Deaths and illnesses due to metabolic risks have increased since 2000

The latest findings from the 2021 Global Burden of Disease, Injuries and Risk Factors Study (GBD), published in The Lancet, provide new data on health problems and risk factors which cause them.

The increasing number of people exposed to 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 demonstrates the consequences aging population and changing lifestyles on a global scale.

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

During this period, poor health in people aged 15 to 49 years was increasingly associated with high BMI and high fasting plasma glucose (FPG), also known as high blood sugar, which increases the risk of diabetes. Other metabolic risk factors, such as high SBP and high LDL cholesterol, also ranked among the top 10 risk factors for people in this age group.

"Although these risk factors are metabolic in nature, their development can often be influenced by various lifestyle factors, especially among younger generations," said Dr. Michael Brower, associate professor at the Institute for Health Metrics and Evaluation (IHME).

"They also point to an aging population that is more likely to develop these conditions over time. Targeting the reduction of preventable noncommunicable diseases through modifiable risk factors represents a tremendous opportunity to proactively change the trajectory of global health through policy and education." p>

The GBD Risk Factor Analysis provides comprehensive estimates of disease burden for 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 proof" methodology, which carefully evaluates the evidence linking risk factors to disease and injury and offers an additional perspective to prioritize actions and identify areas requiring further research.

Particulate air pollution, smoking, low birth weight and short gestational age were also among the largest contributors to DALYs in 2021, with significant variations by age, sex and location.

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

"Risk factors that currently lead to poor health, such as obesity and other components of metabolic syndrome, exposure to particulate matter in ambient air and smoking must be addressed through a combination of global health policy and exposure reduction efforts to mitigate health risks and improve public health," said Dr. Emmanuela Gakidou, professor of health performance 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 sweetened drinks, there is an urgent need for interventions targeting obesity and metabolic syndromes," Dr. Greg Roth, director of the Cardiovascular Health Evaluation Program and adjunct assistant professor of health performance sciences at IHME.

"The GBD highlights that future trends may differ significantly from past ones due to factors such as climate change and increases in obesity and addiction, but at the same time there is enormous opportunity to change the trajectory of health in the next generation." said Dr Lian Ong, Principal Scientist at IHME.

The largest reductions in disease burden occurred for risk factors associated with maternal and child health, unsafe water, sanitation, and hand hygiene, driven by both lower exposure levels and proportionately smaller infant and youth populations.

These figures suggest that public health responses and humanitarian health initiatives have been successful over the past three decades, with particularly high rates of reduction in the burden associated with these risk factors in regions with low scores on the Sociodemographic 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 undernutrition such as childhood stunting, with a 71.5% reduction in age-standardized DALYs between 2000 and 2021, and low weight in birth and short gestational age, with a decrease of 33.0% over the same period.

The authors found that despite global declines, disease burden attributable to risk factors for child and maternal undernutrition remained high in the GBD super regions of sub-Saharan Africa, South Asia, parts of North Africa and the Middle East, and in parts of Southeast Asia, East Asia and Oceania.

The disease burden associated with unsafe water sources, unsafe sanitation, and lack of access to handwashing facilities (all ranked in the top 25 risks) decreased, with age-standardized DALYs decreasing by 66.3%, 69.2% and 65.7% respectively.

In contrast, the burden of smoking (age-standardized DALYs at risk) has increased modestly due to population aging, despite declining exposure to this risk factor. The disease burden (age-standardized risk DALYs) associated with particulate matter air pollution, high BMI, high FPG, and high SBP has increased significantly as exposure to these risk factors increases and the population ages.

Also published in The Lancet is a GBD projection study for 204 countries from 2022 to 2050, indicating that global life expectancy is likely to increase between 2022 and 2050.