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. 2016 Dec 16;13(1):122.
doi: 10.1186/s12966-016-0447-x.

The impact of dietary risk factors on the burden of non-communicable diseases in Ethiopia: findings from the Global Burden of Disease study 2013

Yohannes Adama Melaku  1   2 , Awoke Misganaw Temesgen  3 , Amare Deribew  4   5   6 , Gizachew Assefa Tessema  7   8 , Kebede Deribe  9   10   11 , Berhe W Sahle  12   13 , Semaw Ferede Abera  12   14 , Tolesa Bekele  15 , Ferew Lemma  11 , Azmeraw T Amare  16   17   18 , Oumer Seid  12 , Kedir Endris  12 , Abiy Hiruye  11 , Amare Worku  19 , Robert Adams  20 , Anne W Taylor  21 , Tiffany K Gill  21 , Zumin Shi  21 , Ashkan Afshin  3 , Mohammad H Forouzanfar  3
Affiliations

The impact of dietary risk factors on the burden of non-communicable diseases in Ethiopia: findings from the Global Burden of Disease study 2013

Yohannes Adama Melaku et al. Int J Behav Nutr Phys Act. .

Abstract

Background: The burden of non-communicable diseases (NCDs) has increased in sub-Saharan countries, including Ethiopia. The contribution of dietary behaviours to the NCD burden in Ethiopia has not been evaluated. This study, therefore, aimed to assess diet-related burden of disease in Ethiopia between 1990 and 2013.

Method: We used the 2013 Global Burden of Disease (GBD) data to estimate deaths, years of life lost (YLLs) and disability-adjusted life years (DALYs) related to eight food types, five nutrients and fibre intake. Dietary exposure was estimated using a Bayesian hierarchical meta-regression. The effect size of each diet-disease pair was obtained based on meta-analyses of prospective observational studies and randomized controlled trials. A comparative risk assessment approach was used to quantify the proportion of NCD burden associated with dietary risk factors.

Results: In 2013, dietary factors were responsible for 60,402 deaths (95% Uncertainty Interval [UI]: 44,943-74,898) in Ethiopia-almost a quarter (23.0%) of all NCD deaths. Nearly nine in every ten diet-related deaths (88.0%) were from cardiovascular diseases (CVD) and 44.0% of all CVD deaths were related to poor diet. Suboptimal diet accounted for 1,353,407 DALYs (95% UI: 1,010,433-1,672,828) and 1,291,703 YLLs (95% UI: 961,915-1,599,985). Low intake of fruits and vegetables and high intake of sodium were the most important dietary factors. The proportion of NCD deaths associated with low fruit consumption slightly increased (11.3% in 1990 and 11.9% in 2013). In these years, the rate of burden of disease related to poor diet slightly decreased; however, their contribution to NCDs remained stable.

Conclusions: Dietary behaviour contributes significantly to the NCD burden in Ethiopia. Intakes of diet low in fruits and vegetables and high in sodium are the leading dietary risks. To effectively mitigate the oncoming NCD burden in Ethiopia, multisectoral interventions are required; and nutrition policies and dietary guidelines should be developed.

Keywords: Burden of disease; Dietary risks; Ethiopia; Non-communicable diseases.

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Figures

Fig. 1
Fig. 1
Diet-related burden of disease (deaths, disability-adjusted life years (DALYs) and years of life lost (YLLs)) and the proportion of contribution to the burden of all causes and non-communicable diseases (NCDs) by age and sex in Ethiopia for 2013
Fig. 2
Fig. 2
Age-standardized burden of disease (deaths, disability-adjusted life years (DALYs) and year of life lost (YLLs)) related to specific dietary risks and the proportion of contribution to the burden of all causes and non-communicable diseases (NCDs) for 1990 and 2013 in Ethiopia (The sum of percentages exceeds the total for all dietary risk factors combined because of overlaps between various risk factors.)
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