Global, regional and national burden of ischemic heart disease attributable to suboptimal diet, 1990–2023: a Global Burden of Disease study

Marcin W. Wojewodzic Dinesh Upadhya Ahmed Bilal Waqar Kazumasa Yamagishi Zhiyong Zou Y. Waheed Suowen Xu Abdul Rohim Tualeka Dakshitha Praneeth Wickramasinghe Mircea Tampa Nuwan Darshana Wickramasinghe Rasiah Thayakaran Felicia Wu Rajshree Thapa Pugazhenthan Thangaraju Dehui Yin Isidora S. Vujcic Galal Yahya Mohamad Hani Temsah Yunquan Zhang Shoban Babu Varthya Muhammad Umair Marcos Roberto Tovani-Palone Domenico Trico Casper J. P Zhang Madhur Verma Aurora Zanghì Xiao Dong Zhou Dong Keon Yon Bin Zhu Nguyen Tran Minh Duc Habib Yaribeygi Mohammed Zawiah Jibrin Sammani Usman Tommi Juhani Vasankari Loc Tri Vu Peter Willeit Dominique Vervoort Pengpeng Ye Kavumpurathu Raman Thankappan Dipan Uppal Min Seo Kim Ramna Thakur Anggi Lukman Wicaksana Naohiro Yonemoto Stefanos Tyrovolas Chuanhua Yu Yuichi Yasufuku Zenghong Wu Andrea Werdecker Khaled Trabelsi Mary Njeri Wanjau Jacques Lukenze Tamuzi Shuduo Zhou Nguyen Tran Minh Duc Aniefiok John Udoakang Haosu Tang Sojit Tomo Lakshmi Thangavelu Ghazal Zoghi Masayuki Teramoto Toyiba Hiyaru Wassie Georgios Ioannis Verras Joe Varghese Subah Abderehim Yesuf Nathan Y. Tat Anthony Zhong Zhiqiang Zhang Abzal Zhumagaliuly Thang Huu Tran Manish Vinayak Thien Tan Tri Tai Truyen Asokan Govindaraj Vaithinathan Sa’ed H. Zyoud Magdalena Zielińska Asokan Govindaraj Vaithinathan Krishna Tiwari Jansje Henny Vera Ticoalu Nghia Minh Tran Munkhtuya Tumurkhuu Quynh Thuy Huong Tran Jef Van den Eynde Yanzhong Wang Xiaoyue Xu Mohammed Y. Youssef Wanqing Xie Xingxin Wang Hanqing Zhao Yuichiro Yano Yihun Miskir Wubie Claire Chenwen Zhong Salih M.Mustafa Salih Zebari Sa’ed H. Zyoud Yuichi Yasufuku Lakshmi Thangavelu Tewodros Eshete Wonde Rekha Thapar Xing Wang Casper J. P Zhang Liqun Zhang Mohammed G. M Zeariya Era Upadhyay Ali H. Mokdad Marcello Tonelli Iman M. Talaat Mathilde Touvier

Publication Name: Nature Medicine

Publication Date: 2026-04-01

Volume: 32

Issue: 4

Page Range: 1454-1478

Description:

Ischemic heart disease (IHD) remains a leading cause of death worldwide, with dietary risks being its most significant modifiable factor. Here, using the Global Burden of Diseases, Injuries and Risk Factors Study 2023, we estimated the mortality and disability-adjusted life years from diet-related IHD across 204 countries. In 2023, a suboptimal diet was responsible for 4.06 million (95% uncertainty interval (UI) 0.74–6.22) IHD deaths and 96.84 million (18.82–142.52) IHD disability-adjusted life years. The global age-standardized death rate of IHD attributable to suboptimal diet decreased by 43.92% (95% UI 34.44–53.23) per 100,000 population from 1990 to 2023. Among dietary factors, low intake of nuts and seeds (9.87, 95% UI 2.84–17.12 deaths per 100,000 population), low whole grains (9.22, 4.73–13.67), low fruits (7.25, 1.54–13.34) and high sodium (7.15, 0.92–17.97) were primary contributors to IHD deaths. The burden was particularly pronounced in low- and middle-sociodemographic index countries. By disentangling dietary risk factors, we identified the portion of IHD burden directly modifiable through food interventions.

Open Access: Yes

DOI: 10.1038/s41591-026-04250-8

Authors - 106

Marcin W. Wojewodzic

15019918600

Dinesh Upadhya

24333659800

Ahmed Bilal Waqar

35088909900

Kazumasa Yamagishi

35231751500

Zhiyong Zou

35270950600

Y. Waheed

35303643700

Suowen Xu

35303824800

Abdul Rohim Tualeka

36447791600

Dakshitha Praneeth Wickramasinghe

37099212100

Mircea Tampa

55324899600

Nuwan Darshana Wickramasinghe

55326938000

Rasiah Thayakaran

55515625100

Felicia Wu

55700782200

Rajshree Thapa

55845440200

Pugazhenthan Thangaraju

55854329500

Dehui Yin

55881605800

Isidora S. Vujcic

55957120100

Galal Yahya

55971917800

Mohamad Hani Temsah

56115852000

Yunquan Zhang

56568510200

Shoban Babu Varthya

56586223000

Muhammad Umair

56641365200

Marcos Roberto Tovani-Palone

56644977900

Domenico Trico

56755363000

Casper J. P Zhang

57157668500

Madhur Verma

57189521090

Aurora Zanghì

57189760694

Xiao Dong Zhou

57192705858

Dong Keon Yon

57193675906

Bin Zhu

57195958809

Nguyen Tran Minh Duc

57199622107

Habib Yaribeygi

57200135767

Mohammed Zawiah

57200374267

Jibrin Sammani Usman

57200394078

Tommi Juhani Vasankari

57200592416

Loc Tri Vu

57200613009

Peter Willeit

57201562616

Dominique Vervoort

57202385503

Pengpeng Ye

57202839295

Kavumpurathu Raman Thankappan

57202955435

Dipan Uppal

57203063847

Min Seo Kim

57203591936

Ramna Thakur

57203728704

Anggi Lukman Wicaksana

57204802271

Naohiro Yonemoto

57204947657

Stefanos Tyrovolas

57207793475

Chuanhua Yu

57208140344

Yuichi Yasufuku

57208641890

Zenghong Wu

57208700583

Andrea Werdecker

57208964895

Khaled Trabelsi

57209079185

Mary Njeri Wanjau

57209206928

Jacques Lukenze Tamuzi

57210897062

Shuduo Zhou

57216339945

Nguyen Tran Minh Duc

57216549849

Aniefiok John Udoakang

57217492763

Haosu Tang

57218599887

Sojit Tomo

57219773428

Lakshmi Thangavelu

57221436939

Ghazal Zoghi

57222254861

Masayuki Teramoto

57222309775

Toyiba Hiyaru Wassie

57224994489

Georgios Ioannis Verras

57226630938

Joe Varghese

57372145200

Subah Abderehim Yesuf

57800370700

Nathan Y. Tat

57820156400

Anthony Zhong

57886452300

Zhiqiang Zhang

57924906200

Abzal Zhumagaliuly

57999133100

Thang Huu Tran

58158086500

Manish Vinayak

58199948600

Thien Tan Tri Tai Truyen

58308873300

Asokan Govindaraj Vaithinathan

58309502900

Sa’ed H. Zyoud

58486874500

Magdalena Zielińska

58491440100

Asokan Govindaraj Vaithinathan

58547317600

Krishna Tiwari

58560409500

Jansje Henny Vera Ticoalu

58806122400

Nghia Minh Tran

58956499800

Munkhtuya Tumurkhuu

59156725100

Quynh Thuy Huong Tran

59208404200

Jef Van den Eynde

59383291100

Yanzhong Wang

59417336500

Xiaoyue Xu

59560820600

Mohammed Y. Youssef

59571620400

Wanqing Xie

59667879600

Xingxin Wang

59668183900

Hanqing Zhao

59742707300

Yuichiro Yano

59776825000

Yihun Miskir Wubie

59950923600

Claire Chenwen Zhong

60033328900

Salih M.Mustafa Salih Zebari

60264327900

Sa’ed H. Zyoud

60338330400

Yuichi Yasufuku

60370448000

Lakshmi Thangavelu

60530978700

Tewodros Eshete Wonde

60545170100

Rekha Thapar

60570049300

Xing Wang

60573655600

Casper J. P Zhang

60584807400

Liqun Zhang

60585009700

Mohammed G. M Zeariya

60585009800

Era Upadhyay

6505961711

Ali H. Mokdad

7004813962

Marcello Tonelli

7103102534

Iman M. Talaat

7801465176

Mathilde Touvier

8877033300