The burden of dietary risk factors in the Nordic and Baltic countries: a systematic analysis for the Global Burden of Disease Study 2023.

Background: Detailed knowledge about the disease burden from unhealthy diet in Nordic and Baltic countries is lacking. This study quantifies and compares deaths and disability-adjusted life-years (DALYs) from dietary risks in these countries. Methods: Data from the Global Burden of Disease study 2023 (GBD 2023) was used. Attributable disease burden from 15 dietary risks was analysed using the comparative risk assessment framework. Steps included: (1) estimating dietary intake; (2) assessing relative risks of dietary factors on disease endpoints; (3) determining theoretical minimum risk exposure levels (TMREL); and (4) estimating dietary risk-attributable disease burden as numbers and age-standardised rates (ASR) of deaths and DALYs. Findings: Across the Nordic and Baltic countries (total population = 34,064,020), dietary risks resulted in 38,450 attributed deaths (95% uncertainty interval 10,749-59,386) and 735,284 DALYs (242,417-1,06,638) in 2023. Leading dietary risks included high intake of processed meat and low intake of fruits and whole grains. Dietary risks accounted for 24.9% of cardiovascular disease burden (5.0-37.6), 29.6% of diabetes and kidney disease burden (18.6-40.0), and 7.8% of neoplasm burden (2.9-12.1), with higher burden in the Baltic countries and Greenland than in the Nordic countries. Interpretation: A substantial disease burden can be attributed to dietary risks in the Nordic and Baltic countries. Knowledge about the impact from unhealthy diet can inform targeted public health policies. Funding: Gates Foundation and Norwegian Institute of Public Health.