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Plant-Based and Planetary-Health Diets, Environmental Burden, and Risk of Mortality: A Prospective Study in Chinaplant-Based and Planetary-Health Diets, Environmental Burden, and Risk of Mortality: A Prospective Study in China

21 Pages Posted: 29 Jun 2023

See all articles by Hui Chen

Hui Chen

Zhejiang University - School of Public Health

Xiaoxi Wang

Zhejiang University - China Academy for Rural Development

John S. Ji

Tsinghua University - Vanke School of Public Health

Liyan Huang

Zhejiang University - School of Public Health

Ye Qi

Zhejiang University - School of Public Health

You Wu

Tsinghua University School of Medicine

Pan He

Cardiff University - School of Earth and Environmental Sciences

Yanping Li

Harvard University - Department of Nutrition

Benjamin Bodirsky

Potsdam-Institut für Klimafolgenforschung (PIK)

Christoph Müller

Zhejiang University - China Academy for Rural Development

Walter Willet

Harvard Catalyst

Changzheng Yuan

Zhejiang University - School of Public Health

More...

Abstract

Background: Plant-based and planetary-health diets (PBDs and PHD) are recommended for their potential health and environmental benefits, but population-based evidence in various cultures and developmental contexts is limited.

Methods: We included 9420 adults aged >=45 years (52·3% female) from the open cohort of the China Health and Nutrition Survey. Dietary intake was assessed using 3-day 24-hour dietary recalls combined with weighing methods from 1997 to 2011, and mortality was documented until 2015. We calculated overall, healthful, and unhealthful PBD indices (PDI, hPDI, and uPDI, range: 18-90) and PHD score (range: 0-140), estimated their related greenhouse gas (GHG) emissions, land appropriation (LA), and total water footprint (TWF), and examined their associations with mortality. 

Findings: PBD indices were inversely related to GHG emissions , LA, and TWF, whereas higher PHD score was related to higher environmental burdens (P-trends <0·0001). During follow-up (mean = 9·2 years), 800 (8·5%) death cases were documented. PDI and hPDI were not significantly associated with mortality (hazard ratio for highest vs. lowest quartile = 1·10, 95% confidence interval: 0·90-1·35 for PDI and 0·97, 0·79-1·20 for hPDI), whereas higher uPDI was related to higher mortality risk (1·56, 1·27-1·93). In contrast, higher PHD score was associated with lower mortality risk (0·68, 95% CI: 0·53-0·86).

Interpretation: The environmentally friendly PBDs are not necessarily associated with lower mortality risk. The PHD, developed mainly based on Western populations, was related to lower mortality risk but higher environmental burdens in the Chinese population.

Funding: This study was supported by National Natural Science Foundation of China (72273126) (granted to XW); Fundamental Research Funds from the Central Universities of Zhejiang University and Zhejiang University Global Partnership Fund (granted to CY).

Declaration of Interest: The authors declare no competing interests.

Keywords: Dietary pattern, environmental sustainability, mortality, cohort study

Suggested Citation

Chen, Hui and Wang, Xiaoxi and Ji, John S. and Huang, Liyan and Qi, Ye and Wu, You and He, Pan and Li, Yanping and Bodirsky, Benjamin and Müller, Christoph and Willet, Walter and Yuan, Changzheng, Plant-Based and Planetary-Health Diets, Environmental Burden, and Risk of Mortality: A Prospective Study in Chinaplant-Based and Planetary-Health Diets, Environmental Burden, and Risk of Mortality: A Prospective Study in China. Available at SSRN: https://ssrn.com/abstract=4491647 or http://dx.doi.org/10.2139/ssrn.4491647

Hui Chen

Zhejiang University - School of Public Health ( email )

Hangzhou
China

Xiaoxi Wang

Zhejiang University - China Academy for Rural Development ( email )

Qizhen Building, Zijingang Campus,ZJU
Hangzhou, Zhejiang 310058
China

John S. Ji

Tsinghua University - Vanke School of Public Health ( email )

Beijing
China

Liyan Huang

Zhejiang University - School of Public Health ( email )

Ye Qi

Zhejiang University - School of Public Health ( email )

You Wu

Tsinghua University School of Medicine ( email )

China

Pan He

Cardiff University - School of Earth and Environmental Sciences ( email )

Yanping Li

Harvard University - Department of Nutrition ( email )

Benjamin Bodirsky

Potsdam-Institut für Klimafolgenforschung (PIK) ( email )

Telegrafenberg 31
Potsdam, Brandenburg 14473
Germany

Christoph Müller

Zhejiang University - China Academy for Rural Development ( email )

Walter Willet

Harvard Catalyst ( email )

10 Shattuck Street
Boston, MA 02115
United States

Changzheng Yuan (Contact Author)

Zhejiang University - School of Public Health ( email )

Hangzhou
China

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