveys, and obtained information
on deaths from different diseases from the US National Health
Center for Health Statistics. They also used previously published
studies to estimate how much each risk factor increased the risk
from a disease, and applied a mathematical model to estimate the
number of deaths related to each factor.
Smoking and high blood pressure, which both
have effective interventions, are responsible for the largest
number of preventable deaths, followed by obesity, physical inactivity
and high salt intake. Notably, 84,000 deaths were attributable
to insufficient omega-3
intake, slightly higher than high trans fatty acid intake (82,000).
Though the study focused upon the most common
causes of death such as cancer, heart disease and respiratory
diseases, the findings that inadequate consumption of omega-3,
and fruits and vegetables are important risk factors may be notable
for visual health as well. EPA
(from fish), as well as lutein
(from produce), have been strongly linked to the risk of AMD and,
possibly, other ocular conditions. The typical intake of EPA
for example is 100-200 mg daily, while the AREDS-2 trial is testing
1,000 mg. In addition, 10 mg of lutein
and 2 mg of zeaxanthin
are being employed in AREDS-2, while the average daily consumption
of these carotenoids is 2 mg.
Danaei G, et al. The Preventable Causes of Death
in the United States: Comparative Risk Assessment of Dietary,
Lifestyle, and Metabolic Risk Factors. PLoS Med 6(4): e1000058.
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