In a marked change from 25 years ago, the leading causes of premature death around the world today are poor diet and high blood pressure, an international study shows.
In 1990, the list was led by malnutrition in children and expectant mothers, unsafe water supplies and poor general sanitation.
While those are still risk factors in many parts of the world, they have been surpassed by the twin risks of unhealthy diet and high blood pressure, researchers report in The Lancet after analyzing cause-of-death data collected worldwide.
They analyzed the incidence of 79 different risk factors for death in 188 countries, covering the time period 1990 to 2013, in data collected by the Global Burden of Disease, Injuries and Risk Factor project.
Leading the list of risk factors for both men and women was high blood pressure, or hypertension.
It was also found out that deaths attributed to hypertension increased by nearly 50 percent between 1990 and 2013.
Age and family history play a part in high blood pressure, so as do obesity, lack of exercise, smoking, excessive consumption of salt and overindulgence in alcohol.
Poor diets, including with few whole grains, fruits and vegetable or high in red meat and sugary beverages, have also become a leading cause of premature deaths.
Since half of the world's deaths and more than a third of disabling ill health are attributable to preventable risks, it is vital that governments around the world heed the study's findings and act on them.
"There's great potential to improve health by avoiding certain risks like smoking and poor diet as well as tackling environmental risks like air pollution," says Dr. Christopher Murray, director of the Institute of Health Metrics and Evaluation at the University of Washington. "The challenge for policymakers will be to use what we know to guide prevention efforts and health policies."
Malnutrition among children fell out of the top 10 factors of mortality risk during the study period, but globally it still remains the leading cause of death in children younger than five.
That problem was most acute in sub-Saharan African countries, say IHME researchers and study leader Dr. Mohammad Hossein Forouzanfar.
"While we have seen a tremendous growth in risk factors that contribute to noncommunicable diseases like heart disease, pulmonary diseases and diabetes, childhood undernutrition remains a huge challenge for some countries," Dr. Mohammad says.