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. 2025 Jul 2:12:1617644.
doi: 10.3389/fnut.2025.1617644. eCollection 2025.

Global burden of disease from high-sodium diets, 1990-2021: analysis of GBD 2021 data

Yanwu Nie #  1 , Naibo Wang #  1   2 , Mingzhu Huang #  1 , Yuanzhi Li  1 , Yuanan Lu  1   3 , Hui Li  4 , Lei Wu  1
Affiliations

Global burden of disease from high-sodium diets, 1990-2021: analysis of GBD 2021 data

Yanwu Nie et al. Front Nutr. .

Abstract

Objectives: This study aimed to assess the global, regional, and national burden of disease attributable to high-sodium diets from 1990 to 2021.

Methods: Data on the global high-sodium diet-related disease burden were obtained from the Global Burden of Disease 2021 (GBD2021). A Bayesian age-period-cohort model (BAPC) was used to project trends from 2022 to 2040.

Results: Between 1990 and 2021, both the age-standardized death rate (ASDR) and age-standardized disability-adjusted life years rate (ASYR) attributable to high-sodium diets declined. The burden varied across Social Development Index (SDI) levels, regions, and countries, with Central Europe, East Asia, and Southeast Asia experiencing the highest burden. At the national level across 204 countries, the Republic of Bulgaria recorded the highest ASDR and ASYR, while the Islamic Republic of Pakistan experienced the most rapid increases in both ASDR and ASYR. Additionally, the ASDR and ASYR increased with age and were consistently higher in men than in women. The GBD2021 reported 8 diseases attributed to high-sodium diets, arranged in descending order of disease burden as follows: stroke, Ischemic heart disease, Hypertensive heart disease, Stomach cancer, Chronic kidney disease, Atrial fibrillation and flutter, Aortic aneurysm, Lower extremity peripheral arterial disease. The BAPC prediction results showed that the ASDR and ASYR of high-sodium diets would decrease by 23.28 and 19.46%, respectively, from 2022 to 2040.

Conclusions: The global disease burden due to high-sodium diets has decreased over the past three decades, though disparities remain. Targeted investigations are urgently needed, particularly in high-burden regions, to further reduce the health impacts of excessive sodium intake.

Keywords: GBD2021; cardiovascular diseases; global burden; global trend; high sodium intake.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Six line graphs display trends in ASDR and ASYR per 100,000 from 1990 to 2020, segmented by gender and SDI. Global trends and specific SDI categories are shown. Overall, all graphs indicate a decline over time.
Figure 1
ASDR and ASYR of high-sodium diets at global and different SDI levels, 1990–2021.
Two world maps labeled A and B display different regional data using color gradients. Map A shows data ranging from 6.22 to 103.11 with colors from blue to red. Map B shows data from 124.58 to 1831.63 with a similar gradient. Insets highlight regions such as the Caribbean, Persian Gulf, and Southeast Asia for detailed views.
Figure 2
The distribution of ASDR (A) and ASYR (B) caused by high-sodium diets in 204 countries and territories in 2021.
Two population pyramids show data distribution by age and gender across different Socio-Demographic Index (SDI) regions. Chart A represents numbers ranging from zero to two hundred thousand, while Chart B ranges up to five million. Both graphs illustrate male and female populations in high, high-middle, middle, low-middle, and low SDI regions using a colored gradient from green (males) to red (females). Global gender rates are also charted with solid lines. The x-axis displays age groups from twenty to ninety-five plus years, highlighting population distribution and global rates for each segment.
Figure 3
Age-specific ASDR (A) and ASYR (B) of high-sodium diets in different SDI regions in 2021.
Two panels labeled A and B compare age-standardized death rates (ASDR) and age-standardized years of life lost (ASYR) per 100,000 for 1990 and 2021 across different sociodemographic index (SDI) levels. Each panel contains graphs categorized by age group, showing data for both sexes with distinct symbols for male and female. Panel A displays ASDR, while Panel B shows ASYR. Global, high, high-middle, middle, low-middle, and low SDI data are included. In both years, 2021 shows higher rates across the graphs compared to 1990, with variations among SDI levels.
Figure 4
ASDR (A) and ASYR (B) of high-sodium diets by sex, age group, and social development index, 1990 and 2021.
Two panels, A and B, each with three line graphs representing age-standardized rates per 100,000 population from 1990 to 2040. Panel A shows rates for both, female, and male groups using observed and predicted lines. Panel B presents similar data for a different metric. Lines are differentiated by solid (observed) and dashed (predicted), with predictions extending beyond 2020. Shaded areas indicate prediction confidence intervals.
Figure 5
The BAPC model's prediction of ASDR (A) and ASYR (B) attributable to high-sodium diets by different genders from 2022 to 2040.
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