The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis
Identifieur interne : 000276 ( Main/Exploration ); précédent : 000275; suivant : 000277The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis
Auteurs : Ashkan Afshin [États-Unis] ; Renata Micha [États-Unis, Grèce] ; Shahab Khatibzadeh [États-Unis] ; Saman Fahimi [États-Unis, Iran] ; Peilin Shi [États-Unis] ; John Powles [Royaume-Uni] ; Gitanjali Singh [États-Unis] ; Mohammad Yawar Yakoob [États-Unis] ; Morteza Abdollahi [Iran] ; Suad Al-Hooti [Koweït] ; Farshad Farzadfar [Iran] ; Anahita Houshiar-Rad [Iran] ; Nahla Hwalla [Liban] ; Eda Koksal [Turquie] ; Abdulrahman Musaiger [Bahreïn] ; Gulden Pekcan [Turquie] ; Abla Mehio Sibai [Liban] ; Sahar Zaghloul [Égypte] ; Goodarz Danaei [États-Unis] ; Majid Ezzati [Royaume-Uni] ; Dariush Mozaffarian [États-Unis]Source :
- BMJ Open [ 2044-6055 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Afrique du Nord (épidémiologie), Appréciation des risques (MeSH), Cause de décès (MeSH), Comparaison interculturelle (MeSH), Comportement alimentaire (MeSH), Diabète (mortalité), Facteurs de risque (MeSH), Femelle (MeSH), Glycémie (métabolisme), Humains (MeSH), Indice de masse corporelle (MeSH), Jeune adulte (MeSH), Maladies cardiovasculaires (mortalité), Moyen Orient (épidémiologie), Mâle (MeSH), Pression sanguine (MeSH), Régime alimentaire (MeSH), Santé mondiale (MeSH), Sujet âgé (MeSH), Théorème de Bayes (MeSH).
- MESH :
- mortalité : Diabète, Maladies cardiovasculaires.
- métabolisme : Glycémie.
- épidémiologie : Afrique du Nord, Moyen Orient.
- Adulte, Adulte d'âge moyen, Appréciation des risques, Cause de décès, Comparaison interculturelle, Comportement alimentaire, Facteurs de risque, Femelle, Humains, Indice de masse corporelle, Jeune adulte, Mâle, Pression sanguine, Régime alimentaire, Santé mondiale, Sujet âgé, Théorème de Bayes.
English descriptors
- KwdEn :
- Adult (MeSH), Africa, Northern (epidemiology), Aged (MeSH), Bayes Theorem (MeSH), Blood Glucose (metabolism), Blood Pressure (MeSH), Body Mass Index (MeSH), Cardiovascular Diseases (mortality), Cause of Death (MeSH), Cross-Cultural Comparison (MeSH), Diabetes Mellitus (mortality), Diet (MeSH), Feeding Behavior (MeSH), Female (MeSH), Global Health (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Middle East (epidemiology), Risk Assessment (MeSH), Risk Factors (MeSH), Young Adult (MeSH).
- MESH :
- chemical , metabolism : Blood Glucose.
- epidemiology : Africa, Northern, Middle East.
- mortality : Cardiovascular Diseases, Diabetes Mellitus.
- Adult, Aged, Bayes Theorem, Blood Pressure, Body Mass Index, Cause of Death, Cross-Cultural Comparison, Diet, Feeding Behavior, Female, Global Health, Humans, Male, Middle Aged, Risk Assessment, Risk Factors, Young Adult.
Abstract
We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality was obtained from clinical trials and observational studies. The number of disease-specific deaths was obtained from the 2010 Global Burden of Disease mortality database. Mortality due to each risk factor was determined using the population attributable fraction and total number of disease-specific deaths.
Adult population in the Middle East by age, sex, country and time.
Suboptimal diet was the leading risk factor for CMD mortality in 11 countries accounting for 48% (in Morocco) to 72% (in the United Arab Emirates) of CMD deaths. Non-optimal systolic blood pressure was the leading risk factor for CMD deaths in eight countries causing 45% (in Bahrain) to 68% (in Libya) of CMD deaths. Non-optimal body mass index and fasting plasma glucose were the third and fourth leading risk factors for CMD mortality in most countries. Among individual dietary factors, low intake of fruits accounted for 8% (in Jordan) to 21% (in Palestine) of CMD deaths and low intake of whole grains was responsible for 7% (in Palestine) to 22% (in the United Arab Emirates) of CMD deaths. Between 1990 and 2010, the CMD mortality attributable to most risk factors had decreased except for body mass index and trans-fatty acids.
Our findings highlight key similarities and differences in the impact of the dietary and metabolic risk factors on CMD mortality in the countries of the Middle East and inform priorities for policy measures to prevent CMD.
Url:
DOI: 10.1136/bmjopen-2014-006385
PubMed: 25995236
PubMed Central: 4442236
Affiliations:
- Bahreïn, Grèce, Iran, Koweït, Liban, Royaume-Uni, Turquie, Égypte, États-Unis
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xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Yakoob, Mohammad Yawar" sort="Yakoob, Mohammad Yawar" uniqKey="Yakoob M" first="Mohammad Yawar" last="Yakoob">Mohammad Yawar Yakoob</name><affiliation wicri:level="1"><nlm:aff id="af6"><institution>Johns Hopkins University</institution>,<addr-line>Baltimore, Maryland</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Abdollahi, Morteza" sort="Abdollahi, Morteza" uniqKey="Abdollahi M" first="Morteza" last="Abdollahi">Morteza Abdollahi</name><affiliation wicri:level="1"><nlm:aff id="af7"><institution>National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences</institution>,<addr-line>Tehran</addr-line>,<country>Iran</country></nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Al Hooti, Suad" sort="Al Hooti, Suad" uniqKey="Al Hooti S" first="Suad" last="Al-Hooti">Suad Al-Hooti</name><affiliation wicri:level="1"><nlm:aff id="af8"><institution>Kuwait Institute for Scientific Research</institution>,<addr-line>Kuwait</addr-line>,<country>Kuwait</country></nlm:aff><country xml:lang="fr">Koweït</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Farzadfar, Farshad" sort="Farzadfar, Farshad" uniqKey="Farzadfar F" first="Farshad" last="Farzadfar">Farshad Farzadfar</name><affiliation wicri:level="1"><nlm:aff id="af9"><institution>Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences</institution>,<addr-line>Tehran</addr-line>,<country>Iran</country></nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Houshiar Rad, Anahita" sort="Houshiar Rad, Anahita" uniqKey="Houshiar Rad A" first="Anahita" last="Houshiar-Rad">Anahita Houshiar-Rad</name><affiliation wicri:level="1"><nlm:aff id="af7"><institution>National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences</institution>,<addr-line>Tehran</addr-line>,<country>Iran</country></nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hwalla, Nahla" sort="Hwalla, Nahla" uniqKey="Hwalla N" first="Nahla" last="Hwalla">Nahla Hwalla</name><affiliation wicri:level="1"><nlm:aff id="af10"><addr-line>Faculty of Agricultural & Food Sciences</addr-line>,<institution>American University of Beirut</institution>,<addr-line>Beirut</addr-line>,<country>Lebanon</country></nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Koksal, Eda" sort="Koksal, Eda" uniqKey="Koksal E" first="Eda" last="Koksal">Eda Koksal</name><affiliation wicri:level="1"><nlm:aff id="af11">Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara</wicri:regionArea></affiliation></author><author><name sortKey="Musaiger, Abdulrahman" sort="Musaiger, Abdulrahman" uniqKey="Musaiger A" first="Abdulrahman" last="Musaiger">Abdulrahman Musaiger</name><affiliation wicri:level="1"><nlm:aff id="af12"><institution>Arab Center for Nutrition</institution>,<addr-line>Manama</addr-line>,<country>Bahrain</country></nlm:aff><country xml:lang="fr">Bahreïn</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Pekcan, Gulden" sort="Pekcan, Gulden" uniqKey="Pekcan G" first="Gulden" last="Pekcan">Gulden Pekcan</name><affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Department of Nutrition and Dietetics</addr-line>,<institution>Hacettepe University</institution>,<addr-line>Ankara</addr-line>,<country>Turkey</country></nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sibai, Abla Mehio" sort="Sibai, Abla Mehio" uniqKey="Sibai A" first="Abla Mehio" last="Sibai">Abla Mehio Sibai</name><affiliation wicri:level="1"><nlm:aff id="af10"><addr-line>Faculty of Agricultural & Food Sciences</addr-line>,<institution>American University of Beirut</institution>,<addr-line>Beirut</addr-line>,<country>Lebanon</country></nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Zaghloul, Sahar" sort="Zaghloul, Sahar" uniqKey="Zaghloul S" first="Sahar" last="Zaghloul">Sahar Zaghloul</name><affiliation wicri:level="1"><nlm:aff id="af14"><addr-line>Department of Nutrition Requirements and Growth</addr-line>,<institution>National Nutrition Institute</institution>,<addr-line>Cairo</addr-line>,<country>Egypt</country></nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Danaei, Goodarz" sort="Danaei, Goodarz" uniqKey="Danaei G" first="Goodarz" last="Danaei">Goodarz Danaei</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Global Health and Population</addr-line>,<institution>Harvard T.H. Chan School of Public Health</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af15"><addr-line>Department of Epidemiology</addr-line>,<institution>Harvard T.H. Chan School of Public Health</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ezzati, Majid" sort="Ezzati, Majid" uniqKey="Ezzati M" first="Majid" last="Ezzati">Majid Ezzati</name><affiliation wicri:level="1"><nlm:aff id="af16"><addr-line>Department of Epidemiology and Biostatistics</addr-line>,<institution>School of Public Health, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Mozaffarian, Dariush" sort="Mozaffarian, Dariush" uniqKey="Mozaffarian D" first="Dariush" last="Mozaffarian">Dariush Mozaffarian</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Friedman School of Nutrition Science & Policy, Tufts University</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25995236</idno><idno type="pmc">4442236</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442236</idno><idno type="RBID">PMC:4442236</idno><idno type="doi">10.1136/bmjopen-2014-006385</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000159</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000159</idno><idno type="wicri:Area/Pmc/Curation">000159</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000159</idno><idno type="wicri:Area/Pmc/Checkpoint">000234</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000234</idno><idno type="wicri:source">PubMed</idno><idno type="RBID">pubmed:25995236</idno><idno type="wicri:Area/PubMed/Corpus">000539</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000539</idno><idno type="wicri:Area/PubMed/Curation">000537</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000537</idno><idno type="wicri:Area/PubMed/Checkpoint">000521</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000521</idno><idno type="wicri:Area/Main/Merge">000276</idno><idno type="wicri:Area/Main/Curation">000276</idno><idno type="wicri:Area/Main/Exploration">000276</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis</title><author><name sortKey="Afshin, Ashkan" sort="Afshin, Ashkan" uniqKey="Afshin A" first="Ashkan" last="Afshin">Ashkan Afshin</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Friedman School of Nutrition Science & Policy, Tufts University</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Micha, Renata" sort="Micha, Renata" uniqKey="Micha R" first="Renata" last="Micha">Renata Micha</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Friedman School of Nutrition Science & Policy, Tufts University</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Food Science and Human Nutrition</addr-line>,<institution>Agricultural University of Athens</institution>,<addr-line>Athens</addr-line>,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Khatibzadeh, Shahab" sort="Khatibzadeh, Shahab" uniqKey="Khatibzadeh S" first="Shahab" last="Khatibzadeh">Shahab Khatibzadeh</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Global Health and Population</addr-line>,<institution>Harvard T.H. Chan School of Public Health</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Fahimi, Saman" sort="Fahimi, Saman" uniqKey="Fahimi S" first="Saman" last="Fahimi">Saman Fahimi</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Global Health and Population</addr-line>,<institution>Harvard T.H. Chan School of Public Health</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af4">Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran</nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea>Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran</wicri:regionArea></affiliation></author><author><name sortKey="Shi, Peilin" sort="Shi, Peilin" uniqKey="Shi P" first="Peilin" last="Shi">Peilin Shi</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Friedman School of Nutrition Science & Policy, Tufts University</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Powles, John" sort="Powles, John" uniqKey="Powles J" first="John" last="Powles">John Powles</name><affiliation wicri:level="1"><nlm:aff id="af5"><addr-line>Department of Public Health and Primary Care</addr-line>,<institution>Cambridge Institute of Public Health</institution>,<addr-line>Cambridge</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Singh, Gitanjali" sort="Singh, Gitanjali" uniqKey="Singh G" first="Gitanjali" last="Singh">Gitanjali Singh</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Friedman School of Nutrition Science & Policy, Tufts University</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Yakoob, Mohammad Yawar" sort="Yakoob, Mohammad Yawar" uniqKey="Yakoob M" first="Mohammad Yawar" last="Yakoob">Mohammad Yawar Yakoob</name><affiliation wicri:level="1"><nlm:aff id="af6"><institution>Johns Hopkins University</institution>,<addr-line>Baltimore, Maryland</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Abdollahi, Morteza" sort="Abdollahi, Morteza" uniqKey="Abdollahi M" first="Morteza" last="Abdollahi">Morteza Abdollahi</name><affiliation wicri:level="1"><nlm:aff id="af7"><institution>National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences</institution>,<addr-line>Tehran</addr-line>,<country>Iran</country></nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Al Hooti, Suad" sort="Al Hooti, Suad" uniqKey="Al Hooti S" first="Suad" last="Al-Hooti">Suad Al-Hooti</name><affiliation wicri:level="1"><nlm:aff id="af8"><institution>Kuwait Institute for Scientific Research</institution>,<addr-line>Kuwait</addr-line>,<country>Kuwait</country></nlm:aff><country xml:lang="fr">Koweït</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Farzadfar, Farshad" sort="Farzadfar, Farshad" uniqKey="Farzadfar F" first="Farshad" last="Farzadfar">Farshad Farzadfar</name><affiliation wicri:level="1"><nlm:aff id="af9"><institution>Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences</institution>,<addr-line>Tehran</addr-line>,<country>Iran</country></nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Houshiar Rad, Anahita" sort="Houshiar Rad, Anahita" uniqKey="Houshiar Rad A" first="Anahita" last="Houshiar-Rad">Anahita Houshiar-Rad</name><affiliation wicri:level="1"><nlm:aff id="af7"><institution>National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences</institution>,<addr-line>Tehran</addr-line>,<country>Iran</country></nlm:aff><country xml:lang="fr">Iran</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hwalla, Nahla" sort="Hwalla, Nahla" uniqKey="Hwalla N" first="Nahla" last="Hwalla">Nahla Hwalla</name><affiliation wicri:level="1"><nlm:aff id="af10"><addr-line>Faculty of Agricultural & Food Sciences</addr-line>,<institution>American University of Beirut</institution>,<addr-line>Beirut</addr-line>,<country>Lebanon</country></nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Koksal, Eda" sort="Koksal, Eda" uniqKey="Koksal E" first="Eda" last="Koksal">Eda Koksal</name><affiliation wicri:level="1"><nlm:aff id="af11">Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara</wicri:regionArea></affiliation></author><author><name sortKey="Musaiger, Abdulrahman" sort="Musaiger, Abdulrahman" uniqKey="Musaiger A" first="Abdulrahman" last="Musaiger">Abdulrahman Musaiger</name><affiliation wicri:level="1"><nlm:aff id="af12"><institution>Arab Center for Nutrition</institution>,<addr-line>Manama</addr-line>,<country>Bahrain</country></nlm:aff><country xml:lang="fr">Bahreïn</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Pekcan, Gulden" sort="Pekcan, Gulden" uniqKey="Pekcan G" first="Gulden" last="Pekcan">Gulden Pekcan</name><affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Department of Nutrition and Dietetics</addr-line>,<institution>Hacettepe University</institution>,<addr-line>Ankara</addr-line>,<country>Turkey</country></nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sibai, Abla Mehio" sort="Sibai, Abla Mehio" uniqKey="Sibai A" first="Abla Mehio" last="Sibai">Abla Mehio Sibai</name><affiliation wicri:level="1"><nlm:aff id="af10"><addr-line>Faculty of Agricultural & Food Sciences</addr-line>,<institution>American University of Beirut</institution>,<addr-line>Beirut</addr-line>,<country>Lebanon</country></nlm:aff><country xml:lang="fr">Liban</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Zaghloul, Sahar" sort="Zaghloul, Sahar" uniqKey="Zaghloul S" first="Sahar" last="Zaghloul">Sahar Zaghloul</name><affiliation wicri:level="1"><nlm:aff id="af14"><addr-line>Department of Nutrition Requirements and Growth</addr-line>,<institution>National Nutrition Institute</institution>,<addr-line>Cairo</addr-line>,<country>Egypt</country></nlm:aff><country xml:lang="fr">Égypte</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Danaei, Goodarz" sort="Danaei, Goodarz" uniqKey="Danaei G" first="Goodarz" last="Danaei">Goodarz Danaei</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Global Health and Population</addr-line>,<institution>Harvard T.H. Chan School of Public Health</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af15"><addr-line>Department of Epidemiology</addr-line>,<institution>Harvard T.H. Chan School of Public Health</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ezzati, Majid" sort="Ezzati, Majid" uniqKey="Ezzati M" first="Majid" last="Ezzati">Majid Ezzati</name><affiliation wicri:level="1"><nlm:aff id="af16"><addr-line>Department of Epidemiology and Biostatistics</addr-line>,<institution>School of Public Health, Imperial College London</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Mozaffarian, Dariush" sort="Mozaffarian, Dariush" uniqKey="Mozaffarian D" first="Dariush" last="Mozaffarian">Dariush Mozaffarian</name><affiliation wicri:level="1"><nlm:aff id="af1"><institution>Friedman School of Nutrition Science & Policy, Tufts University</institution>,<addr-line>Boston, Massachusetts</addr-line>,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Africa, Northern (epidemiology)</term><term>Aged (MeSH)</term><term>Bayes Theorem (MeSH)</term><term>Blood Glucose (metabolism)</term><term>Blood Pressure (MeSH)</term><term>Body Mass Index (MeSH)</term><term>Cardiovascular Diseases (mortality)</term><term>Cause of Death (MeSH)</term><term>Cross-Cultural Comparison (MeSH)</term><term>Diabetes Mellitus (mortality)</term><term>Diet (MeSH)</term><term>Feeding Behavior (MeSH)</term><term>Female (MeSH)</term><term>Global Health (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Middle East (epidemiology)</term><term>Risk Assessment (MeSH)</term><term>Risk Factors (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Afrique du Nord (épidémiologie)</term><term>Appréciation des risques (MeSH)</term><term>Cause de décès (MeSH)</term><term>Comparaison interculturelle (MeSH)</term><term>Comportement alimentaire (MeSH)</term><term>Diabète (mortalité)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Glycémie (métabolisme)</term><term>Humains (MeSH)</term><term>Indice de masse corporelle (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Maladies cardiovasculaires (mortalité)</term><term>Moyen Orient (épidémiologie)</term><term>Mâle (MeSH)</term><term>Pression sanguine (MeSH)</term><term>Régime alimentaire (MeSH)</term><term>Santé mondiale (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Théorème de Bayes (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="metabolism" xml:lang="en"><term>Blood Glucose</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Africa, Northern</term><term>Middle East</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Cardiovascular Diseases</term><term>Diabetes Mellitus</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Diabète</term><term>Maladies cardiovasculaires</term></keywords><keywords scheme="MESH" qualifier="métabolisme" xml:lang="fr"><term>Glycémie</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Afrique du Nord</term><term>Moyen Orient</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Bayes Theorem</term><term>Blood Pressure</term><term>Body Mass Index</term><term>Cause of Death</term><term>Cross-Cultural Comparison</term><term>Diet</term><term>Feeding Behavior</term><term>Female</term><term>Global Health</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Risk Assessment</term><term>Risk Factors</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Appréciation des risques</term><term>Cause de décès</term><term>Comparaison interculturelle</term><term>Comportement alimentaire</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Indice de masse corporelle</term><term>Jeune adulte</term><term>Mâle</term><term>Pression sanguine</term><term>Régime alimentaire</term><term>Santé mondiale</term><term>Sujet âgé</term><term>Théorème de Bayes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective/design</title><p>We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality was obtained from clinical trials and observational studies. The number of disease-specific deaths was obtained from the 2010 Global Burden of Disease mortality database. Mortality due to each risk factor was determined using the population attributable fraction and total number of disease-specific deaths.</p></sec><sec><title>Setting/population</title><p>Adult population in the Middle East by age, sex, country and time.</p></sec><sec><title>Results</title><p>Suboptimal diet was the leading risk factor for CMD mortality in 11 countries accounting for 48% (in Morocco) to 72% (in the United Arab Emirates) of CMD deaths. Non-optimal systolic blood pressure was the leading risk factor for CMD deaths in eight countries causing 45% (in Bahrain) to 68% (in Libya) of CMD deaths. Non-optimal body mass index and fasting plasma glucose were the third and fourth leading risk factors for CMD mortality in most countries. Among individual dietary factors, low intake of fruits accounted for 8% (in Jordan) to 21% (in Palestine) of CMD deaths and low intake of whole grains was responsible for 7% (in Palestine) to 22% (in the United Arab Emirates) of CMD deaths. Between 1990 and 2010, the CMD mortality attributable to most risk factors had decreased except for body mass index and trans-fatty acids.</p></sec><sec><title>Conclusions</title><p>Our findings highlight key similarities and differences in the impact of the dietary and metabolic risk factors on CMD mortality in the countries of the Middle East and inform priorities for policy measures to prevent CMD.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lozano, R" uniqKey="Lozano R">R Lozano</name></author><author><name sortKey="Naghavi, M" uniqKey="Naghavi M">M Naghavi</name></author><author><name sortKey="Foreman, K" uniqKey="Foreman K">K Foreman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lim, Ss" uniqKey="Lim S">SS Lim</name></author><author><name sortKey="Vos, T" uniqKey="Vos T">T Vos</name></author><author><name sortKey="Flaxman, Ad" uniqKey="Flaxman A">AD 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uniqKey="Alsmadi O">O Alsmadi</name></author><author><name sortKey="Behbehani, K" uniqKey="Behbehani K">K Behbehani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Musaiger, Ao" uniqKey="Musaiger A">AO Musaiger</name></author><author><name sortKey="Hassan, As" uniqKey="Hassan A">AS Hassan</name></author><author><name sortKey="Obeid, O" uniqKey="Obeid O">O Obeid</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mehio Sibai, A" uniqKey="Mehio Sibai A">A Mehio Sibai</name></author><author><name sortKey="Nasreddine, L" uniqKey="Nasreddine L">L Nasreddine</name></author><author><name sortKey="Mokdad, Ah" uniqKey="Mokdad A">AH Mokdad</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Afshin, A" uniqKey="Afshin A">A Afshin</name></author><author><name sortKey="Micha, R" uniqKey="Micha R">R Micha</name></author><author><name sortKey="Khatibzadeh, S" uniqKey="Khatibzadeh S">S Khatibzadeh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Musaiger, Ao" uniqKey="Musaiger A">AO Musaiger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fitch, J" uniqKey="Fitch J">J Fitch</name></author><author><name sortKey="Jaberin, A" uniqKey="Jaberin A">A Jaberin</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Afshin, A" uniqKey="Afshin A">A Afshin</name></author><author><name sortKey="Shangguan, S" uniqKey="Shangguan S">S Shangguan</name></author><author><name sortKey="Nomura Baba, M" uniqKey="Nomura Baba M">M Nomura-Baba</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Appel, Lj" uniqKey="Appel L">LJ Appel</name></author><author><name sortKey="Moore, Tj" uniqKey="Moore T">TJ Moore</name></author><author><name sortKey="Obarzanek, E" uniqKey="Obarzanek E">E Obarzanek</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Estruch, R" uniqKey="Estruch R">R Estruch</name></author><author><name sortKey="Ros, E" uniqKey="Ros E">E Ros</name></author><author><name sortKey="Salas Salvado, J" uniqKey="Salas Salvado J">J Salas-Salvado</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lock, K" uniqKey="Lock K">K Lock</name></author><author><name sortKey="Pomerleau, J" uniqKey="Pomerleau J">J Pomerleau</name></author><author><name sortKey="Causer, L" uniqKey="Causer L">L Causer</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mozaffarian, D" uniqKey="Mozaffarian D">D Mozaffarian</name></author><author><name sortKey="Micha, R" uniqKey="Micha R">R Micha</name></author><author><name sortKey="Wallace, S" uniqKey="Wallace S">S Wallace</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mozaffarian, D" uniqKey="Mozaffarian D">D Mozaffarian</name></author><author><name sortKey="Katan, Mb" uniqKey="Katan M">MB Katan</name></author><author><name sortKey="Ascherio, A" uniqKey="Ascherio A">A Ascherio</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Bahreïn</li><li>Grèce</li><li>Iran</li><li>Koweït</li><li>Liban</li><li>Royaume-Uni</li><li>Turquie</li><li>Égypte</li><li>États-Unis</li></country></list><tree><country name="États-Unis"><noRegion><name sortKey="Afshin, Ashkan" sort="Afshin, Ashkan" uniqKey="Afshin A" first="Ashkan" last="Afshin">Ashkan Afshin</name></noRegion><name sortKey="Danaei, Goodarz" sort="Danaei, Goodarz" uniqKey="Danaei G" first="Goodarz" last="Danaei">Goodarz Danaei</name><name sortKey="Danaei, Goodarz" sort="Danaei, Goodarz" uniqKey="Danaei G" first="Goodarz" last="Danaei">Goodarz Danaei</name><name sortKey="Fahimi, Saman" sort="Fahimi, Saman" uniqKey="Fahimi S" first="Saman" last="Fahimi">Saman Fahimi</name><name sortKey="Khatibzadeh, Shahab" sort="Khatibzadeh, Shahab" uniqKey="Khatibzadeh S" first="Shahab" last="Khatibzadeh">Shahab Khatibzadeh</name><name sortKey="Micha, Renata" sort="Micha, Renata" uniqKey="Micha R" first="Renata" last="Micha">Renata Micha</name><name sortKey="Mozaffarian, Dariush" sort="Mozaffarian, Dariush" uniqKey="Mozaffarian D" first="Dariush" last="Mozaffarian">Dariush Mozaffarian</name><name sortKey="Shi, Peilin" sort="Shi, Peilin" uniqKey="Shi P" first="Peilin" last="Shi">Peilin Shi</name><name sortKey="Singh, Gitanjali" sort="Singh, Gitanjali" uniqKey="Singh G" first="Gitanjali" last="Singh">Gitanjali Singh</name><name sortKey="Yakoob, Mohammad Yawar" sort="Yakoob, Mohammad Yawar" uniqKey="Yakoob M" first="Mohammad Yawar" last="Yakoob">Mohammad Yawar Yakoob</name></country><country name="Grèce"><noRegion><name sortKey="Micha, Renata" sort="Micha, Renata" uniqKey="Micha R" first="Renata" last="Micha">Renata Micha</name></noRegion></country><country name="Iran"><noRegion><name sortKey="Fahimi, Saman" sort="Fahimi, Saman" uniqKey="Fahimi S" first="Saman" last="Fahimi">Saman Fahimi</name></noRegion><name sortKey="Abdollahi, Morteza" sort="Abdollahi, Morteza" uniqKey="Abdollahi M" first="Morteza" last="Abdollahi">Morteza Abdollahi</name><name sortKey="Farzadfar, Farshad" sort="Farzadfar, Farshad" uniqKey="Farzadfar F" first="Farshad" last="Farzadfar">Farshad Farzadfar</name><name sortKey="Houshiar Rad, Anahita" sort="Houshiar Rad, Anahita" uniqKey="Houshiar Rad A" first="Anahita" last="Houshiar-Rad">Anahita Houshiar-Rad</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Powles, John" sort="Powles, John" uniqKey="Powles J" first="John" last="Powles">John Powles</name></noRegion><name sortKey="Ezzati, Majid" sort="Ezzati, Majid" uniqKey="Ezzati M" first="Majid" last="Ezzati">Majid Ezzati</name></country><country name="Koweït"><noRegion><name sortKey="Al Hooti, Suad" sort="Al Hooti, Suad" uniqKey="Al Hooti S" first="Suad" last="Al-Hooti">Suad Al-Hooti</name></noRegion></country><country name="Liban"><noRegion><name sortKey="Hwalla, Nahla" sort="Hwalla, Nahla" uniqKey="Hwalla N" first="Nahla" last="Hwalla">Nahla Hwalla</name></noRegion><name sortKey="Sibai, Abla Mehio" sort="Sibai, Abla Mehio" uniqKey="Sibai A" first="Abla Mehio" last="Sibai">Abla Mehio Sibai</name></country><country name="Turquie"><noRegion><name sortKey="Koksal, Eda" sort="Koksal, Eda" uniqKey="Koksal E" first="Eda" last="Koksal">Eda Koksal</name></noRegion><name sortKey="Pekcan, Gulden" sort="Pekcan, Gulden" uniqKey="Pekcan G" first="Gulden" last="Pekcan">Gulden Pekcan</name></country><country name="Bahreïn"><noRegion><name sortKey="Musaiger, Abdulrahman" sort="Musaiger, Abdulrahman" uniqKey="Musaiger A" first="Abdulrahman" last="Musaiger">Abdulrahman Musaiger</name></noRegion></country><country name="Égypte"><noRegion><name sortKey="Zaghloul, Sahar" sort="Zaghloul, Sahar" uniqKey="Zaghloul S" first="Sahar" last="Zaghloul">Sahar Zaghloul</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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