Non-communicable diseases mortality attributable to lifestyle risk factors in 5 Latin American countries: a PRIME model study

Non-communicable diseases (NCD) are the leading causes of death in Latin American countries, yet the burden of NCD attributable to lifestyle risk factors in the region remains poorly understood. In this study, we aimed to estimate the proportion and number of NCD deaths attributable to lifestyle risk factors in five Latin American countries. We used data from national surveys conducted in five Latin American countries (Argentina, Brazil, Chile, Colombia, and El Salvador), comprising 259,327 participants. Self-reported data on fruit and vegetable consumption, physical activity, alcohol use, and tobacco smoking were stratified by sex and age group. The Preventable Risk Integrated Model (PRIME) was applied to compare baseline distributions of lifestyle risk factors with a counterfactual scenario based on World Health Organization (WHO) recommendations, estimating changes in annual NCD deaths due to cardiovascular disease (CVD), diabetes, and chronic obstructive pulmonary disease in 2021. We estimated that 184,111 NCD deaths could have been prevented or delayed across the five countries by adhering to WHO lifestyle recommendations. Brazil (46.1%) and Argentina (30.1%) accounted for the largest shares of preventable deaths. CVD represented 46.3% of the total preventable deaths. Tobacco smoking contributed to 56.8% of the preventable deaths, followed by physical inactivity (25.0%), inadequate fruit and vegetable intake (11.0%), and alcohol use (6.9%). Our findings provide population-level estimates of NCD mortality attributable to modifiable lifestyle risk factors in Latin America. Strengthening preventive strategies that target these key behaviors could substantially reduce the NCD burden in the region.