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Bill & Melinda Gates Funded Study Finds Poor Diet
 Cause of More Deaths Worldwide than Smoking

We’ve long had a special interest in Bill Gates. While still a teenager in 1975, he and Paul Allen founded Microsoft in Albuquerque.

The three-episode Netflix documentary Inside Bill’s Brain (Decoding Bill Gates) put our interest into high gear. We’ve always know that he is a high powered computer nerd, but we had no idea of the capacity of his brain. He reads 150 pages an hour with over 90% retention and can juggle humongous amounts of data in his brain at one time.

He and Melinda transferred $20 billion of Microsoft stock to the Gates Foundation and began traveling the world assessing health problems in poor countries. Google: Bill Gates: The day I knew what I wanted to do for

The effect of poor diets around the world is one of many problems they have taken on since his early retirement from Microsoft. 

The scope of their efforts is writ large in the study of dietary risks from 1990 to 2017—in 195 countries.

Findings All Encompassing

The study, published in The Lancet on April 3, 2019, evaluated the consumption of major foods and nutrients across 195 countries to assess their impact on non-communicable diseases (NCDs). The magnitude of such an undertaking is nothing short of Herculean.  

The methods are summarized at the beginning of the report:

By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor… among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome.

Got that?

Philanthropy News Digest [PND] encapsulated the results on April 9, 2019, in easily understood language:

Sub-optimal diets are responsible for more deaths than any other risk factor, with diets high in sodium, low in whole grains, low in fruit, low in nuts and seeds, low in vegetables, and low in omega-3 fatty acids each account for more than 2 percent of deaths worldwide.

They found that in 2017, 11 million deaths were attributable to dietary risk factors — more than those attributable to smoking — through conditions and illnesses such as cardiovascular disease, type 2 diabetes, high blood pressure, and colorectal cancer.

Mean consumption of nuts and seeds, milk, and whole grains ranged between just 12 percent and 23 percent of optimal intake, while mean consumption of processed meat and of red meat exceeded the optimal intake by 90 percent and 18 percent, respectively. Consumption of sodium and sugar-sweetened beverages exceeded optimal levels in nearly every region, while red meat consumption was highest in Australasia, southern Latin America, and tropical Latin America; processed meat consumption was highest in high-income North America, followed by high-income Asia Pacific and Western Europe; trans fats intake was highest in high-income North America, central Latin America, and Andean Latin America.

The report highlights the need for more comprehensive and effective food system interventions to promote the broader production, distribution, and consumption of healthy foods.

*  *  *

Looking ahead, the study forecast that their findings will inform dietary interventions and provide a platform for evaluation of their impact on human health annually.

“In summary, we found that poor dietary habits are associated with a range of chronic diseases and can potentially be a major contributor to NCD mortality in all countries worldwide. This finding highlights the urgent need for coordinated global efforts to improve the quality of human diet.”

Accentuate the Positive, Think Healthy

Lead investigator, Ashkan Afshin, MD (University of Washington, Seattle) told TCTMD that it might be time to emphasize increased consumption of certain foods, as opposed to cutting out others.

“It’s important to focus on healthy dietary factors that aren’t being consumed enough,” he explained. “Whole grains and nuts, for example, are relatively neglected. The intake in many countries is close to zero. It means some type of transformation is needed to increase availability, affordability, and accessibility of these types of food items.”

For physicians, there needs to be more of a focus on “diet” as a risk factor.

“Historically the focus of physicians for prevention of disease has been established risk factors, such as tobacco use, obesity, and high blood pressure,” said Afshin. “These factors are routinely assessed in the clinical visit. Now we see that diet is actually more important at the population level but very, very few physicians ask about it. Perhaps it’s time for physicians to start thinking about how they can include dietary assessments as part of the visit.”

Kelly Hogan, clinical nutrition and wellness manager at New York’s Mount Sinai Hospital, told Market Watch that the study supports the healthy guidelines that she and other dietitians have been sharing with their patients. “For a long time, we’ve really been trying to focus on diet quality when it comes to the risk reduction of various chronic disease; focusing on what people should eat more of, as opposed to telling them what not to eat,” she said. “When you tell people what not to do, they’re not necessarily going to know what to do. Sometimes it’s not intuitive for them to eat the ‘right’ thing.”

(If you read Facebook support groups for diets like keto, which drastically limits carbs, and the Whole 30, which cuts sugar, dairy and legumes, the majority of topics center around people asking what they can still eat.)

The report highlights the need for food system interventions and dietary policies to help individual countries identify which ingredients their residents are missing in order to have a well-balanced diet, and to then produce and distribute these healthy foods in those areas.

How successful is that likely to be, especially if people don't know what a healthy diet looks like?

Health experts say the main takeaway for most people should be that adding in healthy foods to their diets is more important that cutting “bad” things out.

“We have to look at diet quality as a whole over time. No one food is that bad and terrible that you have to avoid it forever,” said Hogan. “It really is looking at the big picture: Is the majority of your diet plant foods that maybe you’re not eating enough of now? If it’s not, then work toward that, knowing there is still other things that you might enjoy as well.”

Just eat those in moderation.

My Take

As noted above, I’m blown away by the fact that Bill and Melinda Gates are giving back in such a massive and thoughtful manner. If you are not a fan of the fact that their contribution to computer technology has changed the world—and made them super rich, you’ll be hard put to find fault in their efforts to help the downtrodden around the world.

If I had any qualms before, the Netflix documentary and this study have made me a believer. 

Returning to the takeaways of the study, I’m in full agreement with accentuating the positives of healthy eating.

I’ve long maintained that food plans based on denial do not work. They conjure up thoughts of hunger and deprivation.

Do is much more powerful than don’t.

Best results are likely to come from encouraging people to eat more plant based foods such as fruit, vegetables, whole grains, nuts, and beans, along with milk, eggs, poultry, and fish. If they do that they will be far less likely to overeat on unhealthy foods such processed meats and foods high in sugar and salt.

Suggesting that people focus on eating foods the way they come in nature also makes them less likely to eat processed foods.

The fact that people in certain parts of the world thrive on what has come to be called the Mediterranean Diet—vegetables, fruits, whole grains, nuts, and legumes, along with some fish and chicken, plus some olive oil, and red wine in moderation—suggests that healthy eating can be quite satisfying.

The Mediterranean Diet is ranked as the best overall diet by U.S. News & World Report.

If you eat the right things, it's actually hard to overeat. What happens is you become full and satisfied before you take in more calories than you burn.


 I'm living proof that eating mainly whole foods, basically the Mediterranean Diet, and regular exercise
 will make and keep you lean and healthy without counting calories or macronutrients.

Photo by Guy Appelman

*  *  *

Kudos to Bill and Melinda Gates for helping to show the way to a better nourished and healthier world.

December 1, 2019

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