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Will poor diet kill one in five of us?

The Lancet just published a comprehensive report that states that 22% of human deaths are directly caused by poor diet. Just to put that in perspective, poor diet kills 11 million people a year, while tobacco only kills 7 million people a year. So eating better is going to make your life better even if you smoke like a chimney?

I have to admit, this study is comprehensive. You're going through the data from 195 countries. And it all sounds very convincing. Right up to the point where they estimate that salt kills three million people a year. Wait, what? We had a New England Journal of Medicine report on salt being a killer back in 2014. These researchers estimated that too much salt killed 1.5 million people a year. They assessed every study on salt up through 2014. So we would have to assume that A) either deaths from salt intake have doubled in the last four years or B) either the Lancet or the New England Journal of Medicine is wrong.

There's a third option, that the information we receive from the various different medical systems of the world varies dramatically. Depending on how you weigh that data and massage it, you can come up with 1.5 million or 3 million. Both illustrious groups are right, they just varied in how they evaluated what they were given.

Which means what? Is poor diet worse than smoking? Sure, depending on your other risk factors. Of the death from poor diet, about 10 of the 11 million were due to heart disease. Another million were due to cancer, and then diabetes made up the difference. So if you're a diabetic with heart disease, is a poor diet worse than smoking? Duh. For the rest of us, smoking is still worse.

Oh, for those of you excited about a grain free diet, here's a quote to irritate you,"Low intake of whole grains was the leading dietary risk factor for deaths and DALYs in the USA, India, Brazil, Pakistan, Nigeria, Russia, Egypt, Germany, Iran, and Turkey." Really? Are we really thinking the cure for death is going to be more brown grains? Or is it fairer to say that we should all eat better and it will make a difference in how long we live.

I liked this disclaimer paragraph, which kind of nullifies a lot of the very strong recommendations that have come before.

We did not evaluate the effect of other forms of malnutrition (ie, undernutrition and obesity). The epidemiological evidence supporting a causal relationship between dietary risks and disease endpoints were mostly from observational studies, and the strength of evidence was generally weaker than the strength of evidence supporting a causal relationship between other established risks factors (eg, tobacco use and high systolic blood pressure) and chronic diseases. Additionally, the strength of evidence varied across foods and nutrients. Dietary data were from mixed sources and were not available for all countries. 

In other words, we didn't factor if you were already sick into our assessment of whether you would die, we used survey data, which is about as accurate as political polling data (take it with a large grain of ... potassium). Oh, and even though we say we assessed 195 countries, a lot of them didn't return our surveys, so we wrote up what we could get.

That said, eat better and live longer.

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