Publications by authors named "Leslie Cornaby"

3 Publications

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The Global Nutrient Database: availability of macronutrients and micronutrients in 195 countries from 1980 to 2013.

Lancet Planet Health 2018 08;2(8):e353-e368

Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA. Electronic address:

Background: Few data are available on the supply and consumption of nutrients at the country level. To address this data gap, we aimed to create a database that provides information on availability (ie, supply) of 156 nutrients across 195 countries and territories from 1980 to 2013.

Methods: We matched 394 food and agricultural commodities from the Food and Agriculture Organization of the United Nations Supply and Utilization Accounts (SUAs) to food items in the United States Department of Agriculture Food Composition Database and obtained data on nutrient composition of the SUAs' food items. Then, after adjusting for inedible portion of each food item, we added the contributions of individual food items to the availability of each nutrient and estimated the national availability of macronutrients and micronutrients in each year. We validated our estimates by comparing our results with those of national nutrition surveys from three countries (the USA, South Korea, and Ecuador). Using dietary consumption data from the Global Burden of Disease study and two popular machine learning algorithms (Random Forest and XGBoost [extreme gradient boosting]), we developed predictive models to estimate the consumption of each nutrient based on their national availability.

Findings: Globally 2710 kcal (95% UI 2660-2770) were available per person per day in 2013. Carbohydrates were the major contributor to energy availability (70·5%), followed by fats (17·4%), and protein (10·5%). The energy availability and the contribution of macronutrients to total energy widely varied across levels of development. Countries at the higher level of development (high Socio-demographic Index countries) had more energy available per person per day (3270 kcal, 3220-3310); greater contributions from fats (26·0%) and proteins (11·9%) to total energy availability; and lower contributions from carbohydrate (54·8%). During 1980-2013, energy availability and the contributions of protein and fats to energy availability have increased globally and across levels of development while the contribution of carbohydrates to total energy availability has decreased. The supply of the micronutrients has also increased during the same period globally and across levels of development. Our validation analysis showed that, after accounting for waste at the retail and household level, our estimates of macronutrient availability were very close to the consumption data in nationally representative surveys. Our machine-learning models closely predicted the observed intake of nutrients with the out-of-sample correlation of greater than 0·8 between predicted and observed intake for the nutrients included in the analysis.

Interpretation: Our global nutrient database provides a picture of the supply of various nutrients at the country level and can be useful to assess the performance of national food systems in addressing the nutritional needs of their population.

Funding: Bill & Melinda Gates Foundation.
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August 2018

The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States.

Ali H Mokdad Katherine Ballestros Michelle Echko Scott Glenn Helen E Olsen Erin Mullany Alex Lee Abdur Rahman Khan Alireza Ahmadi Alize J Ferrari Amir Kasaeian Andrea Werdecker Austin Carter Ben Zipkin Benn Sartorius Berrin Serdar Bryan L Sykes Chris Troeger Christina Fitzmaurice Colin D Rehm Damian Santomauro Daniel Kim Danny Colombara David C Schwebel Derrick Tsoi Dhaval Kolte Elaine Nsoesie Emma Nichols Eyal Oren Fiona J Charlson George C Patton Gregory A Roth H Dean Hosgood Harvey A Whiteford Hmwe Kyu Holly E Erskine Hsiang Huang Ira Martopullo Jasvinder A Singh Jean B Nachega Juan R Sanabria Kaja Abbas Kanyin Ong Karen Tabb Kristopher J Krohn Leslie Cornaby Louisa Degenhardt Mark Moses Maryam Farvid Max Griswold Michael Criqui Michelle Bell Minh Nguyen Mitch Wallin Mojde Mirarefin Mostafa Qorbani Mustafa Younis Nancy Fullman Patrick Liu Paul Briant Philimon Gona Rasmus Havmoller Ricky Leung Ruth Kimokoti Shahrzad Bazargan-Hejazi Simon I Hay Simon Yadgir Stan Biryukov Stein Emil Vollset Tahiya Alam Tahvi Frank Talha Farid Ted Miller Theo Vos Till Bärnighausen Tsegaye Telwelde Gebrehiwot Yuichiro Yano Ziyad Al-Aly Alem Mehari Alexis Handal Amit Kandel Ben Anderson Brian Biroscak Dariush Mozaffarian E Ray Dorsey Eric L Ding Eun-Kee Park Gregory Wagner Guoqing Hu Honglei Chen Jacob E Sunshine Jagdish Khubchandani Janet Leasher Janni Leung Joshua Salomon Jurgen Unutzer Leah Cahill Leslie Cooper Masako Horino Michael Brauer Nicholas Breitborde Peter Hotez Roman Topor-Madry Samir Soneji Saverio Stranges Spencer James Stephen Amrock Sudha Jayaraman Tejas Patel Tomi Akinyemiju Vegard Skirbekk Yohannes Kinfu Zulfiqar Bhutta Jost B Jonas Christopher J L Murray

JAMA 2018 04;319(14):1444-1472

Institute for Health Metrics and Evaluation, University of Washington, Seattle.

Introduction: Several studies have measured health outcomes in the United States, but none have provided a comprehensive assessment of patterns of health by state.

Objective: To use the results of the Global Burden of Disease Study (GBD) to report trends in the burden of diseases, injuries, and risk factors at the state level from 1990 to 2016.

Design And Setting: A systematic analysis of published studies and available data sources estimates the burden of disease by age, sex, geography, and year.

Main Outcomes And Measures: Prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost (YLLs) due to premature mortality, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 333 causes and 84 risk factors with 95% uncertainty intervals (UIs) were computed.

Results: Between 1990 and 2016, overall death rates in the United States declined from 745.2 (95% UI, 740.6 to 749.8) per 100 000 persons to 578.0 (95% UI, 569.4 to 587.1) per 100 000 persons. The probability of death among adults aged 20 to 55 years declined in 31 states and Washington, DC from 1990 to 2016. In 2016, Hawaii had the highest life expectancy at birth (81.3 years) and Mississippi had the lowest (74.7 years), a 6.6-year difference. Minnesota had the highest HALE at birth (70.3 years), and West Virginia had the lowest (63.8 years), a 6.5-year difference. The leading causes of DALYs in the United States for 1990 and 2016 were ischemic heart disease and lung cancer, while the third leading cause in 1990 was low back pain, and the third leading cause in 2016 was chronic obstructive pulmonary disease. Opioid use disorders moved from the 11th leading cause of DALYs in 1990 to the 7th leading cause in 2016, representing a 74.5% (95% UI, 42.8% to 93.9%) change. In 2016, each of the following 6 risks individually accounted for more than 5% of risk-attributable DALYs: tobacco consumption, high body mass index (BMI), poor diet, alcohol and drug use, high fasting plasma glucose, and high blood pressure. Across all US states, the top risk factors in terms of attributable DALYs were due to 1 of the 3 following causes: tobacco consumption (32 states), high BMI (10 states), or alcohol and drug use (8 states).

Conclusions And Relevance: There are wide differences in the burden of disease at the state level. Specific diseases and risk factors, such as drug use disorders, high BMI, poor diet, high fasting plasma glucose level, and alcohol use disorders are increasing and warrant increased attention. These data can be used to inform national health priorities for research, clinical care, and policy.
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April 2018

Health Effects of Overweight and Obesity in 195 Countries over 25 Years.

Ashkan Afshin Mohammad H Forouzanfar Marissa B Reitsma Patrick Sur Kara Estep Alex Lee Laurie Marczak Ali H Mokdad Maziar Moradi-Lakeh Mohsen Naghavi Joseph S Salama Theo Vos Kalkidan H Abate Cristiana Abbafati Muktar B Ahmed Ziyad Al-Aly Ala’a Alkerwi Rajaa Al-Raddadi Azmeraw T Amare Alemayehu Amberbir Adeladza K Amegah Erfan Amini Stephen M Amrock Ranjit M Anjana Johan Ärnlöv Hamid Asayesh Amitava Banerjee Aleksandra Barac Estifanos Baye Derrick A Bennett Addisu S Beyene Sibhatu Biadgilign Stan Biryukov Espen Bjertness Dube J Boneya Ismael Campos-Nonato Juan J Carrero Pedro Cecilio Kelly Cercy Liliana G Ciobanu Leslie Cornaby Solomon A Damtew Lalit Dandona Rakhi Dandona Samath D Dharmaratne Bruce B Duncan Babak Eshrati Alireza Esteghamati Valery L Feigin João C Fernandes Thomas Fürst Tsegaye T Gebrehiwot Audra Gold Philimon N Gona Atsushi Goto Tesfa D Habtewold Kokeb T Hadush Nima Hafezi-Nejad Simon I Hay Masako Horino Farhad Islami Ritul Kamal Amir Kasaeian Srinivasa V Katikireddi Andre P Kengne Chandrasekharan N Kesavachandran Yousef S Khader Young-Ho Khang Jagdish Khubchandani Daniel Kim Yun J Kim Yohannes Kinfu Soewarta Kosen Tiffany Ku Barthelemy Kuate Defo G Anil Kumar Heidi J Larson Mall Leinsalu Xiaofeng Liang Stephen S Lim Patrick Liu Alan D Lopez Rafael Lozano Azeem Majeed Reza Malekzadeh Deborah C Malta Mohsen Mazidi Colm McAlinden Stephen T McGarvey Desalegn T Mengistu George A Mensah Gert B M Mensink Haftay B Mezgebe Erkin M Mirrakhimov Ulrich O Mueller Jean J Noubiap Carla M Obermeyer Felix A Ogbo Mayowa O Owolabi George C Patton Farshad Pourmalek Mostafa Qorbani Anwar Rafay Rajesh K Rai Chhabi L Ranabhat Nikolas Reinig Saeid Safiri Joshua A Salomon Juan R Sanabria Itamar S Santos Benn Sartorius Monika Sawhney Josef Schmidhuber Aletta E Schutte Maria I Schmidt Sadaf G Sepanlou Moretza Shamsizadeh Sara Sheikhbahaei Min-Jeong Shin Rahman Shiri Ivy Shiue Hirbo S Roba Diego A S Silva Jonathan I Silverberg Jasvinder A Singh Saverio Stranges Soumya Swaminathan Rafael Tabarés-Seisdedos Fentaw Tadese Bemnet A Tedla Balewgizie S Tegegne Abdullah S Terkawi J S Thakur Marcello Tonelli Roman Topor-Madry Stefanos Tyrovolas Kingsley N Ukwaja Olalekan A Uthman Masoud Vaezghasemi Tommi Vasankari Vasiliy V Vlassov Stein E Vollset Elisabete Weiderpass Andrea Werdecker Joshua Wesana Ronny Westerman Yuichiro Yano Naohiro Yonemoto Gerald Yonga Zoubida Zaidi Zerihun M Zenebe Ben Zipkin Christopher J L Murray

N Engl J Med 2017 07 12;377(1):13-27. Epub 2017 Jun 12.

Background: Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

Methods: We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

Results: In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

Conclusions: The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem. (Funded by the Bill and Melinda Gates Foundation.).
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July 2017