Well, shit - it’s not just Americans who are living longer but sicker lives, and it’s not just Western nations, either. The new Global Burden of Disease Report – a massive undertaking compiled by the World Health Organization using data from 50 countries over 20 years - found “a massive shift in global health trends,” at the root of which lies widespread obesity. And maybe lack of fruit.

In charting disease risk factors, researchers found low-fruit diets were responsible for more disease than obesity or lack of exercise.

“We were very surprised,” said Christopher J.L. Murray, who headed the study. “I’m a pretty profound diet skeptic. But the evidence on diet is as convincing as on obesity.”

The good news: “Kids who used to die from infections diseases are now doing extremely well with immunization,” said Ali Mokdad, co-author of the study. We’re also living 10-13 years longer than projected 20 years ago.

The bad news: We’re seeing the impact of not just a few more obese countries but a more obese world.

All 50 of the countries studied with the exception of those in sub-Saharan Africa showed alarmingly high obesity rates–an 82% increase globally between 1990 and 2010. Middle Eastern countries saw a 100% increase during that time.

“The so-called ‘Western lifestyle’ is being adapted all around the world, and the impacts are all the same,” said Mokdad.

Countries that never used to see diabetes, stroke and heart disease are now seeing these creep up into their leading causes of death or illness, and the leading disease risk factor globally is now high blood pressure.

“We’re even seeing a large percentage of people suffering (obesity-related) back pain now,” he said. Low-back pain is now a bigger worldwide cause of disability than anemia or childbirth complications.

Global shift: On average, people spend the last 14 years of their lives dogged by disease or disability, according to the report. Murray said we’re transitioning “to a world where disability is the dominant concern as opposed to premature death.”

Other shifts? Deaths from car accidents, lung cancer and diabetes are on the rise. But malnutrition dropped from 11th to the 21st leading global cause of death, and deaths from measles dropped from the world’s 19th leading cause of death to 62nd.

The report:  Nearly 500 researchers from 302 institution in 50 countries worked on the study. It’s the largest and most ambitious population-wide health study ever attempted, charting 235 causes of death and 67 disease “risk factors,” from household air pollution to to vitamin A deficiency to childhood sexual abuse. The package of seven papers totaling nearly 200 pages was published in the British journal the Lancet on Thursday. Here’s a cool interactive tool that lets you look at different results.

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Elizabeth Nolan Brown