What Are You Not Eating?

Messages about nutrition often tend to focus on avoiding unhealthy foods in our diets, particularly sugar, salt and fat, when the more troubling aspect of our diets has become what we are not eating. More people die from not eating the right kind of food than from eating the wrong kind of food. Our poor eating habits are a global health crisis, according to an international study.

The Global Burden of Diseases, Injuries, and Risk Factors Study combined information from several epidemiologic studies involving researchers around the world. It analyzed trends in the consumption of 15 food and nutrients between 1990 and 2017 in 195 countries. The foods and nutrients tracked included fruits, vegetables, legumes, whole grains, nuts, seeds, milk, fiber, calcium, seafood, omega-3 fats, polyunsaturated fats, red and processed meats, sugary beverages, trans fats and sodium.

It’s good to eat less salt, sugar and saturated fat and cut back on processed meats. But it’s more important to fill your grocery cart with fruits, vegetables, whole grains and legumes.

About 11 million deaths worldwide were attributed to unhealthy diets. There were 10 million deaths from heart disease, over 900,000 deaths due to obesity-related cancers and nearly 339,000 deaths linked to type 2 diabetes, the study found. More deaths occurred as a result of poor diet than tobacco use and high blood pressure.

Diet-related deaths were not the result of too many unhealthy foods, but instead, too little healthy food. In fact, more than half of diet-related deaths were due to just three risk factors: not eating enough fruit, not eating enough whole grains and eating too much salt. In the U.S., a lack of whole grains was found to be the leading dietary risk factor for diet-related deaths. Failure to meet the guidelines for these foods also accounted for 66 percent of disabilities from various chronic diseases.

It's the microminerals and trace elements in healthy food that make a difference. The healthy foods that were consumed in the least quantities included nuts, seeds, milk and whole grains. The unhealthy foods most commonly overconsumed were sugary beverages, processed meats and sodium.

While the impact of certain foods or nutrients on death rates varies from country to country based on cultural preferences, affordability, access to certain healthy foods or even lack of access to clean water, not eating enough healthy food is a global problem. Correcting the dietary imbalances in the world could prevent over 20 percent of deaths. Doing so would be no easy feat and would require major changes in food systems both around the world and within countries.

“Avoid these foods” messages have overshadowed the message to eat more fruits, vegetables, whole grains, nuts and legumes.

The study provides evidence that shifting the emphasis in dietary guidance from dietary “don’ts” to “do's” could be a good start. Instead of messages that focus on foods people should avoid, more helpful nutritional messages would tell people the healthy foods they should be eating.

What does all this mean for the typical American? It appears that “avoid these foods” messages have overshadowed the message to eat more fruits, vegetables, whole grains, nuts and legumes.

It’s good to eat less salt, less sugar, and less saturated and trans fat. It’s good to cut back on red and processed meats. But it’s more important to eat a plant-based diet and fill your grocery cart with fruits, vegetables, whole grains, nuts, seeds and legumes. These are the foods — and the micronutrients they contain — that are likely to pay big dividends to your health down the road and possibly extend your life.

The study is published in The Lancet.