Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012
Background. Low intake of fruit and vegetables is associated with an increased risk of various non-communicable diseases, including major causes of death and disability such as cardiovascular disease, diabetes mellitus and cancers. Diets low in fruit and vegetables are prevalent in the Sout...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
South African Medical Association
2022-09-01
|
| Series: | South African Medical Journal |
| Subjects: | |
| Online Access: | https://samajournals.co.za/index.php/samj/article/view/206 |
| _version_ | 1797370057405235200 |
|---|---|
| author | A Cois N Abdelatief N Steyn E B Turawa O F Awotiwon R A Roomaney I Neethling J D Joubert R Pacella D Bradshaw V Pillay van-Wyk |
| author_facet | A Cois N Abdelatief N Steyn E B Turawa O F Awotiwon R A Roomaney I Neethling J D Joubert R Pacella D Bradshaw V Pillay van-Wyk |
| author_sort | A Cois |
| collection | DOAJ |
| description |
Background. Low intake of fruit and vegetables is associated with an increased risk of various non-communicable diseases, including major causes of death and disability such as cardiovascular disease, diabetes mellitus and cancers. Diets low in fruit and vegetables are prevalent in the South African (SA) population, and average intake is well below the internationally recommended threshold.
Objectives. To estimate the burden of disease attributable to a diet low in fruit and vegetables by sex and age group in SA for the years 2000, 2006 and 2012.
Methods. We followed World Health Organization and Global Burden of Disease Study comparative risk assessment methodology. Population attributable fractions – calculated from fruit and vegetable intake estimated from national and local surveys and relative risks for health outcomes based on the current literature – were applied to the burden estimates from the second South African National Burden of Disease Study (SANBD2). Outcome measures included deaths and disability-adjusted life years (DALYs) lost from ischaemic heart disease, stroke, type 2 diabetes, and five categories of cancers.
Results. Between 2000 and 2012, the average intake of fruit of the SA adult population (≥25 years) declined by 7%, from 48.5 g/d (95% uncertainty interval (UI) 46.6 - 50.5) to 45.2 g/d (95% UI 42.7 - 47.6). Vegetable intake declined by 25%, from 146.9 g/d (95% UI 142.3 - 151.8) to 110.5 g/d (95% UI 105.9 - 115.0). In 2012, these consumption patterns are estimated to have caused 26 423 deaths (95% UI 24 368 - 28 006), amounting to 5.0% (95% UI 4.6 - 5.3%) of all deaths in SA, and the loss of 514 823 (95% UI 473 508 - 544 803) healthy life years or 2.5% (95% UI 2.3 - 2.6%) of all DALYs. Cardiovascular disease comprised the largest proportion of the attributable burden, with 83% of deaths and 84% of DALYs. Age-standardised death rates were higher for males (145.1 deaths per 100 000; 95% UI 127.9 - 156.2) than for females (108.0 deaths per 100 000; 95% UI 96.2 - 118.1); in both sexes, rates were lower than those observed in 2000 (–9% and –12%, respectively).
Conclusion. Despite the overall reduction in standardised death rates observed since 2000, the absolute burden of disease attributable to inadequate intake of fruit and vegetables in SA remains of significant concern. Effective interventions supported by legislation and policy are needed to reverse the declining trends in consumption observed in most age categories and to curb the associated burden.
|
| first_indexed | 2024-03-08T17:56:56Z |
| format | Article |
| id | doaj.art-10e287ed976949489f98353424eb0446 |
| institution | Directory Open Access Journal |
| issn | 0256-9574 2078-5135 |
| language | English |
| last_indexed | 2024-03-08T17:56:56Z |
| publishDate | 2022-09-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj.art-10e287ed976949489f98353424eb04462024-01-02T04:19:11ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352022-09-011128B10.7196/SAMJ.2022.v112i8b.16486Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012A Cois0N Abdelatief1N Steyn2E B Turawa3O F Awotiwon4R A Roomaney5I Neethling6J D Joubert7R Pacella8D Bradshaw9V Pillay van-Wyk10Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South AfricaBiostatistics Research Unit, South African Medical Research Council, Cape Town, South AfricaDepartment of Human Biology, Faculty of Health Sciences, University of Cape Town, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; Institute for Lifecourse Development, Faculty of Education, Health and Human Sciences, University of Greenwich, London, UK Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa Institute for Lifecourse Development, Faculty of Education, Health and Human Sciences, University of Greenwich, London, UKBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa; Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, South AfricaBurden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa Background. Low intake of fruit and vegetables is associated with an increased risk of various non-communicable diseases, including major causes of death and disability such as cardiovascular disease, diabetes mellitus and cancers. Diets low in fruit and vegetables are prevalent in the South African (SA) population, and average intake is well below the internationally recommended threshold. Objectives. To estimate the burden of disease attributable to a diet low in fruit and vegetables by sex and age group in SA for the years 2000, 2006 and 2012. Methods. We followed World Health Organization and Global Burden of Disease Study comparative risk assessment methodology. Population attributable fractions – calculated from fruit and vegetable intake estimated from national and local surveys and relative risks for health outcomes based on the current literature – were applied to the burden estimates from the second South African National Burden of Disease Study (SANBD2). Outcome measures included deaths and disability-adjusted life years (DALYs) lost from ischaemic heart disease, stroke, type 2 diabetes, and five categories of cancers. Results. Between 2000 and 2012, the average intake of fruit of the SA adult population (≥25 years) declined by 7%, from 48.5 g/d (95% uncertainty interval (UI) 46.6 - 50.5) to 45.2 g/d (95% UI 42.7 - 47.6). Vegetable intake declined by 25%, from 146.9 g/d (95% UI 142.3 - 151.8) to 110.5 g/d (95% UI 105.9 - 115.0). In 2012, these consumption patterns are estimated to have caused 26 423 deaths (95% UI 24 368 - 28 006), amounting to 5.0% (95% UI 4.6 - 5.3%) of all deaths in SA, and the loss of 514 823 (95% UI 473 508 - 544 803) healthy life years or 2.5% (95% UI 2.3 - 2.6%) of all DALYs. Cardiovascular disease comprised the largest proportion of the attributable burden, with 83% of deaths and 84% of DALYs. Age-standardised death rates were higher for males (145.1 deaths per 100 000; 95% UI 127.9 - 156.2) than for females (108.0 deaths per 100 000; 95% UI 96.2 - 118.1); in both sexes, rates were lower than those observed in 2000 (–9% and –12%, respectively). Conclusion. Despite the overall reduction in standardised death rates observed since 2000, the absolute burden of disease attributable to inadequate intake of fruit and vegetables in SA remains of significant concern. Effective interventions supported by legislation and policy are needed to reverse the declining trends in consumption observed in most age categories and to curb the associated burden. https://samajournals.co.za/index.php/samj/article/view/206burden of diseasediet low in fruit and vegetables |
| spellingShingle | A Cois N Abdelatief N Steyn E B Turawa O F Awotiwon R A Roomaney I Neethling J D Joubert R Pacella D Bradshaw V Pillay van-Wyk Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012 South African Medical Journal burden of disease diet low in fruit and vegetables |
| title | Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012 |
| title_full | Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012 |
| title_fullStr | Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012 |
| title_full_unstemmed | Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012 |
| title_short | Estimating the burden of disease attributable to a diet low in fruit and vegetables in South Africa for 2000, 2006 and 2012 |
| title_sort | estimating the burden of disease attributable to a diet low in fruit and vegetables in south africa for 2000 2006 and 2012 |
| topic | burden of disease diet low in fruit and vegetables |
| url | https://samajournals.co.za/index.php/samj/article/view/206 |
| work_keys_str_mv | AT acois estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT nabdelatief estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT nsteyn estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT ebturawa estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT ofawotiwon estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT raroomaney estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT ineethling estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT jdjoubert estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT rpacella estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT dbradshaw estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 AT vpillayvanwyk estimatingtheburdenofdiseaseattributabletoadietlowinfruitandvegetablesinsouthafricafor20002006and2012 |