Background Diet is an important risk factor for cancer that is amenable to intervention. Estimating the cancer burden associated with diet informs evidence-based priorities for nutrition policies to reduce cancer burden in the United States. Methods Using a comparative risk assessment model that incorporated nationally representative data on dietary intake, national cancer incidence, and estimated associations of diet with cancer risk from meta-analyses of prospective cohort studies, we estimated the annual number and proportion of new cancer cases attributable to suboptimal intakes of seven dietary factors among US adults ages 20 years or older, and by population subgroups. Results An estimated 80 110 (95% uncertainty interval [UI] = 76 316 to 83 657) new cancer cases were attributable to suboptimal diet, accounting for 5.2% (95% UI = 5.0% to 5.5%) of all new cancer cases in 2015. Of these, 67 488 (95% UI = 63 583 to 70 978) and 4.4% (95% UI = 4.2% to 4.6%) were attributable to direct associations and 12 589 (95% UI = 12 156 to 13 038) and 0.82% (95% UI = 0.79% to 0.85%) to obesity-mediated associations. By cancer type, colorectal cancer had the highest number and proportion of diet-related cases (n = 52 225, 38.3%). By diet, low consumption of whole grains (n = 27 763, 1.8%) and dairy products (n = 17 692, 1.2%) and high intake of processed meats (n = 14 524, 1.0%) contributed to the highest burden. Men, middle-aged (45–64 years) and racial/ethnic minorities (non-Hispanic blacks, Hispanics, and others) had the highest proportion of diet-associated cancer burden than other age, sex, and race/ethnicity groups. Conclusions More than 80 000 new cancer cases are estimated to be associated with suboptimal diet among US adults in 2015, with middle-aged men and racial/ethnic minorities experiencing the largest proportion of diet-associated cancer burden in the United States.

BackgroundFiscal interventions are promising strategies to improve diets, reduce cardiovascular disease and diabetes (cardiometabolic diseases; CMD), and address health disparities. The aim of this study is to estimate the impact of specific dietary taxes and subsidies on CMD deaths and disparities in the US.MethodsUsing nationally representative data, we used a comparative risk assessment to model the potential effects on total CMD deaths and disparities of price subsidies (10%, 30%) on fruits, vegetables, whole grains, and nuts/seeds and taxes (10%, 30%) on processed meat, unprocessed red meats, and sugar-sweetened beverages. We modeled two gradients of price-responsiveness by education, an indicator of socioeconomic status (SES), based on global price elasticities (18% greater price-responsiveness in low vs. high SES) and recent national experiences with taxes on sugar-sweetened beverages (65% greater price-responsiveness in low vs. high SES).ResultsEach price intervention would reduce CMD deaths. Overall, the largest proportional reductions were seen in stroke, followed by diabetes and coronary heart disease. Jointly altering prices of all seven dietary factors (10% each, with 18% greater price-responsiveness by SES) would prevent 23,174 (95% UI 22,024–24,595) CMD deaths/year, corresponding to 3.1% (95% UI 2.9–3.4) of CMD deaths among Americans with a lower than high school education, 3.6% (95% UI 3.3–3.8) among high school graduates/some college, and 2.9% (95% UI 2.7–3.5) among college graduates. Applying a 30% price change and larger price-responsiveness (65%) in low SES, the corresponding reductions were 10.9% (95% UI 9.2–10.8), 9.8% (95% UI 9.1–10.4), and 6.7% (95% UI 6.2–7.6). The latter scenario would reduce disparities in CMD between Americans with lower than high school versus a college education by 3.5 (95% UI 2.3–4.5) percentage points.ConclusionsModest taxes and subsidies for key dietary factors could meaningfully reduce CMD and improve US disparities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0971-9) contains supplementary material, which is available to authorized users.

Objective: To quantify diet-related burdens of cardiometabolic diseases (CMD) by country, age and sex in Latin America and the Caribbean (LAC). Design: Intakes of eleven key dietary factors were obtained from the Global Dietary Database Consortium. Aetiologic effects of dietary factors on CMD outcomes were obtained from meta-analyses. We combined these inputs with cause-specific mortality data to compute country-, age- and sex-specific absolute and proportional CMD mortality of eleven dietary factors in 1990 and 2010. Setting: Thirty-two countries in LAC. Participants: Adults aged 25 years and older. Results: In 2010, an estimated 513 371 (95 % uncertainty interval (UI) 423 286–547 841; 53·8 %) cardiometabolic deaths were related to suboptimal diet. Largest diet-related CMD burdens were related to low intake of nuts/seeds (109 831 deaths (95 % UI 71 920–121 079); 11·5 %), low fruit intake (106 285 deaths (95 % UI 94 904–112 320); 11·1 %) and high processed meat consumption (89 381 deaths (95 % UI 82 984–97 196); 9·4 %). Among countries, highest CMD burdens (deaths per million adults) attributable to diet were in Trinidad and Tobago (1779) and Guyana (1700) and the lowest were in Peru (492) and The Bahamas (504). Between 1990 and 2010, greatest decline (35 %) in diet-attributable CMD mortality was related to greater consumption of fruit, while greatest increase (7·2 %) was related to increased intakes of sugar-sweetened beverages. Conclusions: Suboptimal intakes of commonly consumed foods were associated with substantial CMD mortality in LAC with significant heterogeneity across countries. Improved access to healthful foods, such as nuts and fruits, and limits in availability of unhealthful factors, such as processed foods, would reduce diet-related burdens of CMD in LAC.

ObjectivesOver the past 10 years, the burden of chronic diseases in Korea has increased. However, there are currently no quantitative estimates of how changes in diet and metabolic factors have contributed to these shifting burdens. This study aims to evaluate the contributions of dietary and metabolic risk factors to death from cardiometabolic diseases (CMDs) such as cardiovascular conditions, strokes and diabetes in Korea, and to estimate how these contributions have changed over the past 10 years (1998–2011).Design and methodsWe used data on 6 dietary and 4 metabolic risk factors by sex, age and year from the Korea National Health and Nutrition Examination Survey. The relative risks for the effects of the risk factors on CMD mortality were obtained from meta-analyses. The population-attributable fraction attributable to the risk factors was calculated by using a comparative risk assessment approach across sex and age strata (males and females, age groups 25–34, 35–44, 45–54, 55–64, 65–74 and 75+ years) from 1998 to 2011.ResultsThe results showed that a suboptimal diet and high blood pressure were the main risk factors for CMD mortality in Korea. High blood pressure accounted for 127 096 (95% uncertainty interval (UI): 121 907 to 132 218) deaths from CMD. Among the individual dietary risk factors, a high intake of sodium (42 387 deaths; 95% UI: 42 387 to 65 094) and a low intake of fruit (50 244 deaths; 95% UI: 40 981 to 59 178) and whole grains (54 248 deaths; 95% UI: 47 020 to 61 343) were responsible for the highest number of CMD deaths in Korea.ConclusionsIndicating the relative importance of risk factors in Korea, the results suggest that metabolic and dietary risk factors were major contributors to CMD mortality.