Zhongguo quanke yixue (Jan 2025)
Trend and Prediction of Changes in the Disease Burden of Diet-related Ischemic Heart Disease in China, 1990-2021
Abstract
Background Ischemic heart disease (IHD) is the second leading cause of disease burden in the Chinese population, and dietary factors are considered as effective and feasible approaches to reduce the disease burden. Objective To analyze the trends in the disease burden of IHD attributable to dietary factors from 1990 to 2021 and future trends in China, aiming to provide a reference basis for dietary prevention and treatment of IHD in China. Methods Data related to the disease burden of IHD attributable to dietary factors in China, worldwide, and regions with varied socio-demographic index (SDI) from 1990 to 2021 were extracted from the Global Burden of Disease 2021 (GBD 2021) database. Using the Joinpoint model, the annual percent change (APC) and average annual percent change (AAPC) were calculated to analyze the disease burden of IHD attributable to dietary factors in China, worldwide, and regions with varied SDI. Furthermore, the model evaluated the diet-ralated disease burden by gender and age groups in China, as well as the burden of disease attributable to specific dietary factors within the Chinese population from 1990 to 2021. Additionally, the Bayesian age-period-cohort (BAPC) model was used to predict the standardized mortality rate and the standardized disability-adjusted life year (DALY) rate of IHD attributable to dietary factors from 2022 to 2031. Results In 2021, the standardized mortality rate and standardized DALY rate of IHD attributable to dietary factors in China were 44.26/100 000 and 820.87/100 000, respectively, which were close to the global levels, but higher than those of high SDI regions and lower than the remaining four categories of SDI regions. From 1990 to 2021, the standardized mortality rate (AAPC=-0.17%, P<0.001) and the standardized DALY rate (AAPC=-0.50%, P<0.001) of IHD attributable to dietary factors in China showed a decreased trend, which were consistent with the global trend and those in the five categories of SDI regions. The global decrease was significantly higher than that in China, with the fastest decrease in the high SDI regions. Disease burden of IHD attributable to dietary factors was significantly higher in Chinese males than in females in 1990 and 2021. The standardized mortality rate (AAPC=0.25%, P<0.001) of IHD attributable to dietary factors in Chinese males showed an increasing trend from 1990 to 2021. The standardized mortality rate (AAPC=-0.71%, P<0.001) and standardized DALY rate (AAPC=-1.23%, P<0.001) in Chinese females both showed a decreased trend. Disease burden of IHD attributable to dietary factors showed an increased trend with age in China in 1990 and 2021, and the highest mortality and DALY rate were detected in people ≥70 years old. The mortality and DALY rate of IHD attributable to dietary factors for the residents aged 50-69 years showed a decreased trend from 1990 to 2021, while those in the 15-49 years and ≥70 years showed an increased trend (P<0.001). Among the 13 dietary factors attributed to the standardized mortality and standardized DALY rate of IHD in 1990 and 2021, the top were excessive sodium intake and insufficient intake of whole grains. Dietary factors attributed to the most significant increased trends in the standardized mortality and standardized DALY rate of IHD from 1990 to 2021 were excessive intake of sugar-sweetened beverages, excessive intake of processed meats, and red meat intake. The BAPC model showed that the standardized mortality rate and standardized DALY rate of IHD attributable to dietary factors in China will decline over the next 10 years. Conclusion From 1990 to 2021, the standardized mortality and standardized DALY rate of IHD attributable to dietary factors decreased in China, but the decline is slower compared to high SDI regions. Disease burden of IHD attributable to dietary factors is heavier among men and the elderly. Therefore, it is essential to focus on dietary prevention and control strategies for IHD. Efforts should be made to promote healthy dietary patterns, increase the intake of whole grains, and reduce the consumption of sodium, sugar-sweetened beverages, processed meats, and red meats. Targeted measures and effective interventions are needed to further reduce the disease burden.
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