Impacto de alterações no consumo alimentar nas mortes prematuras por doenças crônicas não transmissíveis no Brasil

Abstract

Noncommunicable diseases (NCDs) account for approximately 75% of total deaths in Brazil and worldwide. A significant proportion of these deaths occur prematurely, between the ages of 30 and 69. Among the modifiable risk factors for NCDs, unhealthy diet stands out. There is robust evidence on the harmful effects of sugar consumption—including sugar-sweetened beverages—and trans-fat intake on health. These are among the main dietary factors targeted by public policies and consumption guidelines for healthy eating, both nationally and internationally. The objective of this study is to estimate the reduction in premature deaths from NCDs resulting from changes in sugar and trans-fat consumption in the Brazilian population. Using a comparative risk assessment framework, we calculated the population attributable fraction of premature mortality due to cardiovascular diseases—both overall and specifically ischemic heart disease—as well as diabetes mellitus, attributable to excessive sugar intake, consumption of sugar-sweetened beverages, and trans-fat intake, stratified by sex, age groups, and geographic regions. Mortality data were obtained from the Mortality Information System, dietary intake data were sourced from the 2017–2018 Brazilian National Dietary Survey through 24-hour dietary recalls, and relative risks were derived from prospective cohort studies. Uncertainty was quantified using probabilistic simulations. In 2018, among adults aged 30 to 69, there were 141,910 premature deaths from cardiovascular diseases, 54,298 deaths from ischemic heart disease, and 27,810 from diabetes, with higher mortality rates among men. A high intake of sugar-sweetened beverages was observed, with no significant differences in trans-fat consumption by sex or age. Added sugars accounted for an average of 9.86% of total energy intake, with higher consumption among women, individuals under 50 years of age, and residents of the South and Southeast regions. Approximately 6% of premature deaths from ischemic heart disease and diabetes mellitus in 2018 were attributable to sugar-sweetened beverages, with a more pronounced effect among men. Trans fat consumption accounted for 1,783 deaths (3%) from ischemic heart disease, while excessive sugar intake accounted for 2,400 premature deaths (1.7%) from cardiovascular diseases, with higher percentages among women (2.1%). This study highlights the impact of unhealthy dietary patterns on premature mortality from noncommunicable diseases in Brazil, identifying priority target categories for each dietary factor.