The number of people with poor health and premature death due to metabolic risk factors has increased since 2000

The latest findings from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, published in The Lancet, provide new insights into health challenges and the risk factors that cause them.

An increase in the number of people with metabolic risk factors, such as high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body mass index (BMI), high LDL cholesterol and kidney dysfunction, shows the consequences of an aging population and changing lifestyles on a global scale.

According to the study, between 2000 and 2021, there was a 49.4% increase in global DALYs, or disability-adjusted life years (years of healthy life lost due to poor health and premature death), attributable to metabolic risk factors . .

During this period, poor health among people aged 15 to 49 was increasingly attributable to high BMI and high FPG – also known as high blood sugar – increasing the risk of developing diabetes. Other metabolic risk factors, such as high SBP and high LDL cholesterol, were also in the top 10 risk factors for people in this age group.

“Although metabolic in nature, developing these risk factors can often be influenced by various lifestyle factors, especially among younger generations,” says Dr. Michael Brauer, associate professor at the Institute for Health Metrics and Evaluation (IHME).

“They are also indicative of an aging population that is more likely to develop these conditions over time. Targeting the reduction of preventable, non-communicable diseases through modifiable risk factors offers a tremendous opportunity to preemptively change the trajectory of global health through policy. and education.”

The GBD Risk Factor Analysis presents comprehensive estimates of the disease burden of 88 risk factors and associated health outcomes for 204 countries and territories from 1990 to 2021. For the first time, the GBD Study includes IHME’s new burden of evidence methodology, which rigorously evaluates the evidence that risk factors, connects diseases and injuries, providing an additional lens through which to set priorities and highlight areas in need of further research.

Air pollution from particulate matter, smoking, low birth weight and short gestation were also among the biggest contributors to DALYs in 2021, with significant differences across ages, genders and locations.

The study found that significant progress has been made between 2000 and 2021 in reducing the global burden of disease attributable to risk factors associated with maternal and child health; unsafe water, sanitation and handwashing; and household air pollution from cooking with solid fuels.

“Risk factors that currently lead to poor health, such as obesity and other components of the metabolic syndrome, exposure to particulate matter air pollution and tobacco use, need to be addressed through a combination of global health policy and exposure reduction efforts to reduce limit health risks. and improve public health,” said Dr. Emmanuela Gakidou, Professor of Health Metrics Sciences at IHME.

“With increasing exposure to risk factors such as high blood sugar, high blood pressure, low physical activity and a diet high in sugar-sweetened beverages, there is an urgent need for interventions targeting obesity and metabolic syndromes,” said Dr. Greg Roth. , director of the Program in Cardiovascular Health Metrics and adjunct associate professor of Health Metrics Sciences at IHME.

“GBD highlights that future trends may be very different from past trends due to factors such as climate change and rising obesity and addiction, but at the same time there is enormous opportunity to change the trajectory of the health of the next generation,” said Dr. . Liane Ong, chief research scientist at IHME.

The largest reductions in disease burden occurred among risk factors related to maternal and child health and unsafe water, sanitation and handwashing, largely due to reductions in risk exposure, but also from proportionately smaller infant and youth populations.

These figures suggest that public health measures and humanitarian healthcare initiatives over the past three decades have been successful, with particularly high burden reductions attributable to these risk factors in areas that score lower on the socio-demographic index, a measure of income , fertility , and education.

There was a significant reduction in the global burden of disease associated with risk factors for child and maternal malnutrition, such as childhood stunting, with age-standardized attributable DALY rates declining by 71.5% between 2000 and 2021, and a low birth weight and short gestation, with figures falling by 33.0% in the same period.

The authors found that despite declines at the global level, the burden of disease attributable to risk factors associated with child and maternal malnutrition remained high in the GBD super-regions of sub-Saharan Africa, South Asia, areas of Northern Africa and the Middle East. as well as parts of Southeast Asia, East Asia and Oceania.

The burden of disease associated with unsafe water sources, unsafe sanitation and no access to handwashing facilities (all top 25 risks) has decreased, with a decrease of 66.3%, 69.2% and 65.7% respectively in the attributable, age-standardized DALY rates.

In contrast, the burden attributable to smoking (age-standardized risk-attributable DALYs) has increased moderately as the population ages, even as people’s exposure to this risk factor has decreased. The burden of disease (age-standardized risk-attributable DALYs) associated with particulate air pollution, high BMI, high FPG, and high SBP increased significantly as people’s exposure to these risk factors increased and the population grew older.

Also released in The Lancet is the GBD forecast analysis of 204 countries from 2022 to 2050, which shows that global life expectancy is likely to increase between 2022 and 2050.