Risk assessmentindependent cross-checkabstract checked★ key study I-SYS-102 standard review
Global health 2023
Burden of 375 diseases and injuries, risk-attributable burden of 88 risk factors, and healthy life expectancy in 204 countries and territories, including 660 subnational locations, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023.
Overview
GBD 2023 Disease and Injury and Risk Factor Collaborators. Lancet 2025 · PMID 41092926 · DOI 10.1016/S0140-6736(25)01637-X
About half of all ill health is linked to known risk factors; high blood pressure, air pollution, high blood sugar and smoking lead.
Does the study support the specific claim? Partly · Methodological quality: high
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Global burden 2023.
- How was the study done?
Modelling.
- How many people, animals or samples were studied?
204 countries.
- What was actually found?
Half of burden from known risks.
- How large was the observed effect?
1.27/2.80 billion DALYs.
- What do the results mean in everyday life?
Many causes besides food.
- What are the study's limitations?
Model-based.
- What does it say about Elawady's specific claim?
Contradicts food-only explanations.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Unmeasured causes.
Scientific in-depth review
1. Full reference
- Authors
- GBD 2023 Disease and Injury and Risk Factor Collaborators
- Journal
- Lancet
- Year
- 2025
- Identifier
- PMID 41092926 DOI 10.1016/S0140-6736(25)01637-X
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Gates Foundation and Bloomberg Philanthropies; declarations in full text
2. Research question
Burden of 375 diseases and 88 risk factors, 1990-2023
3. Study design and population
- Study design
- Risk assessment – Global Burden of Disease Study 2023: diseases and risk-attributable burden
- Population
204 countries and territories
- Country
Global
- Period
1990-2023
- Sample size
>310,000 data sources
- Inclusion and exclusion criteria
not applicable
4. Methods and endpoints
- Exposure / intervention
88 risk factors
- Comparator
TMREL
- Endpoints
DALYs
- Statistical methods
DisMod-MR 2.1, comparative risk assessment
5. Actual results
- Results
Nearly 50% (1.27 billion of 2.80 billion) of global DALYs in 2023 were attributable to the 88 risk factors. Leading Level 3 risks: high systolic blood pressure (8.4% of DALYs), particulate matter pollution, high fasting plasma glucose, smoking, low birthweight and short gestation. Age-standardised attributable rates rose for high BMI (10.5%), drug use and high FPG.
- Absolute risks
As reported
- Authors' conclusion
Rising NCD burden requires addressing air pollution, smoking and metabolic risks, including healthier diets and access to treatments.
6. Strengths
- Newest GBD round
7. Weaknesses
- Model-based
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Modelling assumptions.
9. Assessment of the statistical interpretation
All quantified risks together explain ~45% of DALYs (recalculated 1.27/2.80).
10. Relevance to the specific claim
Shows that even all 88 quantified risks explain about half of disease burden, and the leading single risks are blood pressure, air pollution, glucose and smoking.
11. Independent contrary findings
Diet drives part of SBP, BMI and FPG.
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Contradicts 'mostly caused by food, medicines and cosmetics'.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | high |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | mixed |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
15. Linked fact checks
- Food is the first (leading) cause of modern (non-communicable) diseases. – Studies contradicting or limiting the claim
- Chronic disease is mostly a cumulative reaction to what enters the body daily - contaminated food, medicines and cosmetics - not a fate that comes from outside. – Studies contradicting or limiting the claim