Seattle, WA—Unhealthy diets kill more people annually than smoking tobacco does, according to a study published inThe Lancet.

In the study, titled “Health effects of dietary risks in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017”  researchers estimated the proportion of disease-specific burden attributable to each dietary risk factor among adults aged 25 and older. This included intake of each dietary component and the level of intake associated with the lowest risk of mortality. The researchers then calculated the number of deaths and disability-adjusted life-years (DALYs) attributable to diet for each disease outcome.

In 2017, the researchers report, 11 million deaths and 255 million DALYs were attributable to dietary risk factors. The greatest factors were high sodium intake and low sodium intake of whole grains and fruits.

The Guardian noted that, per the study, the problem isn’t necessarily the junk we eat: it’s the nutritious food we don’t eat. The greatest factors didn’t include high sugar intake or too much processed food—it’s a lack of fruits and whole grains that does people in. And while diets vary from one country to the next, and it might be true that in the U.S. too much sugar is a major issue, the listed risk factors accounted for half of all deaths and two-thirds of the DALYs.

The Guardianalso quotes the study’s finding that poor diets were responsible for 10.9 million deaths in 2017. Tobacco was associated with 8 million deaths, and high blood pressure with 10.4 million.

For more information, find the full studyhere.