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March 7, 2017

Attributing Death to Diet: Precision Counts

Author Affiliations
  • 1Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, Maryland
  • 2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
  • 3Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland
JAMA. 2017;317(9):908-909. doi:10.1001/jama.2017.0946

A substantial body of evidence has implicated several aspects of diet with the occurrence of cardiometabolic disease (CMD)—heart disease, stroke, and type 2 diabetes. Dietary factors studied have included individual nutrients (macronutrients, micronutrients, minerals, vitamins, electrolytes, and phytochemicals), foods, and overall dietary patterns. It is generally accepted that a suboptimal diet is causally related to CMD, but scientists debate which factors are responsible and the relative importance of each factor given the challenges of isolating and estimating the potential effects of individual nutrients and foods, especially in observational studies. Another topic that is receiving considerably more attention is estimating the fraction of preventable deaths due to suboptimal diet and other factors. Policy makers, in particular, are eager to understand the total burden of CMD that may be attributable to suboptimal diet, given that modification of diet is a cornerstone of prevention policy.1

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