Title : Impact of healthy and sustainable diets on the mortality burden in Mexico
Abstract:
Objective(s): Healthy and sustainable diets (HSDs) have been shown to reduce mortality from chronic diseases in high-income countries, but evidence in low- and middle-income countries, such as Mexico, remains limited. This study assessed the impact of various HSD scenarios on mortality burden from cardiometabolic diseases and cancer among Mexican adults.
Material and Methods: A comparative risk assessment model was used to estimate changes in total and premature mortality under six HSD scenarios: the 2023 Healthy and Sustainable Dietary Guidelines for Mexico (HSDG), the EAT-Lancet diet and its Mexican adaptation (EAT-Mex), as well as vegan, vegetarian, and pescetarian diets, compared to the current diet. Relative risks associated with food group consumption were obtained from dose-response meta-analyses. The current diet was based on data from the ENSANUT 2016 survey, and HSDs were simulated according to specific consumption recommendations. Mortality data for cardiovascular diseases (CVD), cerebrovascular diseases (CBVD), type 2 diabetes (T2D), and colorectal cancer (CRC) were obtained from INEGI, defining deaths among individuals aged 20-75 years as premature. Preventable deaths were calculated using potential impact fractions, incorporating uncertainty through bootstrap analyses.
Results: Compared to the current diet, HSDs reduced premature mortality by 25.1% to 30.6% and total mortality by 26.6% to 33.1%, with vegan diets achieving the largest reduction in deaths. The HSDG ranked third, preventing 29.6% of premature deaths (42,470; 95% CI 39,940–45,045) and 31.9% of total deaths (89,337; 95% CI 84,446–94,244). Vegan diets achieved the largest reductions in CVD mortality (62,290; 95% CI 60,271–64,321), pescetarian diets in CBVD mortality (9,791; 95% CI 9,243–10,340), while the EAT-Lancet diet yielded the highest reductions in T2D (23,793; 95% CI 21,733–25,859) and CRC mortality (941; 95% CI 838–1,046).
Conclusion: HSDs have substantial potential to reduce mortality from chronic diseases in Mexico, supporting the need for programs and public policies that promote their adoption and contribute to the prevention of the burden of these diseases in the country.
