Suboptimal diet remains the leading modifiable cause of cardiovascular disease worldwide, but its impact is shifting as the global population grows and ages. In a comprehensive study of 204 countries and territories, researchers found that dietary risk factors were responsible for 5.91 million cardiovascular deaths in 2023. While medical advances have helped lower per-capita death rates, the absolute number of lives lost continues to rise, driven by a "top three" list of dietary villains: high sodium intake, low fruit consumption, and a lack of whole grains.
“Our findings underscore that improving dietary quality must remain a central pillar of global heart disease prevention,” said corresponding author Guoshuang Feng, of the Big Data Center at Beijing Children's Hospital. “While we are seeing a decline in age-standardized mortality rates due to better healthcare, the total absolute burden is staggering. We are essentially in a race against an aging population that is increasingly vulnerable to the harms of high-salt and low-nutrient diets.”
The research team analyzed data from the Global Burden of Disease Study 2023, evaluating 13 different dietary risk factors over a 33-year period. The analysis revealed that ischemic heart disease and stroke are the primary outcomes of these poor dietary habits. The study also highlighted a sharp gender divide, with males consistently experiencing a higher diet-attributable burden than females across nearly all regions.
Geographical disparities were particularly pronounced in the findings. China faced the highest absolute number of diet-related cardiovascular deaths at 1.36 million, followed by India at 1.11 million. However, when looking at mortality rates proportional to population size, Pacific Island nations like the Solomon Islands and Nauru faced the heaviest burden. Researchers attribute this to a "nutrition transition" in these islands, where fresh local produce is being replaced by imported, highly processed foods.
The study authors call for targeted, context-specific policy interventions. For high-population countries like China, structural measures such as mandatory front-of-pack sodium labeling and food reformulation are essential. In smaller, vulnerable island economies, the focus must shift toward food sovereignty and increasing the availability of affordable, fresh fruits and vegetables.
10.59717/j.xinn-nutri.2026.100015
Cardiovascular diseases burden attributable to dietary risk factors in 204 countries and territories
19-Apr-2026
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