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the level of intake associated with the lowest risk of mortality.

Optimal level of intake

We defined the optimal level of intake as the level of risk exposure that minimises the risk from all causes of death. To estimate the optimal intake for each dietary factor, we first calculated the level of intake associated with the lowest risk of mortality from each disease endpoint based on the studies included in the meta-analyses of the dietary relative risks. Then, we calculated the optimal level of intake as the weighted mean of these numbers using the global proportion of deaths from each disease as the weight. To reflect the uncertainty of optimal level of intake, we assumed a uniform uncertainty distribution of 20% above and below the mean.13 For sodium, the evidence supporting the selection of the optimal level of intake was uncertain.2324 Therefore, we included a uniform distribution of different optimal levels of intake in the uncertainty estimation sampling.

 Disease-specific deaths and disability-adjusted life-years

Data on disease-specific deaths and disability-adjusted life-years (DALYs) by age, sex, country, and year were obtained from GBD 2017. The GBD approach to estimating cause-specific mortality and DALYs has been described in detail elsewhere.2526

 Disease burden of dietary risks

We used the GBD comparative risk assessment approach to estimate the population attributable fraction for each diet–disease pair by age, sex, country, and year.10111213 Then, we estimated the number of deaths and DALYs attributable to each dietary risk factor by multiplying the population attributable fraction by the total number of disease-specific deaths and DALYs.To position countries on the development continuum, we used the Socio-demographic Index (SDI), which is a summary measure calculated on the basis of lag-distributed income per capita, mean educational attainment of individuals aged 15 years or older, and total fertility rate among women younger than 25 years.1213 To estimate gaps in intake or excess of intake of individual components of diet, we compared the current intake of each dietary factor with the midpoint of its optimal range of intake (table). High intake of a dietary component refers to an intake level higher than the midpoint of the optimal range of intake, and low intake refers to an intake level lower than the midpoint of the optimal range of intake.