What causes the most nutrition-related deaths?
Ten risks and direct causes are responsible for the majority of nutrition-related deaths according to the Global Burden of Disease (GBD). Specifically, in 2019, the GBD estimated that dietary risks contributed to 7.9 million deaths, the risks of maternal and child malnutrition contributed to 2.9 million deaths, and nutritional deficiencies directly caused 252,000 deaths.
Among dietary risks, diets high in sodium, low in whole grains, legumes, and fruits, and high in red meat contributed to the most deaths. Low birth weight, short gestation (preterm birth), child wasting, underweight, and stunting contributed to the most child and maternal malnutrition-related deaths. The overwhelming majority of deaths from nutritional deficiencies were caused by protein-energy malnutrition.
Diet-related deaths have risen sharply compared to deaths from child and maternal malnutrition and nutritional deficiencies. Between 1990 and 2019, diet-related deaths rose by a massive 47%, compared to declines of 60% for child and maternal malnutrition-related deaths and 67% for deaths caused by nutritional deficiencies.
The steepest declines in child and maternal nutrition-related deaths were from vitamin A deficiency (-89%), zinc deficiency (-84%), child stunting (-80%), discontinued breastfeeding (-76%), and child underweight (-76%).
Who is vulnerable to nutrition-related deaths?
The vast majority (92%) of the 7.9 million diet-related deaths occur among adults aged over 50. In contrast, the majority (97%) of the 2.9 million child and malnutrition-related deaths occur among children under five. Deaths from nutritional deficiencies are more evenly spread across the life-cycle, with 39% occurring among children under five and 50% among adults over 50.
Males make up 57% of diet-related deaths and 55% of child and maternal malnutrition-related deaths. In contrast, females make up 55% of deaths from nutritional deficiencies, due to the larger numbers of young girls and elderly women who die from protein-energy malnutrition. In fact, 73% of deaths from nutritional deficiencies are concentrated among women and children.
Twice as many men as women die from causes related to diets high in red meat, processed meat, and sugar-sweetened beverages, and low in whole grains. More males than females also die from short gestation, low birth weight, child stunting, sub-optimal breastfeeding, zinc deficiency, and vitamin A deficiency.
The one area where the burden of nutrition-related deaths falls exclusively on females is iron deficiency. In addition to contributing to the deaths of an estimated 42,000 women, iron deficiency is a major cause of Disability Adjusted Life Years (DALYs) for women, causing 20,000,000 DALYs in 2019.
Where are the most nutrition-related deaths?
The majority of nutrition-related deaths occur in a subset of ten countries with China, India, Pakistan, Nigeria, the USA, Russia, Indonesia, Ukraine, Bangladesh, and Brazil accounting for two-thirds of all deaths.
Across all categories, China (2 million), India (1.8 million), Pakistan (485,000), Nigeria (480,000), the USA (440,000), Russia (420,000), Indonesia (370,000), Ukraine (200,000), Bangladesh (195,000), and Brazil (190,000) have the most nutrition-related deaths.
Countries from almost every region of the world are on this list indicating the wide spread of nutrition-related deaths. However, most diet-related deaths are in middle and high-income countries while most child and malnutrition-related deaths and deaths from nutritional deficiencies are in South Asia and Sub-Saharan Africa, due to the heavy burdens in India, Pakistan, Nigeria, and other countries.
It is important to note that five countries are struggling with high numbers of nutrition-related deaths across all three categories – dietary risks, child and maternal malnutrition risks, and deaths from nutritional deficiencies – including India, China, Indonesia, Pakistan, and Bangladesh, which is a reflection of the double-burden of malnutrition in Asia.