title: Estimating change in cardiovascular disease and diabetes burdens due to dietary and metabolic factors in Korea 1998-2011: a comparative risk assessment analysis.
abstract: Over the past 10 years, the burden of chronic diseases in Korea has increased. However, there are currently no quantitative estimates of how changes in diet and metabolic factors have contributed to these shifting burdens. This study aims to evaluate the contributions of dietary and metabolic risk factors to death from cardiometabolic diseases (CMDs) such as cardiovascular conditions, strokes and diabetes in Korea, and to estimate how these contributions have changed over the past 10 years (1998-2011).
  
  
  
  We used data on 6 dietary and 4 metabolic risk factors by sex, age and year from the Korea National Health and Nutrition Examination Survey. The relative risks for the effects of the risk factors on CMD mortality were obtained from meta-analyses. The population-attributable fraction attributable to the risk factors was calculated by using a comparative risk assessment approach across sex and age strata (males and females, age groups 25-34, 35-44, 45-54, 55-64, 65-74 and 75+ years) from 1998 to 2011.
  
  
  
  The results showed that a suboptimal diet and high blood pressure were the main risk factors for CMD mortality in Korea. High blood pressure accounted for 127 096 (95% uncertainty interval (UI): 121 907 to 132 218) deaths from CMD. Among the individual dietary risk factors, a high intake of sodium (42 387 deaths; 95% UI: 42 387 to 65 094) and a low intake of fruit (50 244 deaths; 95% UI: 40 981 to 59 178) and whole grains (54 248 deaths; 95% UI: 47 020 to 61 343) were responsible for the highest number of CMD deaths in Korea.
  
  
  
  Indicating the relative importance of risk factors in Korea, the results suggest that metabolic and dietary risk factors were major contributors to CMD mortality.
authors.affiliation: Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul, Republic of Korea.
authors.forename: Yoonsu
authors.initials: Y
authors.lastname: Cho
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: Cudhea
authors.affiliation: Department of Statistics, Dongguk University, Seoul, Republic of Korea.
authors.forename: Ju-Hyun
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul, Republic of Korea.
authors.forename: Jong-Tae
authors.initials: JT
authors.lastname: Lee
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
authors.affiliation: Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA.
authors.forename: Gitanjali
authors.initials: G
authors.lastname: Singh
authors.affiliation: Department of Public Health Sciences, BK21PLUS Program in Embodiment: Health-Society Interaction, Graduate School, Korea University, Seoul, Republic of Korea.
authors.forename: Min-Jeong
authors.identifier: 0000-0002-8952-4008
authors.initials: MJ
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism / Q000401:mortality* / Q000517:prevention & control; D002908:Chronic Disease / Q000639:trends*; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000209:etiology / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000401:mortality; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology / Q000378:metabolism / Q000401:mortality* / Q000517:prevention & control; D008875:Middle Aged; D000073296:Noncommunicable Diseases; D009749:Nutrition Surveys; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D017673:Sodium Chloride, Dietary; D020521:Stroke / Q000209:etiology / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control; D055815:Young Adult
chemical_list: D017673:Sodium Chloride, Dietary
keywords: burden of disease; cardiometabolic disease; cardiovascular disease; dietary risk; metabolic risk