{
  "abstract": "Structured abstractO_ST_ABSBackgroundC_ST_ABSPro-inflammatory and high-environmental-impact diets both threaten population and planetary health, but whether the two objectives align or conflict across countries is unresolved. We tested whether a supply-based dietary inflammatory index (sDII) is coupled to greenhouse-gas (GHG), land and water footprints, and whether a nutrition-feasible reallocation can reduce both at once.\n\nMethodsFrom FAO Food Balance Sheets we built sDII (12 inflammatory-weighted components; construct validity r=0.9999) and five per-capita footprints using three independent life-cycle inventories for 182 national food-supply series. For each country, constrained optimisation reallocated 13 food-group multipliers while holding energy within {+/-}3% and protein [≥]98% of baseline (isoenergetic, isoprotein), under inflammation-first, balanced-Pareto and environment-first weightings. Global totals were population-weighted; avoided emissions were anchored to an external 11.4 Gt CO2e/yr baseline (95% CI 8.2-14.7). Avoidable metabolic-syndrome (MetS) cases used a log-linear per-DII-unit RR=1.044 (1.01-1.07).\n\nResultssDII was only weakly associated with GHG (Spearman {rho}=0.14), land ({rho}=0.13) and freshwater ({rho}=0.28) in 2023. The balanced-Pareto reallocation lowered both sDII and GHG in 182/182 series (100% synergy): population-weighted {Delta}sDII=-0.235, GHG -37.5%, land -49.3%, water -17.2%, i.e. 4.28 Gt CO2e/yr avoided (3.08-5.51). Median shifts cut sugar (-100%), ruminant meat (-80%) and pork (-70%) and raised legumes (+200%), nuts/seeds (+123%) and fruit/vegetables (+58%), matching EAT-Lancet directions. Across 164 countries (7.71 billion people), 23.2 million MetS cases/yr (RR-CI 5.4-36.4; 1.1% of the 2,092-million pool) were potentially avertable. Synergy stayed 100% under conservative-to-ambitious bounds (GHG -23.6% to -44.8%) and across inventories (rank {rho}=0.972-0.976).\n\nConclusionsAnti-inflammatory and low-carbon goals are decoupled rather than conflicting, and an isoenergetic, protein-preserving reallocation reconciles them in every country. Environmental gains are large and robust; health gains are directionally consistent but modest[-] triangulation, not a causal claim.\n\nKey messagesO_LIAt the country level, dietary inflammatory potential and environmental footprints are decoupled (|Spearman {rho}|[≤]0.30), so neither goal automatically delivers the other. C_LIO_LIA nutrition-feasible (isoenergetic, protein-preserving) reallocation achieves 100% country-level synergy, cutting population-weighted dietary GHG by 37.5% (4.28 Gt CO2e/yr) and land use by 49.3%. C_LIO_LIThe result is robust to three life-cycle inventories and three feasibility-bound regimes; the associated reduction in metabolic-syndrome burden is directionally consistent but small ([~]1.1% of the prevalent pool). C_LI",
  "abstract_shown": true,
  "affiliations": [
    "Ningbo City College of Vocational Technology"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "S. Huang"
    },
    {
      "name": "X. Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9e267cxq7esz4.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.08.30.26361755",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361755v1.full",
  "id": "9e267cxq7esz4",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361755v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "nutrition"
    ],
    [
      "openalex",
      "2303|Agriculture Sustainability and Environmental Impact"
    ]
  ],
  "openalex": "W7204900079",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361755v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-08-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9e267cxq7esz4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:28Z",
      "native_id": "10.64898/2026.08.30.26361755",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.08.30.26361755v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:nutrition",
      "subfield": "nutrition"
    }
  ],
  "title": "Decoupled but reconcilable: a nutrition-feasible global reallocation lowers dietary inflammation and environmental footprints simultaneously in every country",
  "title_text": "Decoupled but reconcilable: a nutrition-feasible global reallocation lowers dietary inflammation and environmental footprints simultaneously in every country",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:48Z",
  "url": "https://research.draconitic.com/paper/9e267cxq7esz4",
  "venue": "medRxiv",
  "versions": []
}