Suboptimal diets linked to 4 million heart deaths worldwide in 2023

A global study reveals how everyday diet choices, including low intake of whole foods and high sodium consumption, are contributing to millions of heart disease deaths worldwide

What we eat on a daily basis may be affecting our hearts more than we realise, as even small, routine dietary choices can gradually raise blood pressure, cholesterol, and long-term heart disease risk, say researchers. 

A new global study published in Nature Medicine, titled Global, regional and national burden of ischemic heart disease attributable to suboptimal diet, 1990–2023: a Global Burden of Disease study, has found that poor eating habits were responsible for more than 4 million deaths due to ischaemic heart disease in 2023. 

The data collected from 204 countries shows that while death rates per population have fallen over time, the total number of diet-related heart deaths has surged by over 41 per cent since 1990. So what are we eating wrong, and how is it affecting our hearts?

 

What is ischaemic heart disease and why is it dangerous?

According to the US Centers for Disease Control and Prevention (CDC), ischaemic heart disease (IHD), or coronary heart disease, develops when the arteries supplying the heart with blood become constricted because of the buildup of plaque. This results in a reduction in the supply of oxygen to the heart muscle, thereby predisposing the individual to heart attacks and death. 

The study says this remains one of the main causes of death globally, and therefore, the diet-related factors associated with IHD are a matter of concern.

How many deaths are linked to poor diets globally?

The study estimates that 4.06 million deaths in 2023 were directly attributable to suboptimal diets. 

This is an increase of 41.59 per cent in the total number of deaths since 1990, largely because of population growth and ageing factors. The study says that the silver lining is that the age-standardised death rate has fallen by nearly 44 per cent.  READ | Long-term study shows men develop heart disease much earlier than women

What does a ‘suboptimal diet’ actually mean?

A suboptimal diet refers to eating patterns that lack protective foods or include excessive harmful ones. According to the study, it includes:

• Low intake of nutrient-rich foods
• High consumption of unhealthy components like salt or processed foods

The researchers stress that it is not just about junk food, it is also about missing out on the right foods.

Which foods are most strongly linked to heart disease deaths?

The study identifies four major dietary risk factors driving IHD deaths globally:

• Low intake of nuts and seeds (the highest contributor)
• Low whole grain consumption
• Low fruit intake
• High sodium (salt) intake

Which regions are most affected by diet-related heart disease?

According to the researchers, low- and middle-income countries face a higher burden due to a lack of protective foods like fruits, nuts, and whole grains. 

It found that high-income countries show more risk from excess harmful foods, such as processed meats and sugary beverages. 

While most regions have seen a decline in diet-related IHD burden over time, the study flags worrying trends in:

• South Asia
• Southeast Asia
• Sub-Saharan Africa
• Oceania

The study authors have highlighted that these regions have not experienced the same level of improvement, hence targeted nutrition interventions are urgently needed.

Who is at the highest risk of diet-related heart disease?

The study found that age plays a critical role, and individuals aged 65 and above show significantly higher death rates, while those aged 45 and under have comparatively lower risk, but are not immune. 

What can be done to reduce diet-related heart disease risk?

The study emphasises that a large portion of IHD burden is modifiable through dietary changes. These include:

• Increase intake of nuts, seeds, fruits, and whole grains
• Reduce salt consumption
• Limit processed and sugary foods

The study emphasises that public health policies, food system reforms, and individual choices all play a role in reversing this trend. The study authors stress that improving what we eat could prevent millions of deaths globally.