BACKGROUND The food system accounts for ∼40% 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 2,000 kcal-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 (p=0.0043) 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.

中文翻译：

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低温室气体排放自我选择饮食与 40 岁及以上成年人代谢综合征的风险：韩国的一项前瞻性队列研究。

背景技术 食品系统占人类产生的温室气体 (GHG) 排放量的 40%。同时，日常饮食选择也会影响人体的营养状况和健康。目的 本研究旨在使用替代地中海饮食 (aMED) 评分来评估低温室气体排放饮食的质量以及与发生代谢综合征 (MetS) 风险的关联。方法 健康检查者研究是韩国自 2004 年以来正在进行的一项队列研究，共有 41,659 名年龄在 40 岁或以上、没有 MetS 的健康参与者。根据国家项目和文献回顾，编制了膳食温室气体排放数据库。MetS 是根据国家胆固醇教育计划的成人治疗组 III 标准定义的。根据 2,000 kcal 标准化每日饮食温室气体排放量（Q1：最低能量调整饮食温室气体排放量）将参与者分为五等分。使用多变量逻辑回归模型来分析随访时 MetS 的风险。aMED评分用于评估不同饮食相关温室气体排放组的饮食质量。结果 与能量调整饮食相关温室气体排放量较低的女性相比，能量调整饮食相关温室气体排放量最高的女性，患 MetS 的风险显着降低 (p=0.0043)。此外，与其他组相比，Q1组的aMED得分较高（男性为3.02，女性为3.00），这表明该组参与者的饮食更接近地中海饮食。讨论这些研究结果为韩国和世界范围内旨在改善饮食摄入和减少与饮食相关的温室气体排放的饮食指导和其他政策提供了参考。https://doi.org/10.1289/EHP12727。