Repositioning of the global epicentre of non-optimal cholesterol

Nature | Vol 582 | 4 June 2020 | 73

Article

Repositioning of the global epicentre of

non-optimal cholesterol

NCD Risk Factor Collaboration (NCD-RisC)*

High blood cholesterol is typically considered a feature of wealthy western

countries

1,2

_{. However, dietary and behavioural determinants of blood cholesterol are}

changing rapidly throughout the world

3

_{and countries are using lipid-lowering}

medications at varying rates. These changes can have distinct effects on the levels of

high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have

different effects on human health

4,5

_{. However, the trends of HDL and non-HDL}

cholesterol levels over time have not been previously reported in a global analysis.

Here we pooled 1,127 population-based studies that measured blood lipids in

102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018

in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there

was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net

effect of increases in low- and middle-income countries, especially in east and

southeast Asia, and decreases in high-income western countries, especially those in

northwestern Europe, and in central and eastern Europe. As a result, countries with

the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—

changed from those in western Europe such as Belgium, Finland, Greenland, Iceland,

Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific,

such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL

cholesterol was responsible for an estimated 3.9 million (95% credible interval

3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast

and south Asia. The global repositioning of lipid-related risk, with non-optimal

cholesterol shifting from a distinct feature of high-income countries in northwestern

Europe, north America and Australasia to one that affects countries in east and

southeast Asia and Oceania should motivate the use of population-based policies and

personal interventions to improve nutrition and enhance access to treatment

throughout the world.

Blood cholesterol is one of the most important risk factors for ischaemic

heart disease (IHD) and ischaemic stroke

4–6

_{. Consistent and comparable}

information on cholesterol levels and trends in different countries can

help to benchmark national performance in addressing non-optimal

cholesterol, investigate the reasons behind differential trends and

identify countries in which interventions are needed the most.

A previous global analysis

7

_{reported trends in total cholesterol}

from 1980 to 2008, but did not analyse important lipid fractions—

including HDL and non-HDL cholesterol—that are key to

understand-ing the cardiovascular disease risk associated with non-optimal

cholesterol. Dietary and behavioural determinants of cholesterol

have changed throughout the world in the past decades, including

a worldwide rise in adiposity

8,9

_{, divergent global trends in alcohol}

use

10

_{, a rise in the intake of animal-source foods in middle-income}

countries (especially in east Asia)

3,11

_{, and a replacement of saturated}

fats and trans fats with unsaturated fats in some high-income

coun-tries

3,11,12

_{. There is also considerable variation in how much different}

countries have adopted lipid-lowering medications

13

_{. These changes}

are likely to have influenced cholesterol levels substantially in the

decade since the last estimates were made. Furthermore, HDL and

non-HDL cholesterol, which have opposite associations with

cardio-vascular diseases

4,5

_{, respond differently to diet and treatment, and}

may therefore have different geographical patterns and trends over

time

14

_{. Information on these major lipid fractions, which were not}

included in the previous global estimates, is essential for priority

setting and intervention choice.

Here we pooled 1,127 population-based studies that measured blood

lipids in 102.6 million individuals aged 18 years and older (Extended

Data Figs. 1, 2 and Supplementary Table 1) and used a Bayesian

hierarchi-cal model to estimate trends from 1980 to 2018 in mean total, non-HDL

and HDL cholesterol levels for 200 countries. We also estimated

the number of deaths caused by IHD and ischaemic stroke that were

attributable to high levels of non-HDL cholesterol using information

on its hazards from epidemiological studies.

https://doi.org/10.1038/s41586-020-2338-1

Received: 18 October 2019

Accepted: 2 April 2020

Published online: 3 June 2020

Open access

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74 | Nature | Vol 582 | 4 June 2020

Trends in total cholesterol

In 2018, global age-standardized mean total cholesterol was 4.6 mmol l

−1

(95% credible interval, 4.5–4.7) for women and 4.5 mmol l

−1

_(4.3–4.6)

for men. Global age-standardized mean total cholesterol changed

little over these nearly four decades, decreasing by 0.03 mmol l

−1

_per

decade (−0.02–0.08) in women and 0.05 mmol l

−1

_{per decade (0.00–}

0.11) in men (posterior probability of the observed declines being true

declines = 0.90 for women and 0.98 for men) (Fig. 1). Regionally, total

cholesterol decreased the most in high-income western regions and

in central and eastern Europe. The decrease was the largest (around

0.3 mmol l

−1

_{per decade; posterior probability >0.9999) in}

northwest-ern Europe, where mean total cholesterol levels had been the

high-est in 1980. The decrease in total cholhigh-esterol in high-income whigh-estern

regions and central and eastern Europe was largely due to a decline

in non-HDL cholesterol (Extended Data Fig. 4), which among women

was offset partly by an increase in mean HDL cholesterol levels. Mean

total cholesterol changed little in most of the other regions, with the

notable exception of east and southeast Asia, where it increased by

more than 0.1 mmol l

−1

_{per decade in both women and men (posterior}

probability ≥0.95). The increase in east and southeast Asia was largely

due to an increase in non-HDL cholesterol.

Trends in non-HDL and HDL cholesterol

In 2018, global age-standardized mean non-HDL cholesterol was

3.3 mmol l

−1

_{(3.2–3.4) for women and 3.3 mmol l}

−1

_{(3.3–3.4) for men;}

global age-standardized mean HDL cholesterol was 1.3 mmol l

−1

_(1.2–1.3)

for women and 1.1 mmol l

−1

_{(1.1–1.2) for men. Global age-standardized}

mean non-HDL cholesterol remained almost unchanged from 1980 to

2018, decreasing by only 0.02 mmol l

−1

_{per decade (−0.02–0.06;}

poste-rior probability = 0.80) in women and 0.01 mmol l

−1

_{per decade (−0.03–}

0.06; posterior probability = 0.72) in men. Global age-standardized

mean HDL cholesterol remained unchanged for women and decreased

slightly for men (by 0.02 mmol l

−1

_{per decade, posterior}

probabil-ity = 0.91).

Regionally, non-HDL cholesterol decreased substantially in

high-income western regions and central and eastern Europe. The

largest decrease occurred in northwestern Europe (>0.3 mmol l

−1

per decade; posterior probability >0.9999) (Fig. 2). By contrast, it

increased in east and southeast Asia, parts of sub-Saharan Africa and

Melanesia. The increase was the largest in southeast Asia, increasing by

approximately 0.2 mmol l

−1

_{per decade (posterior probability >0.9999).}

Mean HDL cholesterol increased in the high-income Asia–Pacific region,

by as much as 0.1 mmol l

−1

_{per decade in women (posterior}

probabil-ity >0.9999) but decreased in Melanesia, Polynesia and Micronesia

(Extended Data Fig. 3).

Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland

and Malta had some of the highest non-HDL cholesterol levels in 1980

(>4.5 mmol l

−1

_{in women and >4.7 mmol l}

−1

_{in men) but experienced}

some of the largest declines (Figs. 3, 4). At the extreme, mean non-HDL

cholesterol declined by around 0.45 mmol l

−1

_{per decade or more in}

Belgian and Icelandic women and men, changing their ranks from being

in the top 10 countries in terms of non-HDL cholesterol in 1980 to being

ranked in the lower half of the countries in 2018—below countries in

southwestern Europe such as France and Italy. The largest increases

were found in east Asian countries (for example, China) and southeast

Asian countries (for example, Indonesia, Thailand, Malaysia, Cambodia

and Lao PDR). In these countries, age-standardized mean non-HDL

cholesterol increased by as much as 0.23 mmol l

−1

_{per decade. As a result}

of these opposite trends, countries with the highest age-standardized

mean non-HDL cholesterol levels in 2018 were all outside northwestern

Europe: Tokelau, Malaysia, The Philippines and Thailand, all of which

had mean non-HDL cholesterol around or above 4 mmol l

−1

_{. China, which}

had one of the lowest mean non-HDL cholesterol levels in 1980, reached

or surpassed non-HDL cholesterol levels of many high-income western

countries in 2018. Sub-Saharan African countries had the lowest mean

non-HDL cholesterol in 2018, as low as 2.6 mmol l

−1

_{in some countries,}

as they had in 1980. Not only did high-income countries benefit from

decreasing non-HDL cholesterol levels, they had higher mean HDL

cho-lesterol than low- and middle-income countries (Extended Data Fig. 6).

Deaths attributable to non-optimal cholesterol

In 2017, high non-HDL cholesterol was responsible for an estimated

3.9 million (3.7–4.2 million) worldwide deaths from IHD and ischaemic

stroke (Fig. 5), accounting for a third of deaths from these causes. From

1990 to 2017, the number of deaths caused by IHD and ischaemic stroke

that were attributable to high non-HDL cholesterol increased by around

910,000 globally. This increase was a net result of a large decrease in

western countries, from 950,000 (890,000–990,000) to 480,000

(430,000–530,000), and a large increase throughout Asia. In particular,

the number of deaths attributable to high non-HDL cholesterol more

West Africa

Central Africa East Africa South Asia Southern Africa Polynesia and Micronesia Middle East and north Africa Melanesia World Central Asia East Asia Andean Latin America Southern Latin America High-income English-speaking countries Caribbean Central Latin America Southeast Asia Northwestern Europe High-income Asia–Pacific Central Europe Southwestern Europe Eastern Europe 3.8 4.2 4.6 5.0 5.4 5.8

Age-standardized mean total cholesterol (mmol l–1₎

West Africa East Africa Central Africa Southern Africa South Asia Polynesia and Micronesia Middle East and north Africa Central Asia Melanesia World Caribbean Andean Latin America East Asia Central Latin America High-income English-speaking countries Southern Latin America Southeast Asia Northwestern Europe Southwestern Europe High-income Asia–Pacific Central Europe Eastern Europe 3.8 4.2 4.6 5.0 5.4 5.8

Age-standardized mean total cholesterol (mmol l–1₎

Central and eastern Europe

Central Asia, Middle East and north Africa East and southeast AsiaHigh-income Asia–Pacific High-income western countriesLatin America and Caribbean OceaniaSouth Asia Sub-Saharan AfricaWorld

a

b

Fig. 1 | Change in age-standardized mean total cholesterol between 1980 and 2018 by region for women and men. a, Age-standardized mean total

cholesterol in women. b, Age-standardized mean total cholesterol in men.

The start of the arrow shows the level in 1980 and the head indicates the level in 2018. See Extended Data Fig. 3 for age-standardized mean HDL cholesterol. One mmol l−1 _{is equivalent to 38.61 mg dl}−1_.

Nature | Vol 582 | 4 June 2020 | 75

than tripled in east Asia, from 250,000 (230,000–270,000) to 860,000

(770,000–940,000), and more than doubled in southeast Asia, from

110,000 (100,000–120,000) to 310,000 (290,000–330,000). As a

result, by 2017 east, southeast and south Asia accounted for half of

all deaths attributable to high non-HDL cholesterol, compared with

a quarter in 1990.

Central Africa West Africa East Africa Southern Africa South Asia High-income English-speaking countries High-income Asia–Pacific Middle East and north Africa Northwestern Europe East Asia Southern Latin America World Central Asia Central Europe Southwestern Europe Andean Latin America Eastern Europe Caribbean Polynesia and Micronesia Central Latin America Melanesia Southeast Asia

2.2 2.6 3.0 3.4 3.8 4.2 4.6 Age-standardized mean non-HDL cholesterol (mmol l–1₎

West Africa Central Africa East Africa Southern Africa South Asia Middle East and north Africa Central Asia High-income English-speaking countries World East Asia Northwestern Europe Caribbean Southern Latin America Polynesia and Micronesia Andean Latin America High-income Asia–Pacific Southwestern Europe Melanesia Central Latin America Eastern Europe Southeast Asia Central Europe

2.2 2.6 3.0 3.4 3.8 4.2 4.6 Age-standardized mean non-HDL cholesterol (mmol l–1₎

a

b

Central and eastern Europe

Central Asia, Middle East and north Africa East and southeast AsiaHigh-income Asia–Pacific High-income western countriesLatin America and Caribbean OceaniaSouth Asia Sub-Saharan AfricaWorld Fig. 2 | Change in age-standardized mean non-HDL cholesterol between

1980 and 2018 by region for women and men. a, Age-standardized mean

non-HDL cholesterol in women. b, Age-standardized mean non-HDL

cholesterol in men. The start of the arrow shows the level in 1980 and the head indicates the level in 2018. See Extended Data Fig. 3 for age-standardized mean HDL cholesterol. One mmol l−1 _{is equivalent to 38.61 mg dl}−1_.

Caribbean American Samoa Bahrain Bermuda Brunei Darussalam Cabo Verde Comoros Cook Islands Fiji French Polynesia Kiribati Maldives Marshall Islands Mauritius

Federated States of Micronesia Montenegro Nauru Niue Palau Samoa Sao Tome and Principe

Seychelles Solomon Islands Tokelau Tonga Tuvalu Vanuatu

Caribbean American Samoa Bahrain Bermuda Brunei Darussalam Cabo Verde Comoros Cook Islands Fiji French Polynesia Kiribati Maldives Marshall Islands Mauritius

Federated States of Micronesia Montenegro Nauru Niue Palau Samoa Sao Tome and Principe

Seychelles Solomon Islands Tokelau Tonga Tuvalu Vanuatu

Caribbean American Samoa Bahrain Bermuda Brunei Darussalam Cabo Verde Comoros Cook Islands Fiji French Polynesia Kiribati Maldives Marshall Islands Mauritius

Federated States of Micronesia Montenegro Nauru Niue Palau Samoa Sao Tome and Principe

Seychelles Solomon Islands Tokelau Tonga Tuvalu Vanuatu

Caribbean American Samoa Bahrain Bermuda Brunei Darussalam Cabo Verde Comoros Cook Islands Fiji French Polynesia Kiribati Maldives Marshall Islands Mauritius

Federated States of Micronesia Montenegro Nauru Niue Palau Samoa Sao Tome and Principe

Seychelles Solomon Islands Tokelau Tonga Tuvalu Vanuatu 2.0 2.5 3.0 3.5 4.0 4.5 5.0 Age-standardized mean non-HDL cholesterol (mmol l–1₎

a

b

c

d

Fig. 3 | Age-standardized mean non-HDL cholesterol by country in 1980 and 2018 for women and men. a, Age-standardized mean non-HDL cholesterol in

women in 1980. b, Age-standardized mean non-HDL cholesterol in women in

2018. c, Age-standardized mean non-HDL cholesterol in men in 1980.

d, Age-standardized mean non-HDL cholesterol in men in 2018. See Extended

Data Fig. 5 for age-standardized mean total cholesterol and Extended Data

Fig. 6 for age-standardized mean HDL cholesterol. One mmol l−1 _{is equivalent to}

76 | Nature | Vol 582 | 4 June 2020

Implications

Our results show that over the past nearly four decades, there has been

a major global repositioning of lipid-related risk, with non-optimal

cho-lesterol patterns shifting from being a distinct feature of high-income

countries in northwestern Europe, north America and Australasia to one

that affects middle-income countries in east and southeast Asia, as well

as some countries in Oceania and central Latin America. This transition

is especially noticeable for non-HDL cholesterol, which had not been

quantified previously in a global analysis. This global repositioning has

occurred as a consequence of opposing trends in high-income western

countries and in Asia, which has led to some Asian countries having the

highest worldwide non-HDL cholesterol levels in 2018.

The decrease in non-HDL cholesterol in western countries started

in the 1980s, before statins were widely used

15,16

_{. This indicates that}

changes in diet, especially the replacement of saturated with

unsatu-rated fats

3,17–21

_{and reduction in trans fats}

12,17,22

_{, are major contributors}

to this decline. Nonetheless, the increased use of statins from the

late 1990s onwards

15,16

_{, may explain up to one half of the decrease in}

those countries in which statins are widely used

19,23,24

_{. In contrast to}

high-income western countries, the consumption of animal-source

foods, refined carbohydrates and palm oil has increased substantially

in east and southeast Asia

3,25,26

_{, where statin use remains low}

13,27

_{. For}

example, the Pearson correlation coefficient between the change in

non-HDL cholesterol and the change in a multi-dimensional score

of animal-source foods and sugar

3

_{was 0.69 for women and 0.67 for}

men using data from high-income western countries and countries in

east and southeast Asia, the two regions that experienced the largest

decrease and increase, respectively, in non-HDL cholesterol levels.

Finally, changes in diet, especially a decrease in carbohydrate and an

increase in fat intake

28–31

_{, may have contributed to the large increase}

in HDL cholesterol observed in the high-income Asia–Pacific region,

where there was little increase in overweight and obesity relative to

other regions

8,9

_{. By contrast, the large increase in diabetes}

32

_and

adi-posity

8

_{in Oceania may have contributed to the decrease in HDL}

cho-lesterol in this region. The Pearson correlation coefficient between

the change in HDL cholesterol and the change in body-mass index

8

_was

−0.87 for women and −0.69 for men using countries in the high-income

Asia–Pacific region and Oceania, the two regions that had the largest

increase and decrease, respectively, in HDL cholesterol; the Pearson

correlation coefficient for the change in HDL cholesterol and change

in diabetes prevalence

32

_{was −0.84 for women and −0.69 for men. In the}

same regions, the Pearson correlation coefficient between the change

in non-HDL cholesterol and the change in body-mass index

8

_{was 0.77}

for women and 0.62 for men; for the change in non-HDL cholesterol

and the change in diabetes prevalence

32

_{, the Pearson correlation}

coef-ficient was 0.54 for women and 0.40 for men.

Although it has previously been documented that the prevalence of

adiposity

8,9

_{, diabetes}

32

_{and high blood pressure}

33

_{is now higher in low-}

and middle-income countries than in high-income countries, higher

cholesterol is commonly considered to be a feature of affluent

west-ern nations

1,2

_{. We show that, when focusing on non-HDL cholesterol,}

Caribbean American Samoa

Bahrain Bermuda Brunei Darussalam Cabo Verde Comoros Cook Islands Fiji French Polynesia Kiribati Maldives Marshall Islands Mauritius

Federated States of Micronesia Montenegro Nauru Niue Palau Samoa Sao Tome and Principe

Seychelles Solomon Islands Tokelau Tonga Tuvalu Vanuatu

Caribbean American Samoa Bahrain Bermuda Brunei Darussalam Cabo Verde Comoros Cook Islands Fiji French Polynesia Kiribati Maldives Marshall Islands Mauritius

Federated States of Micronesia Montenegro Nauru Niue Palau Samoa Sao Tome and Principe

Seychelles Solomon Islands Tokelau Tonga Tuvalu Vanuatu −0.49 −0.40 −0.30 −0.20 −0.10 0 0.10 0.20

Change in age-standardized mean non-HDL cholesterol (mmol l–1 _{per decade)}

a

b

Fig. 4 | Change in age-standardized mean non-HDL cholesterol per decade by country for women and men. a, Change per decade in age-standardized

mean non-HDL cholesterol in women. b, Change per decade in

age-standardized mean non-HDL cholesterol in men. See Extended Data Fig. 7

for change per decade in age-standardized mean total cholesterol and Extended Data Fig. 8 for change per decade in age-standardized mean HDL cholesterol. One mmol l−1 _{is equivalent to 38.61 mg dl}−1_.

Number of attributable deaths (millions) Number of attributable deaths (millions) Eastern Europe

Central Europe Southwestern Europe Northwestern Europe

High-income English-speaking countries

Southern Latin America Central Latin America Andean Latin America Caribbean

Polynesia and Micronesia

Melanesia High-income Asia–Pacific East Asia Southeast Asia South Asia Central Asia

Middle East and north Africa East Africa Southern Africa Central Africa West Africa 0 0.5 1.0 1.5 2.0 0 0.5 1.0 1.5 2.0 1990 2017 1990 2017

a

b

Fig. 5 | Deaths from IHD and ischaemic stroke attributable to high non-HDL cholesterol by region in 1990 and 2017 for women and men. a, Deaths in women

Nature | Vol 582 | 4 June 2020 | 77

middle-income countries have emerged as the new global epicentre

of non-optimal cholesterol as they did for other major cardiovascular

disease risk factors, indicating that there is no such a thing as a western

risk factor. At the same time, the populations of high-income countries

would also benefit from further lowering non-HDL cholesterol.

There-fore, population-based policies and personal interventions to improve

nutrition and enhance treatment are now needed in all countries,

espe-cially as a part of the movement towards universal health coverage.

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availability are available at https://doi.org/10.1038/s41586-020-2338-1.

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NCD Risk Factor Collaboration (NCD-RisC)

Cristina Taddei1_{, Bin Zhou}1_{, Honor Bixby}1_{, Rodrigo M. Carrillo-Larco}1_{, Goodarz Danaei}2_{, Rod T.} Jackson3_{, Farshad Farzadfar}4_{, Marisa K. Sophiea}1_{, Mariachiara Di Cesare}5_{, Maria Laura} Caminia Iurilli1_{, Andrea Rodriguez Martinez}1_{, Golaleh Asghari}6_{, Klodian Dhana}7_{, Pablo} Gulayin8_{, Sujay Kakarmath}9_{, Marilina Santero}8_{, Trudy Voortman}10_{, Leanne M. Riley}11_{, Melanie} J. Cowan11_{, Stefan Savin}11_{, James E. Bennett}1_{, Gretchen A. Stevens}1,12_{, Christopher J.} Paciorek13_{, Wichai Aekplakorn}14_{, Renata Cifkova}15,16_{, Simona Giampaoli}17_{, Andre Pascal} Kengne18_{, Young-Ho Khang}19_{, Kari Kuulasmaa}20_{, Avula Laxmaiah}21_{, Paula Margozzini}22_, Prashant Mathur23_{, Børge G. Nordestgaard}24_{, Dong Zhao}25_{, Mette Aadahl}26_{, Leandra} Abarca-Gómez27_{, Hanan Abdul Rahim}28_{, Niveen M. Abu-Rmeileh}29_{, Benjamin} Acosta-Cazares30_{, Robert J. Adams}31_{, Imelda A. Agdeppa}32_{, Javad Aghazadeh-Attari}33_, Carlos A. Aguilar-Salinas34_{, Charles Agyemang}35_{, Tarunveer S. Ahluwalia}36_{, Noor Ani} Ahmad37_{, Ali Ahmadi}38_{, Naser Ahmadi}4_{, Soheir H. Ahmed}39_{, Wolfgang Ahrens}40_{, Kamel} Ajlouni41_{, Monira Alarouj}42_{, Fadia AlBuhairan}43_{, Shahla AlDhukair}44_{, Mohamed M. Ali}11_, Abdullah Alkandari42_{, Ala’a Alkerwi}45_{, Eman Aly}46_{, Deepak N. Amarapurkar}47_{, Philippe} Amouyel48,49_{, Lars Bo Andersen}50_{, Sigmund A. Anderssen}51_{, Ranjit Mohan Anjana}52_{, Alireza} Ansari-Moghaddam53_{, Hajer Aounallah-Skhiri}54_{, Joana Araújo}55_{, Inger Ariansen}56_{, Tahir} Aris37_{, Raphael E. Arku}57_{, Nimmathota Arlappa}21_{, Krishna K. Aryal}58_{, Thor Aspelund}59_{, Maria} Cecília F. Assunção60_{, Juha Auvinen}61,62_{, Mária Avdicová}63_{, Ana Azevedo}64_{, Fereidoun Azizi}65_, Mehrdad Azmin4_{, Nagalla Balakrishna}21_{, Mohamed Bamoshmoosh}66_{, Maciej Banach}67_{, Piotr} Bandosz68_{, José R. Banegas}69_{, Carlo M. Barbagallo}70_{, Alberto Barceló}71_{, Amina Barkat}72_{, Iqbal} Bata73_{, Anwar M. Batieha}74_{, Assembekov Batyrbek}75_{, Louise A. Baur}76_{, Robert Beaglehole}3_, Antonisamy Belavendra77_{, Habiba Ben Romdhane}78_{, Mikhail Benet}79_{, Marianne Benn}24_{, Salim} Berkinbayev80_{, Antonio Bernabe-Ortiz}81_{, Gailute Bernotiene}82_{, Heloisa Bettiol}83_{, Santosh K.} Bhargava84_{, Yufang Bi}85_{, Asako Bienek}86_{, Mukharram Bikbov}87_{, Bihungum Bista}88_{, Peter} Bjerregaard89_{, Espen Bjertness}39_{, Marius B. Bjertness}39_{, Cecilia Björkelund}90_{, Katia V. Bloch}91_, Anneke Blokstra92_{, Simona Bo}93_{, Bernhard O. Boehm}94_{, Jose G. Boggia}95_{, Carlos P.} Boissonnet96_{, Marialaura Bonaccio}97_{, Vanina Bongard}98_{, Rossana Borchini}99_{, Herman} Borghs100_{, Pascal Bovet}101,102_{, Imperia Brajkovich}103_{, Juergen Breckenkamp}104_{, Hermann} Brenner105_{, Lizzy M. Brewster}35_{, Graziella Bruno}93_{, Anna Bugge}106_{, Markus A. Busch}107_, Antonio Cabrera de León108_{, Joseph Cacciottolo}109_{, Günay Can}110_{, Ana Paula C. Cândido}111_, Mario V. Capanzana32_{, Eduardo Capuano}112_{, Vincenzo Capuano}112_{, Viviane C. Cardoso}83_, Joana Carvalho113_{, Felipe F. Casanueva}114_{, Laura Censi}115_{, Charalambos A. Chadjigeorgiou}116_, Snehalatha Chamukuttan117_{, Nish Chaturvedi}118_{, Chien-Jen Chen}119_{, Fangfang Chen}120_, Shuohua Chen121_{, Ching-Yu Cheng}122_{, Bahman Cheraghian}123_{, Angela Chetrit}124_{, Shu-Ti} Chiou125_{, María-Dolores Chirlaque}126_{, Belong Cho}127_{, Yumi Cho}128_{, Jerzy Chudek}129_{, Frank} Claessens130_{, Janine Clarke}131_{, Els Clays}132_{, Hans Concin}133_{, Susana C. Confortin}134_{, Cyrus} Cooper135_{, Simona Costanzo}97_{, Dominique Cottel}136_{, Chris Cowell}76_{, Ana B. Crujeiras}137_, Semánová Csilla138_{, Liufu Cui}121_{, Felipe V. Cureau}139_{, Graziella D’Arrigo}140_{, Eleonora d’Orsi}141_, Jean Dallongeville136_{, Albertino Damasceno}142_{, Rachel Dankner}124_{, Thomas M. Dantoft}26_{, Luc} Dauchet48,49_{, Kairat Davletov}75_{, Guy De Backer}132_{, Dirk De Bacquer}132_{, Giovanni de Gaetano}97_, Stefaan De Henauw132_{, Paula Duarte de Oliveira}60_{, David De Ridder}143_{, Delphine De Smedt}132_, Mohan Deepa52_{, Alexander D. Deev}144_{, Abbas Dehghan}1_{, Hélène Delisle}145_{, Elaine} Dennison135_{, Valérie Deschamps}146_{, Meghnath Dhimal}88_{, Augusto F. Di Castelnuovo}147_{, Zivka} Dika148_{, Shirin Djalalinia}149_{, Annette J. Dobson}150_{, Chiara Donfrancesco}17_{, Silvana P. Donoso}151_, Angela Döring152_{, Maria Dorobantu}153_{, Nico Dragano}154_{, Wojciech Drygas}67,155_{, Yong Du}107_, Charmaine A. Duante32_{, Rosemary B. Duda}156_{, Vilnis Dzerve}157_{, Elzbieta}

Dziankowska-Zaborszczyk67_{, Ricky Eddie}158_{, Ebrahim Eftekhar}159_{, Robert Eggertsen}90_{, Sareh} Eghtesad4_{, Gabriele Eiben}160_{, Ulf Ekelund}51_{, Jalila El Ati}161_{, Denise Eldemire-Shearer}162_{, Marie} Eliasen26_{, Roberto Elosua}163_{, Rajiv T. Erasmus}164_{, Raimund Erbel}165_{, Cihangir Erem}166_{, Louise} Eriksen89_{, Johan G. Eriksson}167_{, Jorge Escobedo-de la Peña}30_{, Saeid Eslami}168_{, Ali Esmaeili}169_, Alun Evans170_{, David Faeh}171_{, Caroline H. Fall}135_{, Elnaz Faramarzi}172_{, Mojtaba Farjam}173_, Mohammad Reza Fattahi174_{, Francisco J. Felix-Redondo}175_{, Trevor S. Ferguson}162_{, Daniel} Fernández-Bergés176_{, Daniel Ferrante}177_{, Marika Ferrari}115_{, Catterina Ferreccio}22_{, Jean} Ferrieres98_{, Bernhard Föger}133_{, Leng Huat Foo}178_{, Ann-Sofie Forslund}179_{, Maria Forsner}179_, Heba M. Fouad46_{, Damian K. Francis}162_{, Maria do Carmo Franco}180_{, Oscar H. Franco}10_, Guillermo Frontera181_{, Yuki Fujita}182_{, Matsuda Fumihiko}183_{, Takuro Furusawa}183_{, Zbigniew} Gaciong184_{, Fabio Galvano}185_{, Jingli Gao}121_{, Manoli Garcia-de-la-Hera}186_{, Sarah P. Garnett}76_, Jean-Michel Gaspoz143_{, Magda Gasull}187_{, Andrea Gazzinelli}188_{, Johanna M. Geleijnse}189_{, Ali} Ghanbari4_{, Erfan Ghasemi}4_{, Oana-Florentina Gheorghe-Fronea}153_{, Anup Ghimire}190_, Francesco Gianfagna147,191_{, Tiffany K. Gill}192_{, Jonathan Giovannelli}48,49_{, Glen Gironella}32_, Aleksander Giwercman193_{, David Goltzman}194_{, Helen Gonçalves}60_{, David A.} Gonzalez-Chica192_{, Marcela Gonzalez-Gross}195_{, Juan P. González-Rivas}196_{, Clicerio} González-Villalpando197_{, María-Elena González-Villalpando}198_{, Angel R. Gonzalez}199_, Frederic Gottrand48_{, Sidsel Graff-Iversen}56_{, Dušan Grafnetter}200_{, Ronald D. Gregor}73_{, Tomasz} Grodzicki201_{, Anders Grøntved}202_{, Giuseppe Grosso}185_{, Gabriella Gruden}93_{, Dongfeng Gu}203_, Pilar Guallar-Castillón69_{, Ong Peng Guan}204_{, Elias F. Gudmundsson}205_{, Vilmundur} Gudnason59_{, Ramiro Guerrero}206_{, Idris Guessous}143_{, Johanna Gunnlaugsdottir}205_{, Rajeev} Gupta207_{, Laura Gutierrez}8_{, Felix Gutzwiller}171_{, Seongjun Ha}208_{, Farzad Hadaegh}209_{, Rosa} Haghshenas4_{, Hamid Hakimi}169_{, Ian R. Hambleton}210_{, Behrooz Hamzeh}211_{, Sari Hantunen}212_, Rachakulla Hari Kumar21_{, Seyed Mohammad Hashemi-Shahri}53_{, Jun Hata}213_{, Teresa} Haugsgjerd214_{, Alison J. Hayes}76_{, Jiang He}215_{, Yuna He}216_{, Marleen Elisabeth Hendriks}217_{, Ana} Henriques55_{, Sauli Herrala}62_{, Ramin Heshmat}218_{, Allan G. Hill}135_{, Sai Yin Ho}219_{, Suzanne C.} Ho220_{, Michael Hobbs}221_{, Albert Hofman}10_{, Reza Homayounfar}173_{, Wilma M. Hopman}222_, Andrea R. V. R. Horimoto223_{, Claudia M. Hormiga}224_{, Bernardo L. Horta}60_{, Leila Houti}225_, Christina Howitt210_{, Thein Thein Htay}226_{, Aung Soe Htet}227_{, Maung Maung Than Htike}227_,

José María Huerta228_{, Ilpo Tapani Huhtaniemi}1_{, Martijn Huisman}229_{, Monica L. Hunsberger}90_, Abdullatif S. Husseini29_{, Inge Huybrechts}230_{, Nahla Hwalla}231_{, Licia Iacoviello}97,191_{, Anna G.} Iannone112_{, Mohsen M. Ibrahim}232_{, Norazizah Ibrahim Wong}37_{, Iris Iglesia}233_{, Nayu Ikeda}234_{, M.} Arfan Ikram10_{, Violeta Iotova}235_{, Vilma E. Irazola}8_{, Takafumi Ishida}236_{, Muhammad Islam}237_, Aziz al-Safi Ismail178_{, Masanori Iwasaki}238_{, Jeremy M. Jacobs}239_{, Hashem Y. Jaddou}74_{, Tazeen} Jafar122_{, Kenneth James}162_{, Konrad Jamrozik}192,448_{, Imre Janszky}240_{, Edward Janus}241_, Marjo-Riitta Jarvelin1,61,62_{, Grazyna Jasienska}201_{, Ana Jelakovic}242_{, Bojan Jelakovic}243_{, Garry} Jennings244_{, Gorm B. Jensen}24_{, Seung-lyeal Jeong}208_{, Anjani Kumar Jha}88_{, Chao Qiang} Jiang245_{, Ramon O. Jimenez}246_{, Karl-Heinz Jöckel}165_{, Michel Joffres}247_{, Jari J. Jokelainen}62_{, Jost} B. Jonas248_{, Torben Jørgensen}26_{, Pradeep Joshi}249_{, Farahnaz Joukar}250_{, Jacek Józwiak}251_{, Anne} Juolevi20_{, Anthony Kafatos}252_{, Eero O. Kajantie}20_{, Ofra Kalter-Leibovici}124_{, Nor Azmi} Kamaruddin253_{, Pia R. Kamstrup}24_{, Khem B. Karki}254_{, Joanne Katz}255_{, Jussi Kauhanen}212_, Prabhdeep Kaur256_{, Maryam Kavousi}10_{, Gyulli Kazakbaeva}87_{, Ulrich Keil}257_{, Sirkka} Keinänen-Kiukaanniemi62_{, Roya Kelishadi}258_{, Maryam Keramati}168_{, Alina Kerimkulova}259_, Mathilde Kersting260_{, Yousef Saleh Khader}74_{, Davood Khalili}6_{, Mohammad Khateeb}41_, Motahareh Kheradmand261_{, Alireza Khosravi}262_{, Ursula Kiechl-Kohlendorfer}263_{, Stefan} Kiechl263_{, Japhet Killewo}264_{, Hyeon Chang Kim}265_{, Jeongseon Kim}266_{, Yeon-Yong Kim}208_, Jurate Klumbiene82_{, Michael Knoflach}263_{, Stephanie Ko}86_{, Hans-Peter Kohler}267_{, Iliana V.} Kohler267_{, Elin Kolle}51_{, Patrick Kolsteren}132_{, Jürgen König}268_{, Raija Korpelainen}61,269_{, Paul} Korrovits270_{, Jelena Kos}242_{, Seppo Koskinen}20_{, Katsuyasu Kouda}271_{, Sudhir Kowlessur}272_, Wolfgang Kratzer273_{, Susi Kriemler}171_{, Peter Lund Kristensen}202_{, Steiner Krokstad}240_{, Daan} Kromhout274_{, Urho M. Kujala}275_{, Pawel Kurjata}155_{, Catherine Kyobutungi}276_{, Fatima Zahra} Laamiri277_{, Tiina Laatikainen}20_{, Carl Lachat}132_{, Youcef Laid}278_{, Tai Hing Lam}219_,

Christina-Paulina Lambrinou279_{, Vera Lanska}200_{, Georg Lappas}280_{, Bagher Larijani}281_{, Tint Swe} Latt282_{, Lars E. Laugsand}240_{, Maria Lazo-Porras}81_{, Jeannette Lee}283_{, Jeonghee Lee}266_{, Nils} Lehmann165_{, Terho Lehtimäki}284,285_{, Naomi S. Levitt}286_{, Yanping Li}2_{, Christa L. Lilly}287_{, Wei-Yen} Lim283_{, M. Fernanda Lima-Costa}288_{, Hsien-Ho Lin}289_{, Xu Lin}290_{, Yi-Ting Lin}291_{, Lars Lind}291_{, Allan} Linneberg26_{, Lauren Lissner}90_{, Jing Liu}25_{, Helle-Mai Loit}292_{, Esther Lopez-Garcia}69_{, Tania} Lopez293_{, Paulo A. Lotufo}83_{, José Eugenio Lozano}294_{, Dalia Luksiene}82_{, Annamari Lundqvist}20_, Robert Lundqvist295_{, Nuno Lunet}113_{, Guansheng Ma}296_{, George L. L. Machado-Coelho}297_, Aristides M. Machado-Rodrigues298_{, Suka Machi}299_{, Ahmed A. Madar}39_{, Stefania Maggi}300_, Dianna J. Magliano301_{, Emmanuella Magriplis}302_{, Gowri Mahasampath}77_{, Bernard Maire}303_, Marcia Makdisse304_{, Fatemeh Malekzadeh}174_{, Reza Malekzadeh}4_{, Kodavanti Mallikharjuna} Rao21_{, Yannis Manios}279_{, Jim I. Mann}305_{, Fariborz Mansour-Ghanaei}250_{, Enzo Manzato}306_, Pedro Marques-Vidal307_{, Reynaldo Martorell}308_{, Luis P. Mascarenhas}309_{, Ellisiv B.}

Mathiesen310_{, Tandi E. Matsha}311_{, Christina Mavrogianni}279_{, Shelly R. McFarlane}162_{, Stephen T.} McGarvey312_{, Stela McLachlan}313_{, Rachael M. McLean}305_{, Scott B. McLean}131_{, Breige A.} McNulty314_{, Sounnia Mediene-Benchekor}225_{, Parinaz Mehdipour}4_{, Kirsten Mehlig}90_{, Amir} Houshang Mehrparvar315_{, Aline Meirhaeghe}316_{, Christa Meisinger}152_{, Ana Maria B. Menezes}60_, Geetha R. Menon317_{, Shahin Merat}4_{, Alibek Mereke}75_{, Indrapal I. Meshram}21_{, Patricia Metcalf}3_, Haakon E. Meyer39_{, Jie Mi}120_{, Nathalie Michels}132_{, Jody C. Miller}305_{, Cláudia S. Minderico}318_{, G.} K. Mini319_{, Juan Francisco Miquel}22_{, J. Jaime Miranda}81_{, Mohammad Reza Mirjalili}315_{, Erkin} Mirrakhimov259_{, Pietro A. Modesti}320_{, Sahar Saeedi Moghaddam}4_{, Bahram Mohajer}4_{, Mostafa} K. Mohamed321_{, Kazem Mohammad}4_{, Zahra Mohammadi}4_{, Noushin Mohammadifard}322_{, Reza} Mohammadpourhodki168_{, Viswanathan Mohan}52_{, Salim Mohanna}81_{, Muhammad Fadhli Mohd} Yusoff37_{, Iraj Mohebbi}33_{, Farnam Mohebi}4_{, Marie Moitry}323,324_{, Line T. Møllehave}26_{, Niels C.} Møller202_{, Dénes Molnár}325_{, Amirabbas Momenan}6_{, Charles K. Mondo}326_{, Eric}

Monterrubio-Flores197_{, Mahmood Moosazadeh}261_{, Alain Morejon}327_{, Luis A. Moreno}233_{, Karen} Morgan328_{, Suzanne N. Morin}194_{, George Moschonis}329_{, Malgorzata Mossakowska}330_{, Aya} Mostafa321_{, Jorge Mota}113_{, Mohammad Esmaeel Motlagh}123_{, Jorge Motta}331_{, Kelias P.} Msyamboza332_{, Maria L. Muiesan}333_{, Martina Müller-Nurasyid}152_{, Jaakko Mursu}212_{, Norlaila} Mustafa253_{, Iraj Nabipour}334_{, Shohreh Naderimagham}4_{, Gabriele Nagel}335_{, Balkish M. Naidu}37_, Farid Najafi211_{, Harunobu Nakamura}336_{, Jana Námešná}63_{, Ei Ei K. Nang}283_{, Vinay B. Nangia}337_, Matthias Nauck338_{, William A. Neal}287_{, Azim Nejatizadeh}159_{, Ilona Nenko}201_{, Flavio Nervi}22_, Nguyen D. Nguyen339_{, Quang Ngoc Nguyen}340_{, Ramfis E. Nieto-Martínez}341_{, Thomas Nihal}77_, Teemu J. Niiranen20,342_{, Guang Ning}85_{, Toshiharu Ninomiya}213_{, Marianna Noale}300_{, Oscar A.} Noboa95_{, Davide Noto}70_{, Mohannad Al Nsour}343_{, Irfan Nuhoğlu}166_{, Terence W. O’Neill}344_, Dermot O’Reilly170_{, Angélica M. Ochoa-Avilés}151_{, Kyungwon Oh}128_{, Ryutaro Ohtsuka}345_{, Örn} Olafsson205_{, Valérie Olié}146_{, Isabel O. Oliveira}60_{, Mohd Azahadi Omar}37_{, Altan Onat}346,448_{, Sok} King Ong347_{, Pedro Ordunez}71_{, Rui Ornelas}348_{, Pedro J. Ortiz}81_{, Clive Osmond}349_{, Sergej M.} Ostojic350_{, Afshin Ostovar}4_{, Johanna A. Otero}224_{, Ellis Owusu-Dabo}351_{, Fred Michel} Paccaud352_{, Elena Pahomova}157_{, Andrzej Pajak}201_{, Luigi Palmieri}17_{, Wen-Harn Pan}119_, Songhomitra Panda-Jonas248_{, Francesco Panza}353_{, Winsome R. Parnell}305_{, Nikhil D. Patel}354_, Nasheeta Peer355_{, Sergio Viana Peixoto}288_{, Markku Peltonen}20_{, Alexandre C. Pereira}223_, Annette Peters152_{, Astrid Petersmann}338_{, Janina Petkeviciene}82_{, Niloofar Peykari}149_{, Son Thai} Pham356_{, Rafael N. Pichardo}357_{, Iris Pigeot}358_{, Aida Pilav}359_{, Lorenza Pilotto}360_{, Aleksandra} Piwonska155_{, Andreia N. Pizarro}113_{, Pedro Plans-Rubió}361_{, Silvia Plata}362_{, Hermann} Pohlabeln358_{, Miquel Porta}163_{, Marileen L. P. Portegies}10_{, Anil Poudyal}88_{, Farhad Pourfarzi}363_, Hossein Poustchi4_{, Rajendra Pradeepa}52_{, Jacqueline F. Price}313_{, Rui Providencia}118_{, Jardena J.} Puder307_{, Soile E. Puhakka}61,269_{, Margus Punab}270_{, Mostafa Qorbani}364_{, Tran Quoc Bao}365_, Ricardas Radisauskas82_{, Salar Rahimikazerooni}174_{, Olli Raitakari}342_{, Sudha Ramachandra} Rao256_{, Ambady Ramachandran}366_{, Elisabete Ramos}64_{, Rafel Ramos}367_{, Lekhraj Rampal}368_, Sanjay Rampal369_{, Josep Redon}370_{, Paul Ferdinand M. Reganit}371_{, Luis Revilla}293_{, Abbas} Rezaianzadeh174_{, Robespierre Ribeiro}372,448_{, Adrian Richter}338_{, Fernando Rigo}373_{, Tobias F.} Rinke de Wit374_{, Fernando Rodríguez-Artalejo}69_{, María del Cristo Rodriguez-Perez}375_{, Laura A.} Rodríguez-Villamizar376_{, Ulla Roggenbuck}165_{, Rosalba Rojas-Martinez}197_{, Dora Romaguera}137_, Elisabetta L. Romeo377_{, Annika Rosengren}90,378_{, Joel G. R. Roy}131_{, Adolfo Rubinstein}8_,

Jean-Bernard Ruidavets379_{, Blanca Sandra Ruiz-Betancourt}30_{, Paola Russo}380_{, Petra Rust}268_, Marcin Rutkowski68_{, Charumathi Sabanayagam}204_{, Harshpal S. Sachdev}381_{, Alireza Sadjadi}4_, Ali Reza Safarpour174_{, Saeid Safiri}172_{, Olfa Saidi}382_{, Nader Saki}123_{, Benoit Salanave}146_{, Diego} Salmerón228_{, Veikko Salomaa}20_{, Jukka T. Salonen}167_{, Massimo Salvetti}333_{, Jose}

Sánchez-Abanto383_{, Susana Sans}384_{, Alba M. Santaliestra-Pasías}233_{, Diana A. Santos}385_{, Maria} Paula Santos113_{, Rute Santos}113_{, Jouko L. Saramies}386_{, Luis B. Sardinha}385_{, Nizal}

Sarrafzadegan387_{, Kai-Uwe Saum}105_{, Savvas C. Savva}116_{, Norie Sawada}388_{, Mariana Sbaraini}139_, Marcia Scazufca389_{, Beatriz D. Schaan}139_{, Herman Schargrodsky}390_{, Christa Scheidt-Nave}107_, Anja Schienkiewitz107_{, Sabine Schipf}338_{, Carsten O. Schmidt}338_{, Ben Schöttker}105_{, Sara} Schramm165_{, Sylvain Sebert}61_{, Aye Aye Sein}227_{, Abhijit Sen}391_{, Sadaf G. Sepanlou}4_{, Jennifer} Servais131_{, Ramin Shakeri}4_{, Svetlana A. Shalnova}144_{, Teresa Shamah-Levy}197_{, Maryam} Sharafkhah4_{, Sanjib K. Sharma}190_{, Jonathan E. Shaw}301_{, Amaneh Shayanrad}4_{, Zumin Shi}28_, Kenji Shibuya392_{, Hana Shimizu-Furusawa}393_{, Dong Wook Shin}394_{, Youchan Shin}204_{, Majid} Shirani38_{, Rahman Shiri}395_{, Namuna Shrestha}88_{, Khairil Si-Ramlee}347_{, Alfonso Siani}380_, Rosalynn Siantar204_{, Abla M. Sibai}231_{, Diego Augusto Santos Silva}141_{, Mary Simon}366_{, Judith} Simons396_{, Leon A. Simons}397_{, Michael Sjöström}398_{, Tea Skaaby}399_{, Jolanta}

Slowikowska-Hilczer67_{, Przemyslaw Slusarczyk}330_{, Liam Smeeth}400_{, Marieke B. Snijder}35_, Stefan Söderberg179_{, Agustinus Soemantri}401_{, Reecha Sofat}118_{, Vincenzo Solfrizzi}402_, Mohammad Hossein Somi172_{, Emily Sonestedt}193_{, Thorkild I. A. Sørensen}403_{, Charles Sossa} Jérome404_{, Aïcha Soumaré}405_{, Kaan Sozmen}406_{, Karen Sparrenberger}139_{, Jan A. Staessen}407_, Maria G. Stathopoulou408_{, Bill Stavreski}244_{, Jostein Steene-Johannessen}51_{, Peter Stehle}409_, Aryeh D. Stein308_{, Jochanan Stessman}239_{, Ranko Stevanović}410_{, Jutta Stieber}152,448_{, Doris} Stöckl152_{, Jakub Stokwiszewski}411_{, Karien Stronks}35_{, Maria Wany Strufaldi}180_{, Ramón} Suárez-Medina412_{, Chien-An Sun}413_{, Johan Sundström}291_{, Paibul Suriyawongpaisal}14_{, Rody G.} Sy371_{, René Charles Sylva}414_{, Moyses Szklo}255_{, E. Shyong Tai}283_{, Abdonas Tamosiunas}82_{, Eng} Joo Tan76_{, Mohammed Rasoul Tarawneh}415_{, Carolina B. Tarqui-Mamani}383_{, Anne Taylor}192_, Julie Taylor118_{, Grethe S. Tell}214_{, Tania Tello}81_{, K. R. Thankappan}416_{, Lutgarde Thijs}407_{, Betina H.} Thuesen26_{, Ulla Toft}26_{, Hanna K. Tolonen}20_{, Janne S. Tolstrup}89_{, Murat Topbas}166_{, Roman} Topór-Madry201_{, María José Tormo}417_{, Michael J. Tornaritis}116_{, Maties Torrent}418_{, Laura} Torres-Collado186_{, Pierre Traissac}303_{, Oanh T. H. Trinh}339_{, Julia Truthmann}107_{, Shoichiro} Tsugane388_{, Marshall K. Tulloch-Reid}162_{, Tomi-Pekka Tuomainen}212_{, Jaakko Tuomilehto}20_, Anne Tybjaerg-Hansen24_{, Christophe Tzourio}405_{, Peter Ueda}398_{, Eunice Ugel}419_{, Hanno} Ulmer263_{, Belgin Unal}420_{, Hannu M. T. Uusitalo}421_{, Gonzalo Valdivia}22_{, Damaskini Valvi}422_{, Rob} M. van Dam283_{, Yvonne T. van der Schouw}423_{, Koen Van Herck}132_{, Hoang Van Minh}424_{, Lenie} van Rossem425_{, Natasja M. Van Schoor}229_{, Irene G. M. van Valkengoed}35_{, Dirk}

Vanderschueren130_{, Diego Vanuzzo}360_{, Anette Varbo}24_{, Patricia Varona-Pérez}412_{, Senthil K.} Vasan135_{, Lars Vatten}240_{, Tomas Vega}294_{, Toomas Veidebaum}292_{, Gustavo}

Velasquez-Melendez188_{, Silvia J. Venero-Fernández}412_{, Giovanni Veronesi}191_{, W. M. Monique} Verschuren92_{, Cesar G. Victora}60_{, Dhanasari Vidiawati}426_{, Lucie Viet}92_{, Salvador} Villalpando197_{, Jesus Vioque}427_{, Jyrki K. Virtanen}212_{, Sophie Visvikis-Siest}408_{, Bharathi} Viswanathan101_{, Tiina Vlasoff}428_{, Peter Vollenweider}307_{, Ari Voutilainen}212_{, Alisha N. Wade}429_, Aline Wagner323_{, Janette Walton}430_{, Wan Mohamad Wan Bebakar}178_{, Wan Nazaimoon Wan} Mohamud431_{, Ming-Dong Wang}432_{, Ningli Wang}433_{, Qian Wang}434_{, Ya Xing Wang}435_{, Ying-Wei} Wang125_{, S. Goya Wannamethee}118_{, Niels Wedderkopp}202_{, Wenbin Wei}435_{, Peter H.} Whincup436_{, Kurt Widhalm}437_{, Indah S. Widyahening}426_{, Andrzej Wiecek}129_{, Alet H. Wijga}92_, Rainford J. Wilks162_{, Johann Willeit}263_{, Peter Willeit}263_{, Tom Wilsgaard}310_{, Bogdan Wojtyniak}411_, Roy A. Wong-McClure27_{, Andrew Wong}118_{, Tien Yin Wong}122_{, Jean Woo}220_{, Mark}

Woodward397,438_{, Frederick C. Wu}344_{, Shouling Wu}121_{, Haiquan Xu}439_{, Liang Xu}433_{, Weili Yan}440_, Xiaoguang Yang216_{, Tabara Yasuharu}183_{, Xingwang Ye}290_{, Toh Peng Yeow}441_{, Panayiotis K.} Yiallouros442_{, Moein Yoosefi}4_{, Akihiro Yoshihara}238_{, San-Lin You}413_{, Novie O.}

Younger-Coleman162_{, Ahmad Faudzi Yusoff}37_{, Ahmad A. Zainuddin}37_{, Seyed Rasoul Zakavi}168_, Mohammad Reza Zali6_{, Farhad Zamani}443_{, Sabina Zambon}306_{, Antonis Zampelas}302_{, Ko Ko} Zaw282_{, Tomasz Zdrojewski}68_{, Tajana Zeljkovic Vrkic}242_{, Zhen-Yu Zhang}407_{, Wenhua Zhao}216_, Shiqi Zhen444_{, Yingfeng Zheng}445_{, Bekbolat Zholdin}446_{, Baurzhan Zhussupov}80_{, Nada} Zoghlami54_{, Julio Zuñiga Cisneros}331_{, Edward W. Gregg}1 _{& Majid Ezzati}1,447 ✉

1_{Imperial College London, London, UK.} 2_{Harvard T. H. Chan School of Public Health, Boston,}

MA, USA. 3_{University of Auckland, Auckland, New Zealand.} 4_{Tehran University of Medical}

Sciences, Tehran, Iran. 5_{Middlesex University, London, UK.} 6_{Shahid Beheshti University of}

Medical Sciences, Tehran, Iran. 7_{Rush University Medical Center, Chicago, IL, USA.} 8_Institute

for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina. 9_{Harvard Medical}

School, Boston, MA, USA. 10_{Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.} 11_{World Health Organization, Geneva, Switzerland.} 12_{Independent researcher, Los Angeles,}

CA, USA. 13_{University of California Berkeley, Berkeley, CA, USA.} 14_{Mahidol University, Nakhon}

Pathom, Thailand. 15_{Charles University in Prague, Prague, Czech Republic.} 16_Thomayer

Hospital, Prague, Czech Republic. 17_{Istituto Superiore di Sanità, Rome, Italy.} 18_{South African}

Medical Research Council, Cape Town, South Africa. 19_{Seoul National University, Seoul,}

Republic of Korea. 20_{Finnish Institute for Health and Welfare, Helsinki, Finland.} 21_ICMR–

National Institute of Nutrition, Hyderabad, India. 22_{Pontificia Universidad Católica de Chile,}

Santiago, Chile. 23_{ICMR–National Centre for Disease Informatics and Research, Bengaluru,}

India. 24_{Copenhagen University Hospital, Copenhagen, Denmark.} 25_{Capital Medical University}

Beijing An Zhen Hospital, Beijing, China. 26_{Bispebjerg and Frederiksberg Hospital,}

Copenhagen, Denmark. 27_{Caja Costarricense de Seguro Social, San José, Costa Rica.} 28_Qatar

University, Doha, Qatar. 29_{Birzeit University, Birzeit, Palestine.} 30_{Instituto Mexicano del Seguro}

Social, Mexico City, Mexico. 31_{Flinders University, Adelaide, South Australia, Australia.} 32_Food

and Nutrition Research Institute, Taguig, The Philippines. 33_{Urmia University of Medical}

Sciences, Urmia, Iran. 34_{Instituto Nacional de Ciencias Médicas y Nutricion, Mexico City,}

Mexico. 35_{University of Amsterdam, Amsterdam, The Netherlands.} 36_{Steno Diabetes Center}

Copenhagen, Gentofte, Denmark. 37_{Ministry of Health Malaysia, Kuala Lumpur, Malaysia.} 38_{Shahrekord University of Medical Sciences, Shahrekord, Iran.} 39_{University of Oslo, Oslo,}

Norway. 40_{University of Bremen, Bremen, Germany.} 41_{National Center for Diabetes,}

Endocrinology and Genetics, Amman, Jordan. 42_{Dasman Diabetes Institute, Kuwait City,}

Kuwait. 43_{Aldara Hospital and Medical Center, Riyadh, Saudi Arabia.} 44_{King Abdullah}

International Medical Research Center, Riyadh, Saudi Arabia. 45_{Luxembourg Institute of}

Health, Strassen, Luxembourg. 46_{World Health Organization Regional Office for the Eastern}

Mediterranean, Cairo, Egypt. 47_{Bombay Hospital and Medical Research Centre, Mumbai, India.} 48_{University of Lille, Lille, France.} 49_{Lille University Hospital, Lille, France.} 50_{Western Norway}

University of Applied Sciences, Sogndal, Norway. 51_{Norwegian School of Sport Sciences,}

Oslo, Norway. 52_{Madras Diabetes Research Foundation, Chennai, India.} 53_{Zahedan University}

of Medical Sciences, Zahedan, Iran. 54_{National Institute of Public Health, Tunis, Tunisia.} 55_{Institute of Public Health of the University of Porto, Porto, Portugal.} 56_{Norwegian Institute of}

Public Health, Oslo, Norway. 57_{University of Massachusetts, Amherst, MA, USA.} 58_Abt

Associates, Kathmandu, Nepal. 59_{University of Iceland, Reykjavik, Iceland.} 60_{Federal University}

of Pelotas, Pelotas, Brazil. 61_{University of Oulu, Oulu, Finland.} 62_{Oulu University Hospital, Oulu,}

Finland. 63_{Regional Authority of Public Health, Banska Bystrica, Slovakia.} 64_{University of Porto}

Medical School, Porto, Portugal. 65_{Research Institute for Endocrine Sciences, Tehran, Iran.} 66_{University of Science and Technology, Sana’a, Yemen.} 67_{Medical University of Lodz, Lodz,}

Poland. 68_{Medical University of Gdansk, Gdansk, Poland.} 69_{Universidad Autónoma de Madrid/}

CIBERESP, Madrid, Spain. 70_{University of Palermo, Palermo, Italy.} 71_{Pan American Health}

Organization, Washington, DC, USA. 72_{Mohammed V University de Rabat, Rabat, Morocco.} 73_{Dalhousie University, Halifax, Nova Scotia, Canada.} 74_{Jordan University of Science and}

Technology, Irbid, Jordan. 75_{Al-Farabi Kazakh National University, Almaty, Kazakhstan.} 76_{University of Sydney, Sydney, New South Wales, Australia.} 77_{Christian Medical College,}

Vellore, India. 78_{University Tunis El Manar, Tunis, Tunisia.} 79_{Cafam University Foundation,}

Bogota, Colombia. 80_{Kazakh National Medical University, Almaty, Kazakhstan.} 81_Universidad

Peruana Cayetano Heredia, Lima, Peru. 82_{Lithuanian University of Health Sciences, Kaunas,}

Lithuania. 83_{University of São Paulo, São Paulo, Brazil.} 84_{Sunder Lal Jain Hospital, Delhi, India.} 85_{Shanghai Jiao-Tong University School of Medicine, Shanghai, China.} 86_{Public Health Agency}

of Canada, Ottawa, Ontario, Canada. 87_{Ufa Eye Research Institute, Ufa, Russia.} 88_{Nepal Health}

Research Council, Kathmandu, Nepal. 89_{University of Southern Denmark, Copenhagen,}

Denmark. 90_{University of Gothenburg, Gothenburg, Sweden.} 91_{Universidade Federal do Rio de}

Janeiro, Rio de Janeiro, Brazil. 92_{National Institute for Public Health and the Environment,}

Bilthoven, The Netherlands. 93_{University of Turin, Turin, Italy.} 94_{Nanyang Technological}

University, Singapore, Singapore. 95_{Universidad de la República, Montevideo, Uruguay.} 96_{Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina.} 97_IRCCS

Neuromed, Pozzilli, Italy. 98_{Toulouse University School of Medicine, Toulouse, France.} 99_{University Hospital of Varese, Varese, Italy.} 100_{University Hospital KU Leuven, Leuven,}

Belgium. 101_{Ministry of Health, Victoria, Seychelles.} 102_{University of Lausanne, Lausanne,}

Switzerland. 103_{Universidad Central de Venezuela, Caracas, Venezuela.} 104_{Bielefeld University,}

Bielefeld, Germany. 105_{German Cancer Research Center, Heidelberg, Germany.} 106_University

College Copenhagen, Copenhagen, Denmark. 107_{Robert Koch Institute, Berlin, Germany.} 108_{Universidad de La Laguna, Tenerife, Spain.} 109_{University of Malta, Msida, Malta.} 110_Istanbul

University – Cerrahpasa, Istanbul, Turkey. 111_{Universidade Federal de Juiz de Fora, Juiz de Fora,}

Brazil. 112_{Gaetano Fucito Hospital, Mercato San Severino, Italy.} 113_{University of Porto, Porto,}

Portugal. 114_{Santiago de Compostela University, Santiago, Spain.} 115_{Council for Agricultural}

Research and Economics, Rome, Italy. 116_{Research and Education Institute of Child Health,}

Nicosia, Cyprus. 117_{Dr. A. Ramachandran’s Diabetes Hospital, Chennai, India.} 118_University

College London, London, UK. 119_{Academia Sinica, Taipei, Taiwan.} 120_{Capital Institute of}

Pediatrics, Beijing, China. 121_{Kailuan General Hospital, Tangshan, China.} 122_{Duke-NUS Medical}

School, Singapore, Singapore. 123_{Ahvaz Jundishapur University of Medical Sciences, Ahvaz,}

Iran. 124_{The Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel.} 125_{Ministry of Health and Welfare, Taipei, Taiwan.} 126_{Murcia Health Council, Murcia, Spain.} 127_{Seoul National University College of Medicine, Seoul, Republic of Korea.} 128_{Korea Centers}

for Disease Control and Prevention, Cheongju-si, Republic of Korea. 129_{Medical University of}

Silesia, Katowice, Poland. 130_{Katholieke Universiteit Leuven, Leuven, Belgium.} 131_Statistics

Canada, Ottawa, Ontario, Canada. 132_{Ghent University, Ghent, Belgium.} 133_{Agency for}

Preventive and Social Medicine, Bregenz, Austria. 134_{Federal University of Maranhão, São Luís,}

Brazil. 135_{University of Southampton, Southampton, UK.} 136_{Institut Pasteur de Lille, Lille,}

France. 137_{CIBEROBN, Madrid, Spain.} 138_{University of Debrecen, Debrecen, Hungary.} 139_{Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.} 140_{National Council of}

Research, Reggio Calabria, Italy. 141_{Federal University of Santa Catarina, Florianópolis, Brazil.} 142_{Eduardo Mondlane University, Maputo, Mozambique.} 143_{Geneva University Hospitals,}

Geneva, Switzerland. 144_{National Research Centre for Preventive Medicine, Moscow, Russia.} 145_{University of Montreal, Montreal, Québec, Canada.} 146_{French Public Health Agency, St}

Maurice, France. 147_{Mediterranea Cardiocentro, Naples, Italy.} 148_{University of Zagreb, Zagreb,}

Croatia. 149_{Ministry of Health and Medical Education, Tehran, Iran.} 150_{University of Queensland,}

Brisbane, Queensland, Australia. 151_{Universidad de Cuenca, Cuenca, Ecuador.} 152_Helmholtz

Zentrum München, Munich, Germany. 153_{Carol Davila University of Medicine and Pharmacy,}

Bucharest, Romania. 154_{University Hospital Düsseldorf, Düsseldorf, Germany.} 155_National

Institute of Cardiology, Warsaw, Poland. 156_{Beth Israel Deaconess Medical Center, Boston, MA,}

USA. 157_{University of Latvia, Riga, Latvia.} 158_{Ministry of Health and Medical Services, Gizo,}

Solomon Islands. 159_{Hormozgan University of Medical Sciences, Bandar Abbas, Iran.} 160_{University of Skövde, Skövde, Sweden.} 161_{National Institute of Nutrition and Food}