Low Greenhouse Gas Emission Self-Selective Diets and Risk of Metabolic Syndrome in Adults 40 and Older: A Prospective Cohort Study in South Korea

BACKGROUND: The food system accounts for [Formula: see text] of human-generated greenhouse gas (GHG) emissions. Meanwhile, daily diet selection also impacts human nutrition status and health. OBJECTIVES: This study aimed to use the alternate Mediterranean Diet (aMED) score to evaluate the quality of a low-GHG emission diet and the association with risk of developing metabolic syndrome (MetS). METHODS: A total of 41,659 healthy participants without MetS 40 y of age or older were selected from the Health Examinees Study, an ongoing cohort study in South Korea from 2004. A dietary GHG emissions database was compiled following a national project and literature review. MetS was defined according to the Adult Treatment Panel III criteria of the National Cholesterol Education Program. The participants were grouped into quintiles based on [Formula: see text] –standardized daily diet-GHG emissions (Q1: the lowest energy-adjusted diet-GHG emissions). A multivariable logistic regression model was used to analyze the risk for MetS at follow-up. The aMED score was used to assess the diet quality of the different diet-related GHG emission groups. RESULTS: Females with lower energy-adjusted diet-related GHG emissions had significantly lower risks of developing MetS ([Formula: see text]) than those with the highest energy-adjusted diet-related GHG emissions. In addition, the Q1 group, in comparison with the other groups, had a higher aMED score (3.02 for males and 3.00 for females), which indicated that the participants in this group had a diet that more closely matched the Mediterranean diet. DISCUSSION: These findings provide a reference for dietary guidance and other policies aimed toward improving dietary intake and reducing diet-related GHG emissions in South Korea and worldwide. https://doi.org/10.1289/EHP12727