Background: Saturated fat ( SFA ), ω‐6 (n‐6) polyunsaturated fat ( PUFA ), and trans fat ( TFA ) influence risk of coronary heart disease ( CHD ), but attributable CHD mortalities by country, age, sex, and time are unclear. Methods and Results: National intakes of SFA , n‐6 PUFA , and TFA were estimated using a Bayesian hierarchical model based on country‐specific dietary surveys; food availability data; and, for TFA , industry reports on fats/oils and packaged foods. Etiologic effects of dietary fats on CHD mortality were derived from meta‐analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. In 2010, nonoptimal intakes of n‐6 PUFA , SFA , and TFA were estimated to result in 711 800 (95% uncertainty interval [UI] 680 700–745 000), 250 900 (95% UI 236 900–265 800), and 537 200 (95% UI 517 600–557 000) CHD deaths per year worldwide, accounting for 10.3% (95% UI 9.9%–10.6%), 3.6%, (95% UI 3.5%–3.6%) and 7.7% (95% UI 7.6%–7.9%) of global CHD mortality. Tropical oil–consuming countries were estimated to have the highest proportional n‐6 PUFA – and SFA ‐attributable CHD mortality, whereas Egypt, Pakistan, and Canada were estimated to have the highest proportional TFA ‐attributable CHD mortality. From 1990 to 2010 globally, the estimated proportional CHD mortality decreased by 9% for insufficient n‐6 PUFA and by 21% for higher SFA, whereas it increased by 4% for higher TFA , with the latter driven by increases in low‐ and middle‐income countries. Conclusions: Nonoptimal intakes of n‐6 PUFA , TFA , and SFA each contribute to significant estimated CHD mortality, with important heterogeneity across countries that informs nation‐specific clinical, public health, and policy priorities.

Objective/design We conducted a comparative risk assessment analysis to estimate the cardiometabolic disease (CMD) mortality attributable to 11 dietary and 4 metabolic risk factors in 20 countries of the Middle East by age, sex and time. The national exposure distributions were obtained from a systematic search of multiple databases. Missing exposure data were estimated using a multilevel Bayesian hierarchical model. The aetiological effect of each risk factor on disease-specific mortality was obtained from clinical trials and observational studies. The number of disease-specific deaths was obtained from the 2010 Global Burden of Disease mortality database. Mortality due to each risk factor was determined using the population attributable fraction and total number of disease-specific deaths. Setting/population Adult population in the Middle East by age, sex, country and time. Results Suboptimal diet was the leading risk factor for CMD mortality in 11 countries accounting for 48% (in Morocco) to 72% (in the United Arab Emirates) of CMD deaths. Non-optimal systolic blood pressure was the leading risk factor for CMD deaths in eight countries causing 45% (in Bahrain) to 68% (in Libya) of CMD deaths. Non-optimal body mass index and fasting plasma glucose were the third and fourth leading risk factors for CMD mortality in most countries. Among individual dietary factors, low intake of fruits accounted for 8% (in Jordan) to 21% (in Palestine) of CMD deaths and low intake of whole grains was responsible for 7% (in Palestine) to 22% (in the United Arab Emirates) of CMD deaths. Between 1990 and 2010, the CMD mortality attributable to most risk factors had decreased except for body mass index and trans-fatty acids. Conclusions Our findings highlight key similarities and differences in the impact of the dietary and metabolic risk factors on CMD mortality in the countries of the Middle East and inform priorities for policy measures to prevent CMD.

Providing the sustainable development goals (SDGs) water, food and energy security to cities relies strongly on resource use outside city borders. Many modern cities have recently invested in a sustainable urban water system, and score high in international city rankings regarding water management and direct urban water use. However, these rankings generally neglect external resource use for cities. Here we quantify the water resources related to food consumption in thirteen cities located in Mediterranean countries, by means of the water footprint (WF) concept. These WFs amount from 3277l per capita per day (l/cap/d) to 5789l/cap/d. These amounts are about thirty times higher than their direct urban water use. We additionally analyse the WF of three diet scenarios, based upon a Mediterranean dietary pattern. Many authors identify the Mediterranean diet as cultural heritage, being beneficial for human health and a model for a sustainable food system. The first diet scenario, a healthy Mediterranean diet including meat, leads to WF reductions of -19% to -43%. The second diet scenario (pesco-vegetarian), leads to WF reductions of -28% to -52%. The third diet scenario (vegetarian), leads to WF reductions of -30% to -53%. In other words, if urban citizens want to save water, they need to look at their diets.

This study aimed to investigate whether there was any difference in eating pattern, abnormal eating behaviour, obesity and the number of food addiction symptoms according to food addiction presence. A total sample of 851 healthy subjects living in Ankara (n = 360 male, n = 491 female) aged 19–65 years were included in this cross-sectional survey. Data on demographic information, 24-hour dietary recalls, Yale Food Addiction Scale (YFAS), Eating Attitudes Test-26 (EAT-26), and anthropometric measurements were collected through face-to-face interviews. Overall, 11.4% of participants were identified as “food addicted” (F: 13.0%; M: 9.2%). Subjects meeting criteria for ‘food addiction' had higher body mass index (35.1% were obese and 3.1% were underweight), compared to subjects without food addiction (13.1% were obese and 10.2% were underweight) (p<0.05). Abnormal eating attitudes estimated with EAT-26 were determined as 45.5% in males, 37.5% in females and 40.2% in total, among subjects with food addiction. Daily energy, protein and fat intakes were significantly higher in food addicted females, compared to non-addicted females (p<0.05). Participants with food addiction reported significantly more problems with foods, which contain high amounts of fat and sugar, compared to the participants without food addiction. Food addiction behaviour should be considered as a part of efforts towards reducing food related problems involving obesity.