Everything turns into sugar: Relationship between diet and non-communicable diseases mortality in Ecuador

Dieta y enfermedades no transmisibles: evidencia en Ecuador

Abstract

This study evaluated the relationship between the protein-and-fat-to-carbohydrate index (ipfC) and mortality from non-communicable diseases (NCDs) in Ecuador, proposing strategies to improve diet quality through nutritional interventions. An observational, ecological, and retrospective study was conducted using national data from 2002 to 2023. Descriptive statistics, Pearson correlation analyses between ipfC, NCD mortality (tmENT), and relative annual inflation (raIR), as well as simple and multivariable linear regression models estimated by ordinary least squares (OLS), were performed, including significance tests, residual diagnostics, and scenario-based projections. A strong negative correlation was observed between ipfC and NCD (r = −0.69), indicating that higher ipfC levels are associated with lower NCD mortality. Multivariable analysis showed that ipfC had a statistically significant effect on NCD (coef = −8.66; p = 0.008), whereas raIR was not statistically significant. Projections suggest that a 2 % annual reduction in carbohydrate consumption could accelerate the decline in NCD mortality. Low-carbohydrate diets prioritizing proteins and healthy fats are effective in the prevention and control of type 2 diabetes and cardiovascular diseases by reducing glucose peaks, improving insulin sensitivity, and decreasing chronic inflammation. This study suggests reallocating unspent public health budget funds to implement economic incentives, such as vouchers for the purchase of protein-rich foods, to improve diet quality in the Ecuadorian population.