Carbon dioxide (CO2) emissions and adherence to Mediterranean diet in an adult population: the Mediterranean diet index as a pollution level index
Authors: García Silvia , Bouzas Cristina , Mateos David , Pastor Rosario , Alvarez Laura , Rubín María , Martínez-González Miguel-Ángel , Salas-Salvadó Jordi , Corella Dolores , Goday Albert , Alfredo Martínez J. , Alonso-Gómez Ángel M , Warnberg Julia , Vioque Jesus , Romaguera Dora , Lopez-Miranda José , Estruch Ramón , Tinahones Francisco
J. , Lapetra José , Serra-Majem Lluis , Riquelme-Gallego Blanca , Pintó Xavier , Gaforio José J. , Matia Pilar , Vidal Josep , Vázquez Clotilde , Daimiel Lidia , Ros Emilio , Bes-Rastrollo Maira , Guillem-Saiz Patricia , Nishi Stephanie , Cabanes Robert , Abete Itziar , Goicolea-Güemez Leire , Gómez-Gracia Enrique , Signes-Pastor Antonio José , Colom Antoni , García-Ríos Antonio , Castro-Barquero Sara , Fernández-García José C. , Santos-Lozano Jose Manuel , Vázquez Zenaida , Sorlí José V , Pascual María , Castañer Olga , Zulet Maria Angeles , Vaquero-Luna Jessica , Javier Basterra-Gortari Francisco , Babio Nancy , Ciurana Ramon , Sánchez Vicente Martín , Tur Josep A. 
Published: August 2024

<p><strong>Background</strong></p>
<p>Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment.</p>
<p><strong>Aim</strong></p>
<p>To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO2 emitted in an older adult population.</p>
<p><strong>Design and population</strong></p>
<p>Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO2 emissions in 6646 participants was assessed.</p>
<p><strong>Methods</strong></p>
<p>Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO2 emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO2 emissions expressed in kg/day: Q1 (≤2.01 kg CO2), Q2 (2.02-2.34 kg CO2), Q3 (2.35-2.79 kg CO2) and Q4 (≥2.80 kg CO2).</p>
<p><strong>Results</strong></p>
<p>More men than women induced higher dietary levels of CO2 emissions. Participants reporting higher consumption of vegetables, fruits, legumes, nuts, whole cereals, preferring white meat, and having less consumption of red meat were mostly emitting less kg of CO2 through diet. Participants with higher adherence to the Mediterranean Diet showed lower odds for dietary CO2 emissions: Q2 (OR 0.87; 95%CI: 0.76-1.00), Q3 (OR 0.69; 95%CI: 0.69-0.79) and Q4 (OR 0.48; 95%CI: 0.42-0.55) vs Q1 (reference).</p>
<p><strong>Conclusions</strong></p>
<p>The Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO2 emissions. Mediterranean Diet index may be used as a pollution level index.</p>