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Systematic review Associations of daily diet-related greenhouse gas emission with chronic diseases incidence and mortality: a systematic review and meta-analysis of epidemiological studies
Jee Yeon Hong1,2orcid , Young Jun Kim1,2orcid , Sanghyuk Bae3orcid , Mi Kyung Kim1,2orcid
Epidemiol Health 2022;e2023011
DOI: https://doi.org/10.4178/epih.e2023011 [Accepted]
Published online: December 30, 2022
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1Department of Preventive Medicine, College of Medicine, Hanyang University, Korea , Seoul, Korea
2Institute for Health and Society, Hanyang University, Seoul, Korea
3Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
Corresponding author:  Mi Kyung Kim,
Email: kmkkim@hanyang.ac.kr
Received: 18 October 2022   • Revised: 28 December 2022   • Accepted: 30 December 2022

Objectives
Despite a large contribution of the whole process from food production to dietary consumption to total greenhouse gas (GHG) emissions, there is just little and inconsistent evidence on the epidemiological association of daily diet-related GHG emission with chronic disease risk and even all-cause mortality. This systematic review and meta-analysis was on the observational epidemiological relationship between daily diet-related GHG emissions and health outcomes including the risk of chronic diseases and all-cause mortality.
Methods
All original articles, published in English until May 2022, were identified by searching PubMed, Ovid-EMBASE, Web of Science, CINAHL, and google scholar. The extracted data were pooled using both fixed-effects and random-effects meta-analyses and presented as hazard and risk ratios with a 95% confidence interval (95% CI).
Results
Finally, 7 cohort studies (21 study arms) were included for qualitative synthesis and meta-analysis. The GHGs emission of dietary consumption was significantly positively associated with the risk of chronic disease incidence and mortality in both fixed-effects and random-effects models [fixed: 1.04 (1.03; 1.05), random: 1.04 (1.02; 1.06)]. This positive association was robust regardless of how to group daily diet-related GHG emissions. A relatively animal-based diet showed higher GHG emissions. However, there were just a few studies on specific chronic diseases, subgroup analysis showed insignificant results. There was no evidence of publication bias among the studies (Egger’s test: p = 0.79).
Conclusions
In conclusion, a relatively higher GHGs-emission-diet is associated with a higher risk of all-cause mortality.


Epidemiol Health : Epidemiology and Health