Associations Between Inflammatory Potential of Diet with the Risk of All-Cause Mortality and Greenhouse Gas Emissions in Chinese Adults

<b>Background:</b> Current research inadequately substantiates the impacts of dietary inflammatory potential based on the dietary inflammatory index (DII) on population health and environmental sustainability in Chinese adults. <b>Objectives:</b> We aimed to investigate the associations between the DII with the risk of all-cause mortality and greenhouse gas (GHG) emissions in Chinese adults. <b>Methods:</b> Data from adults (N = 15,318) in the China Health and Nutrition Survey 1997-2015 wave were included in the analysis. DII and energy-adjusted DII (E-DII) were calculated using dietary intake data collected with a combination of 3-day consecutive 24-h dietary recalls and the food weighing method. The total GHG emissions were calculated by summing the amount of emissions from all the food groups consumed by the participants. Cox proportional hazards regression models and linear regression models were conducted for statistical analysis. <b>Results:</b> A pro-inflammatory diet, as reflected by higher DII and E-DII scores was associated with an increased risk of all-cause mortality (DII: Q5 vs. Q1: HR = 1.82; 95% CI: 1.45-2.30; <i>p</i>-trend < 0.0001; E-DII: Q5 vs. Q1: HR = 1.86; 95% CI: 1.38-2.52; <i>p</i>-trend < 0.0001) and higher amounts of GHG emissions (both <i>p</i>-trend < 0.0001). <b>Conclusions:</b> These findings demonstrated positive associations between pro-inflammatory potentials with an increased risk of all-cause mortality and higher GHG emissions among Chinese adults, suggesting dual adverse impacts of a pro-inflammatory diet on health and environmental sustainability.