Decoupled but reconcilable: a nutrition-feasible global reallocation lowers dietary inflammation and environmental footprints simultaneously in every country
- 1Ningbo City College of Vocational Technology
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.
MethodsFrom 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).
ResultssDII 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).
ConclusionsAnti-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.
Key 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
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BibTeX
@misc{huang2026decoupled,
title = {{Decoupled but reconcilable: a nutrition-feasible global reallocation lowers dietary inflammation and environmental footprints simultaneously in every country}},
author = {S. Huang and X. Wang},
howpublished = {medRxiv},
year = {2026},
month = aug,
doi = {10.64898/2026.08.30.26361755},
url = {https://www.medrxiv.org/content/10.64898/2026.08.30.26361755v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Decoupled but reconcilable: a nutrition-feasible global reallocation lowers dietary inflammation and environmental footprints simultaneously in every country
AU - S. Huang
AU - X. Wang
PY - 2026
DA - 2026/08/30
PB - medRxiv
DO - 10.64898/2026.08.30.26361755
UR - https://www.medrxiv.org/content/10.64898/2026.08.30.26361755v1
AB - 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. MethodsFrom 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). ResultssDII 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). ConclusionsAnti-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. Key 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
ER -