title: Coronary heart disease mortality, cardiovascular disease mortality and all-cause mortality attributable to dietary intake over 20years in Brazil.
abstract: OBJECTIVE
  In the last two decades, in Brazil, there has been a decreasing trend of consumption of in natura or minimally processed food, while intake of ultra-processed food has markedly increased. We estimated the contribution of dietary intake in trends from coronary heart disease mortality (CHDM), cardiovascular disease mortality (CVDM), and all-cause mortality (ACM) over 20years in Brazil.
  
  
  METHODS
  We used a representative sample of Brazilian households located in metropolitan areas to estimate dietary intake in 1987/88 and 2008/09. For both periods, we estimated fractions of CHDM, CVDM, and ACM attributable to healthy (fruits and vegetables) and unhealthy food items (sugar-sweetened beverages, processed and red meat). We also estimated the number of prevented or postponed deaths attributable to these food items.
  
  
  RESULTS
  The fraction of CHDM attributable to all food items increased from 28.6% in 1987/88 to 38.7% in 2008/09. CVDM attributable to food items increased from 13.7% in 1974 to 19.3% in 2008/09. ACM attributable to all food items increased from 20.1% in 1987/88 to 27.3% in 2008/09. Without the decrease in healthy food item consumption, and the increase in unhealthy food items, 3195 deaths from coronary heart disease, 5340 from cardiovascular disease, and 16,970 from all causes could have been prevented or postponed.
  
  
  CONCLUSIONS
  The burden of cardiovascular diseases and mortality attributable to dietary intake has increased over the last 20years in Brazil. These findings suggest a need for a population prevention approach, focused on dietary intake to reduce the burden of disease.
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, Av. Dr. Arnaldo 455, 2° andar, Sao Paulo, Sao Paulo 01246-903, Brazil. Electronic address: lerezende@usp.br.
authors.forename: Leandro Fórnias Machado de
authors.initials: LF
authors.lastname: Rezende
authors.affiliation: Faculdade de Medicina da Universidade Federal de Uberlândia, Curso de Nutrição, Av. Pará, 1720, Bloco 2U, Sala 20, Campus Umuarama, Uberlândia, Minas Gerais 38.405-320, Brazil. Electronic address: catarina@famed.ufu.br.
authors.forename: Catarina Machado
authors.initials: CM
authors.lastname: Azeredo
authors.affiliation: Instituto de Nutrição da Universidade do Estado do Rio de Janeiro, Departamento de Nutrição Aplicada, Rua São Francisco Xavier, 524, Rio de Janeiro, RJ20559-900, Brazil. Electronic address: daniela.canella@uerj.br.
authors.forename: Daniela Silva
authors.initials: DS
authors.lastname: Canella
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, Av. Dr. Arnaldo 455, 2° andar, Sao Paulo, Sao Paulo 01246-903, Brazil. Electronic address: olinda@usp.br.
authors.forename: Olinda do Carmo
authors.initials: Odo C
authors.lastname: Luiz
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, Av. Dr. Arnaldo 455, 2° andar, Sao Paulo, Sao Paulo 01246-903, Brazil. Electronic address: rlevy@usp.brrlevy.
authors.forename: Renata Bertazzi
authors.initials: RB
authors.lastname: Levy
authors.affiliation: Faculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Preventiva, Av. Dr. Arnaldo 455, 2° andar, Sao Paulo, Sao Paulo 01246-903, Brazil. Electronic address: jelufnet@usp.br.
authors.forename: Jose
authors.initials: J
authors.lastname: Eluf-Neto
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000401:mortality*; D004034:Diet Surveys; D002149:Energy Intake; D005247:Feeding Behavior / Q000145:classification*; D005260:Female; D063427:Food Quality; D006801:Humans; D008297:Male; D014505:Urban Population
keywords: Cardiovascular diseases; Diet; Epidemiology; Mortality