Unhealthy diets are responsible for 11m preventable deaths globally per year, more even than smoking tobacco, according to a major study.

But the biggest problem is not the junk we eat but the nutritious food we don’t eat, say researchers, calling for a global shift in policy to promote vegetables, fruit, nuts and legumes.

While sugar and trans-fats are harmful, more deaths are caused by the absence of healthy foods in our diet, the study found.

The research is part of the Global Burden of Disease study by the Institute of Health Metrics and Evaluation (IHME) in Seattle, published in the Lancet medical journal.

Heart attacks and strokes are the main diet-related causes of death, followed by cancers and type 2 diabetes, say researchers.

The study found that eating and drinking better could prevent one in five deaths around the world. Although diets vary from one country to another, eating too few fruits and vegetables and too much sodium (salt) accounted for half of all deaths and two-thirds of the years of disability attributable to diet.

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