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Associations between dietary greenhouse gas emissions, mortality, and chronic disease risk : a prospective cohort study in Sweden

Stubbendorff, Anna LU orcid ; Janzi, Suzanne LU ; Borné, Yan LU ; Carlbaum, Moa LU ; Jukkola, Juulia ; Ericson, Ulrika LU ; Hallström, Elinor LU and Sonestedt, Emily LU orcid (2025) In Environmental Challenges 20. p.1-9
Abstract

Background: The global food system is a major contributor to climate change, accounting for about one-third of human-induced greenhouse gas emissions (GHGE). Shifting toward plant-based diets offers potential benefits for both planetary health and chronic disease prevention. However, epidemiological evidence linking dietary GHGE to health outcomes remains limited and inconsistent. Objective: To examine the associations between dietary GHGE and the risk of all-cause and cause-specific mortality, cardiovascular disease (CVD), and type 2 diabetes in a large Swedish cohort. Methods: This prospective cohort study included 22,388 adults (45–73 years) from the Malmö Diet and Cancer study. Dietary intake was assessed through a validated... (More)

Background: The global food system is a major contributor to climate change, accounting for about one-third of human-induced greenhouse gas emissions (GHGE). Shifting toward plant-based diets offers potential benefits for both planetary health and chronic disease prevention. However, epidemiological evidence linking dietary GHGE to health outcomes remains limited and inconsistent. Objective: To examine the associations between dietary GHGE and the risk of all-cause and cause-specific mortality, cardiovascular disease (CVD), and type 2 diabetes in a large Swedish cohort. Methods: This prospective cohort study included 22,388 adults (45–73 years) from the Malmö Diet and Cancer study. Dietary intake was assessed through a validated modified diet history method and linked to GHGE estimates using life cycle assessment data. Cox proportional hazards models were used to assess associations between GHGE and disease outcomes, adjusting for sociodemographic and lifestyle factors. Results: Over a mean follow-up of 28.5 years, 11,213 deaths, 5322 CVD cases, and 4324 diabetes cases were documented through registers. Higher GHGE were consistently associated with higher risk of diabetes (p > 0.001). For all-cause and CVD mortality, moderate positive associations were observed, particularly among participants with very high GHGE. When participants who reported substantial dietary changes prior to baseline were excluded, a significant linear association was observed for cancer mortality and CVD incidence. Conclusion: Diets with higher climate impact were associated with adverse health outcomes, especially diabetes incidence. These findings suggest that climate-friendly diets may also confer health benefits. Future studies should transparently report GHGE modelling approaches and clarify the roles of specific dietary components in improving both health and environmental outcomes.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Climate, Non-communicable diseases, Sustainability
in
Environmental Challenges
volume
20
article number
101309
pages
1 - 9
publisher
Elsevier
external identifiers
  • scopus:105015052172
ISSN
2667-0100
DOI
10.1016/j.envc.2025.101309
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Authors
id
2d522d04-8451-45b2-a026-026f6b58daf9
date added to LUP
2025-09-15 17:15:11
date last changed
2025-10-14 11:16:29
@article{2d522d04-8451-45b2-a026-026f6b58daf9,
  abstract     = {{<p>Background: The global food system is a major contributor to climate change, accounting for about one-third of human-induced greenhouse gas emissions (GHGE). Shifting toward plant-based diets offers potential benefits for both planetary health and chronic disease prevention. However, epidemiological evidence linking dietary GHGE to health outcomes remains limited and inconsistent. Objective: To examine the associations between dietary GHGE and the risk of all-cause and cause-specific mortality, cardiovascular disease (CVD), and type 2 diabetes in a large Swedish cohort. Methods: This prospective cohort study included 22,388 adults (45–73 years) from the Malmö Diet and Cancer study. Dietary intake was assessed through a validated modified diet history method and linked to GHGE estimates using life cycle assessment data. Cox proportional hazards models were used to assess associations between GHGE and disease outcomes, adjusting for sociodemographic and lifestyle factors. Results: Over a mean follow-up of 28.5 years, 11,213 deaths, 5322 CVD cases, and 4324 diabetes cases were documented through registers. Higher GHGE were consistently associated with higher risk of diabetes (p &gt; 0.001). For all-cause and CVD mortality, moderate positive associations were observed, particularly among participants with very high GHGE. When participants who reported substantial dietary changes prior to baseline were excluded, a significant linear association was observed for cancer mortality and CVD incidence. Conclusion: Diets with higher climate impact were associated with adverse health outcomes, especially diabetes incidence. These findings suggest that climate-friendly diets may also confer health benefits. Future studies should transparently report GHGE modelling approaches and clarify the roles of specific dietary components in improving both health and environmental outcomes.</p>}},
  author       = {{Stubbendorff, Anna and Janzi, Suzanne and Borné, Yan and Carlbaum, Moa and Jukkola, Juulia and Ericson, Ulrika and Hallström, Elinor and Sonestedt, Emily}},
  issn         = {{2667-0100}},
  keywords     = {{Climate; Non-communicable diseases; Sustainability}},
  language     = {{eng}},
  pages        = {{1--9}},
  publisher    = {{Elsevier}},
  series       = {{Environmental Challenges}},
  title        = {{Associations between dietary greenhouse gas emissions, mortality, and chronic disease risk : a prospective cohort study in Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.envc.2025.101309}},
  doi          = {{10.1016/j.envc.2025.101309}},
  volume       = {{20}},
  year         = {{2025}},
}