Co-benefits from sustainable dietary shifts for population and environmental health: an assessment from a large European cohort study.

Autor:	Laine JE; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK. Electronic address: j.laine@imperial.ac.uk., Huybrechts I; International Agency for Research on Cancer, Lyon, France., Gunter MJ; International Agency for Research on Cancer, Lyon, France., Ferrari P; International Agency for Research on Cancer, Lyon, France., Weiderpass E; International Agency for Research on Cancer, Lyon, France., Tsilidis K; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK., Aune D; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK; Department of Nutrition, Bjørknes University College, Oslo, Norway; Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Ullevål, Oslo, Norway., Schulze MB; Institute of Nutritional Sciences, University of Potsdam, Nuthetal, Germany., Bergmann M; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany., Temme EHM; Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands., Boer JMA; Centre for Nutrition, Prevention and Health Services National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands., Agnoli C; Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy., Ericson U; Department of Clinical Sciences, Lund University, Malmö, Sweden., Stubbendorff A; Department of Clinical Sciences, Lund University, Malmö, Sweden., Ibsen DB; Research Unit for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark., Dahm CC; Research Unit for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark., Deschasaux M; Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France., Touvier M; Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France., Kesse-Guyot E; Sorbonne Paris Nord University, Inserm U1153, Inrae U1125, Cnam, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center - University of Paris (CRESS), Bobigny, France., Sánchez Pérez MJ; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain., Rodríguez Barranco M; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain., Tong TYN; Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Papier K; Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Knuppel A; Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK., Boutron-Ruault MC; CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, 94805, Villejuif, France., Mancini F; CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, 94805, Villejuif, France., Severi G; CESP, Faculté de médecine, Université Paris-Saclay, UVSQ, INSERM, 94805, Villejuif, France; Gustave Roussy, F-94805, Villejuif, France; Department of Statistics, Computer Science and Applications 'G. Parenti', University of Florence, Florence, Italy., Srour B; Division of Cancer Epidemiology, German Cancer Rsearch Center Heidelberg, Heidelberg, Germany., Kühn T; Division of Cancer Epidemiology, German Cancer Rsearch Center Heidelberg, Heidelberg, Germany., Masala G; Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy., Agudo A; Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, Nutrition and Cancer Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain., Skeie G; Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway., Rylander C; Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway., Sandanger TM; Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway., Riboli E; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK., Vineis P; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK; Italian Institute of Technology, Genova, Italy.
Jazyk:	angličtina
Zdroj:	The Lancet. Planetary health [Lancet Planet Health] 2021 Nov; Vol. 5 (11), pp. e786-e796. Date of Electronic Publication: 2021 Oct 22.
DOI:	10.1016/S2542-5196(21)00250-3
Abstrakt:	Background: Unhealthy diets, the rise of non-communicable diseases, and the declining health of the planet are highly intertwined, where food production and consumption are major drivers of increases in greenhouse gas emissions, substantial land use, and adverse health such as cancer and mortality. To assess the potential co-benefits from shifting to more sustainable diets, we aimed to investigate the associations of dietary greenhouse gas emissions and land use with all-cause and cause-specific mortality and cancer incidence rates. Methods: Using data from 443 991 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a multicentre prospective cohort, we estimated associations between dietary contributions to greenhouse gas emissions and land use and all-cause and cause-specific mortality and incident cancers using Cox proportional hazards regression models. The main exposures were modelled as quartiles. Co-benefits, encompassing the potential effects of alternative diets on all-cause mortality and cancer and potential reductions in greenhouse gas emissions and land use, were estimated with counterfactual attributable fraction intervention models, simulating potential effects of dietary shifts based on the EAT-Lancet reference diet. Findings: In the pooled analysis, there was an association between levels of dietary greenhouse gas emissions and all-cause mortality (adjusted hazard ratio [HR] 1·13 [95% CI 1·10-1·16]) and between land use and all-cause mortality (1·18 [1·15-1·21]) when comparing the fourth quartile to the first quartile. Similar associations were observed for cause-specific mortality. Associations were also observed between all-cause cancer incidence rates and greenhouse gas emissions, when comparing the fourth quartile to the first quartile (adjusted HR 1·11 [95% CI 1·09-1·14]) and between all-cause cancer incidence rates and land use (1·13 [1·10-1·15]); however, estimates differed by cancer type. Through counterfactual attributable fraction modelling of shifts in levels of adherence to the EAT-Lancet diet, we estimated that up to 19-63% of deaths and up to 10-39% of cancers could be prevented, in a 20-year risk period, by different levels of adherence to the EAT-Lancet reference diet. Additionally, switching from lower adherence to the EAT-Lancet reference diet to higher adherence could potentially reduce food-associated greenhouse gas emissions up to 50% and land use up to 62%. Interpretation: Our results indicate that shifts towards universally sustainable diets could lead to co-benefits, such as minimising diet-related greenhouse gas emissions and land use, reducing the environmental footprint, aiding in climate change mitigation, and improving population health. Funding: European Commission (DG-SANCO), the International Agency for Research on Cancer (IARC), MRC Early Career Fellowship (MR/M501669/1). Competing Interests: Declaration of interests MRB presented at two conferences, which may be a conflict of interest: the MAYOLY-SPINDLER Symposium on pancreatology in practice at the Journées Francophones d'Hépato-gastroentérologie et d'Oncologie Digestive e-conference in 2020 (Why do I see more and more pancreatic cancers?) and the GILEAD e-conference on weight gain and HIV infection in 2020. All other authors declare no competing interests. (© 2021 International Agency for Research on Cancer; licensee Elsevier. This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that IARC endorses any specific organisation, products or services. The use of the IARC logo is not permitted. This notice should be preserved along with the article's original URL.)
Databáze:	MEDLINE
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