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Significant Effects From Dietary and
Lifestyle Risk Factors Contribute To

Many Otherwise Preventable
In The U.S. Annually

Smoking and High Blood Pressure
Each Account For 20% of Deaths in U.S. Adults

Smoking, high blood pressure and being overweight are the
leading preventable risk factors for premature mortality in the
United States, according to a comprehensive new study led

by a team of researchers from the Harvard School of Public
Health (HSPH),
the University of Toronto and the Institute
for Health Metrics & Evaluation at the University of Washington.

The researchers found that smoking is responsible for 467,000 premature
deaths each year, high blood pressure for 395,000, and being overweight
for 216,000. The effects of smoking are attributed to about one in five deaths
in American adults, while high blood pressure is responsible for one in six deaths.

It is the most comprehensive study yet to examine how diet, lifestyle and
metabolic risk factors for chronic disease contribute to mortality in the U.S.

The hundreds of thousands of premature deaths caused by these known,
modifiable risk factors is deplorable and should motivate a serious look
at whether the public health system has enough capacity to seriously
implement effective changes and whether it is currently focusing on the
proper set of interventions.

The researchers also found significant effects from other preventable
dietary and lifestyle risk factors. Below are the numbers of deaths in
the U.S. annually due to each of the individual risk factors examined:

Smoking: 467,000
High blood pressure: 395,000
Overweight-obesity: 216,000
Inadequate physical activity and inactivity: 191,000
High blood sugar: 190,000
High LDL cholesterol: 113,000
Excess dietary salt: 102,000
Insufficient dietary omega-3 fatty acids (seafood): 84,000
High dietary trans fatty acids: 82,000
Insufficient  intake of fruits and vegetables: 58,000
Insufficient dietary poly-unsaturated fatty acids: 15,000
Excess Alcohol use: 64,000
In regard to Alcohol, moderate use averted a balance of 26,000 deaths
from heart disease, stroke and diabetes, because moderate drinking
reduces risk of these diseases. However, these deaths were outweighed
by 90,000 alcohol-related deaths from vehicular homicides and other injuries,
violence, cancers and other diseases.

All of the deaths calculated in the study were considered premature or
preventable in that the victims would not have died when they did if they
had not been subject to the behaviors or activities linked to their deaths.
All of these risk factors are modifiable, because people have the choice
to make healthier decisions.

While earlier studies had quantified deaths linked to a few factors, like
smoking and alcohol, this is the first to look at a wide range of risk factors,
including those linked to diet, lifestyle and metabolic factors, for the whole
U.S. population. This is also the first to use methods that allowed a true
comparison of a diverse set of risks in terms of how many deaths each
of the risk factors is responsible for. The researchers analyzed data from
a number of public sources, including from the National Center for Health
Statistics and numerous published epidemiological studies and clinical trials.

The researchers also found differences between the preventable causes of
death among men and women. High blood pressure was the leading cause
of death in adult women, killing nearly 230,000 American women each year,
nearly 20%  percent of all female deaths. By comparison, High Blood Pressure
is more than five times the 42,000 number of annual deaths in women from
breast cancer.

Smoking was the leading cause of death in men, killing an estimated 248,000
annually, equivalent to 21 percent of all adult male deaths.

The mortality effects of many other risk factors were about equal in men and
women, with alcohol use being a major exception. Seventy percent of all deaths
caused by alcohol were among men and represented 45,000 deaths, a result
because men consumed more alcohol and engaged in more binge drinking
according to the researchers.

The findings are an urgent reminder that although we have been  partially
effective in reducing smoking and high blood pressure, we have not yet
completed the task and have a great deal more to do on these major
preventable factors. The researchers suggest the government should also
use an effective set of regulatory, pricing, and health information initiatives
to substantially reduce salt and trans fats in prepared and packaged foods
as well as to support research that can find effective strategies for modifying
the other dietary, lifestyle, and metabolic risk factors that cause large numbers
of premature deaths in the U.S. However, it is ultimately the responsibility of
individuals to make the healthier choices for themselves.

This research was supported by a cooperative agreement from the Centers
for Disease Control and Prevention through the Association of Schools of
Public Health.