Diet and Health: Diseases and Food 291in diabetes figures for developing countries and a fall for developed countries, yet
it should be noted that diabetes figures are in fact rising rapidly worldwide. The
newness of this diet-related epidemic might have been too late for Murray and
Lopez’s 1990 data.)
One purpose of the DALY method is to enable policy makers to estimate the
relative risk of major factors for health. Table 13.7 gives the Swedish National
Institute of Public Health’s summary of the calculated impacts of smoking, alco-
hol, diet and physical activity for key DALYs in the EU and Australia. Again, the
diet-related disease toll is very high. Smoking, as was noted at the start of this
chapter, is a major contributory factor in heart disease but the dietary factors,
when separated, were almost as great.
The DALY approach was extended in the ‘World Health Report 2002’ which
was based on a series of massive multi-country studies designed to test and refine
the methodology. Figure 13.11 details risk factors by level of development. The
results, however, merely deepened the insights from the earlier study. If anything,
the burden of diet-related disease and of lack of physical activity received even
higher profile. Special studies on the impact of lack of fruit and vegetables in the
diet showed great impact. The WHO–FAO 2003 report underlined how a variety
of diseases, from heart disease to diabetes, were all associated with the same dietary
pattern: over-consumption, excess fat, under-consumption of fruit and vegetables
and excess added sugar and salt.^75
The Financial Costs
In 2001, the Commission on Macroeconomics and Health, created by the WHO,
argued that there were mutual benefits to be had from improved health and for the
economy, particularly for those in low-income countries.^76 Table 13.8 shows how
general health care costs are rising rapidly in many developed economies; in the
developing world, the costs of health care for degenerative diseases are now also
Table 13.7 DALYs lost by selected causes for the EU and Australia around 1995Cause EU % Australia %
Smoking 9.0 9.5
Alcohol consumption 8.4 2.1
Diet and physical activity 8.3 16.4
Overweight 3.7 2.4
Low fruit and vegetable intake 3.5 2.7
High saturated fat intake 1.1 2.6
Physical inactivity 1.4 6.8Sources: National Institute of Public Health, Stockholm (1997).^74