Scientists and researchers around the globe are investigating a series of mysteries about what happens to our bones over time. In a new study, a team led by The University of Texas at Austin, in collaboration with Mayo Clinic and Cedars-Sinai Medical Center just made a major break in the case. New research found that osteocytes undergo dramatic structural and functional changes with age that impair their ability to keep our bones strong. Their findings, published in Small and Aging Cell, offer new insights that could pave the way for better treatments for osteoporosis and age-related bone loss.

Aging and stress can induce cellular senescence in osteocytes, resulting in cytoskeletal and mechanical changes that impair their ability to sense mechanical signals, ultimately weakening bone.

Osteocytes are the master regulators of bone health, sensing mechanical forces and directing when to build or break down bone. But when exposed to senescent cells — damaged cells that stop dividing but don’t die — osteocytes themselves begin to stiffen. This cytoskeletal stiffening and altered plasma membrane viscoelasticity undermine their ability to respond to mechanical signals, disrupting healthy bone remodeling and leading to bone fragility.

“Imagine the cytoskeleton as the scaffolding inside a building,” said Maryam Tilton, assistant professor in the Cockrell School of Engineering’s Walker Department of Mechanical Engineering and principal investigator of the study. “When this scaffolding becomes rigid and less flexible, the building can’t adapt to changes and stresses, leading to structural problems. Similarly, stiffened osteocytes can’t effectively regulate bone remodeling, contributing to bone loss.”

Senescent cells release a toxic brew of molecules, called senescence-associated secretory phenotype (SASP), which triggers inflammation and damage in surrounding tissues. They’ve been linked to the development of cancer and many other chronic diseases. Until now, most research has focused on detecting senescence through genetic markers, a notoriously challenging task because these markers vary widely across cell types.

Tilton and her collaborators approach the issue from a different perspective, focusing on cell mechanics. Combining genetic and mechanical approaches could lead to improved treatments for aging cells.

“Much like physical therapy helps restore movement when our joints stiffen, we’re exploring how mechanical cues might help reverse or even selectively clear these aging cells,” Tilton said.

“In the future, biomechanical markers could not only help identify senescent cells but also serve as precise targets for eliminating them, complementing or offering alternatives to current drug-based senolytic therapies,” added Dr. James Kirkland, principal investigator of the National Institutes of Health Translational Geroscience Network, director at the Center for Advanced Gerotherapeutics at Cedars-Sinai and a co-leader of the new research.

Improved knowledge about how bones age could improve treatments for osteoporosis. The condition leads to weakened bones and an increased risk of fractures and affects millions of people worldwide, particularly those over the age of 50. As the global population ages, understanding the mechanisms behind bone deterioration becomes increasingly important.

The team plans to expand their research by exploring the effects of different stressors on osteocytes and investigating potential therapeutic interventions.

This project is led by Tilton in collaboration with Kirkland. Other co-authors on the project include Junhan Liao, Domenic J. Cordova, and Hossein Shaygani of the Walker Department of Mechanical Engineering; Chanul Kim of the Department of Biomedical Engineering; Maria Astudillo Potes from Mayo Clinic; and Kyle M. Miller of Emory University.

But the disease has made a troubling comeback in recent years as vaccine coverage declined after the COVID-19 pandemic. In 2024, several outbreaks left public health officials and hospitals scrambling to accommodate a sudden influx of patients, primarily infants, who are often too young to be vaccinated and suffer the most severe symptoms.

Now, new research from The University of Texas at Austin could aid in improving whooping cough vaccines to once again push this disease toward eradication by targeting two key weaknesses in the infection.

A New Target

Against this backdrop, a team of researchers, including members of UT’s McKetta Department of Chemical Engineering and Department of Molecular Biosciences, has made significant strides in understanding and enhancing pertussis immunity. One of the things that makes pertussis infections dangerous is pertussis toxin (PT), a chemical weapon produced by the bacteria that weakens a patient’s immune response and causes many of the severe symptoms associated with whooping cough.

The new research, described in a new study published in the Proceedings of the National Academy of Sciences, focuses on two powerful antibodies, hu11E6 and hu1B7, which neutralize the PT in different ways.

Using cutting-edge cryo-electron microscopy approaches, the researchers identified the specific epitopes on PT where these antibodies bind. Epitopes are chemical targets the immune system can zero in on to fight pathogens. Hu11E6 blocks the toxin from attaching to human cells by interfering with sugar-binding sites, while hu1B7 prevents the toxin from entering cells and causing harm. These findings are the first to precisely map these critical regions, providing a blueprint to improve vaccines.

“There are currently several promising new pertussis vaccines in the research and clinical trial phases,” said Jennifer Maynard, professor of chemical engineering at the Cockrell School of Engineering and corresponding author of the new study. “Our findings could be incorporated into future versions quite easily, improving overall effectiveness and longevity of protection.”

She pointed to innovations like mRNA technology used in the COVID-19 vaccine, as well as breakthroughs in using genetic engineering on pertussis toxin (PT_gen) to generate safer and more potent new recombinant acellular pertussis vaccines as technologies preserving neutralizing epitopes that can combine with her team’s new findings.

“Training the immune system to target the most vulnerable sites on the toxin is expected to create more effective vaccines,” Maynard said. “And the more effective and longer-lasting a vaccine is, hopefully, the more people will take it.”

In addition to helping guide future vaccine designs, the hu1B7 and hu11E6 antibodies themselves hold promise as therapeutic medicines for infected and high-risk infants. Previous work by Maynard and colleagues show that they can prevent the lethal aspects of pertussis infection. UT researchers are actively seeking partnerships to develop ways to prevent lung damage and death in newborns exposed to the disease.

A Persistent Threat

Caused by the bacterium Bordetella pertussis, whooping cough is infamous for its violent coughing fits, which can lead to complications like pneumonia, seizures, and even death, particularly in infants. One nickname for the disease is the 100-days cough because the painful coughing fits can linger for months, even in mild or moderate cases. The disease kills an estimated 200,000 people each year worldwide, most of them infants and children, and survivors of severe illness can be left with brain damage and lung scarring.

While modern vaccines have reduced the toll, their effectiveness wanes over time, with protection only lasting two to five years. Modern pertussis vaccines are acellular, which means they contain portions of the bacteria that train the immune system to recognize the pathogen, including PT.

Recent outbreaks of whooping cough around the world have stunned public health officials. This fall, New York City saw a 169% increase in whooping cough cases since 2023. Cases have increased 500% since 2019. Australia is currently suffering through the largest outbreak of whooping cough since the introduction of the vaccine in the 1940s, with an estimated 41,000 cases reported this year.

Health officials point to missed initial and booster vaccinations as major contributors to the outbreaks.

Overcoming Hesitancy

While advances in fighting pertussis are exciting, they face a dual challenge: overcoming the biological complexity of pertussis and the societal hurdles of vaccine hesitancy. The most effective way to prevent pertussis in vulnerable newborns is for mothers to be vaccinated during pregnancy, which confers protection to the newborn until it is old enough to be vaccinated. According to the CDC, the full vaccination rate against pertussis in kindergarteners is typically over 90% in the US, but under 60% of mothers receive the vaccine during pregnancy. Skepticism about vaccine safety and slow normalization of routine vaccination after the COVID-19 pandemic has led to pockets of under-vaccinated communities and overall low protection of newborns, providing fertile ground for deadly outbreaks. This environment, coupled with the limitations of current vaccines, makes innovation essential.

Co-author Annalee W. Nguyen, a research professor in chemical engineering, emphasized the importance of prevention over treatment. “It’s always easier to prevent disease in a high-risk person,” she said. “Once someone is extremely ill, their immune system isn’t functioning well, and it’s harder to help them recover. Mothers have an incredible opportunity to shield their babies after they are born by getting a pertussis booster vaccination during pregnancy, and parents can continue to protect their families by working with their pediatrician to ensure children and teens are up-to-date on vaccinations.”

By focusing on neutralizing epitopes — areas where antibodies can effectively block the toxin — new vaccines can potentially provide stronger, longer-lasting immunity. This could help bolster public confidence in pertussis vaccines and curb the disease’s resurgence.

Rebecca E. Wilen of the McKetta Department of Chemical Engineering at UT Austin, Jory A. Goldsmith and Jason McLellan of the Molecular Biosciences Department at UT Austin and Wassana Wijagkanalan of BioNet-Asia were also authors on the paper. The research was financially supported by the Cancer Prevention and Research Institute of Texas, Welch Foundation and the National Institutes of Health.

But more common viral diseases also contribute to global health challenges and economic costs. For example, seasonal influenza epidemics occur annually, causing a substantial global disease burden and economic losses exceeding $11.2 billion each year in the United States alone. Meanwhile, herpes simplex virus-1 (HSV-1), spread primarily through oral contact, infects over two-thirds of the global population and is the leading cause of infectious blindness in Western countries.

Low vaccination rates for influenza viruses and the lack of an HSV vaccine underscore the need for a new approach — one that targets reducing viral loads at the sites where transmission occurs. And for viruses like these, which are transmitted more efficiently through the mouth than the nose, this means focusing on the oral cavity.

Now, in a study published in Molecular Therapy, researchers at the School of Dental Medicine at the University of Pennsylvania and collaborators in Finland, have done just that.

Building on their previous work — now in clinical trial — showing that a similar approach was able to reduce SARS-CoV-2 in COVID-19 patient saliva or swab samples by more than 95%, Henry Daniell, W.D. Miller Professor in Penn’s School of Dental Medicine, and collaborators tested the ability of a chewing gum made from lablab beans, Lablab purpureus — that naturally contain an antiviral trap protein (FRIL) — to neutralize two herpes simplex viruses (HSV-1 and HSV-2) and two influenza A strains (H1N1 and H3N2). The chewing gum formulation allowed for effective and consistent release of FRIL at sites of viral infection.

They demonstrated that 40 milligrams of a two-gram bean gum tablet was adequate to reduce viral loads by more than 95%, a reduction similar to what they saw in their SARS-CoV-2 study.

Importantly, the researchers prepared the gum as a clinical-grade drug product to comply with the FDA specifications for drug products and found the gum to be safe. Daniell notes, “These observations augur well for evaluating bean gum in human clinical studies to minimize virus infection/transmission.”

Daniell and his colleagues are now looking to use lablab bean powder to tackle bird flu, which is currently having a significant impact in North America. In the previous three months, 54 million birds have been affected by H5N1, and several human infections have been reported in the U.S. and Canada.

Previously, bean powder was shown by others to effectively neutralize H5N1 and H7N9 — two strains of influenza A known to cause bird flu in humans as well as in birds. Daniell and colleagues are currently looking to test its use in bird feed to help control bird flu in birds.

“Controlling transmission of viruses continues to be major global challenge. A broad spectrum antiviral protein (FRIL) present in a natural food product (bean powder) to neutralize not only human flu viruses but also avian (bird) flu is a timely innovation to prevent their infection and transmission,” says Daniell.

Henry Daniell is the W.D. Miller Professor in the Department of Basic & Translational Sciences at the School of Dental Medicine at the University of Pennsylvania.

Other authors include Gary H. Cohen, Yuwei Guo, Uddhab Karki, Rachel J. Kulchar, Rahul Singh, and Geetanjali Wakade of Penn Dental Medicine, Hamid Khazaei of the Natural Resources Institute Finland (Luke) and the University of Finland and Juha-Matti Pihlava of the University of Finland.

Research performed in the Daniell lab is supported by NIH grant R01 HL 107904.

University of Maryland biologists offer new insights into this mysteriously universal pattern in a study published in the journal Proceedings of the National Academy of Sciences on April 4, 2025. The new study on baby plants shows that fighting disease at a young age often comes at a steep cost to growth and future evolutionary fitness — or their ability to reproduce.

“It’s a mystery why young organisms don’t evolve stronger disease resistance because getting sick early in life can be deadly,” said study co-author Emily Bruns, an assistant professor of biology at UMD. “Our findings suggest that a hidden trade-off is involved, stopping them from being able to completely fight off a disease.

The researchers studied a wild plant called Silene latifolia (commonly known as white campion) and its relationship with a fungal disease called anther-smut that infects it. This disease doesn’t kill the plants but prevents them from producing pollen, making them unable to reproduce — much like a “plant STD,” as Bruns describes it.

By testing 45 different genetic variations of the Silene plant under controlled settings, the team discovered that plants with stronger disease resistance as seedlings produced significantly fewer flowers and seeds over their lifetime when grown in a disease-free field. Meanwhile, plants with stronger resistance as adults showed no such penalty.

“We found that young plants paid a higher ‘cost’ for fighting the disease compared with adult plants,” Bruns said. “Trying to fight off the fungus was more difficult and resource-consuming for these baby plants. They only have so much energy to spend. If baby plants spend it on disease defense, they can’t put it toward future growth.”

Using their findings, the researchers created a mathematical model showing that these costs of fighting off pathogens are high enough to prevent the evolution of stronger disease resistance in younger plants. Without these costs, plant families with stronger juvenile resistance would theoretically be able to eliminate the disease entirely. But because developing resistance is so impactful for young plants, they remain vulnerable to infection.

“Some young plants ‘pay the cost’ and survive into adulthood, but they make fewer flowers, meaning they’re less able to reproduce,” Bruns explained. “But most remain susceptible as babies, allowing the disease a toehold.”

The team was surprised that these costs didn’t show up right away. Plants that invested in disease resistance as seedlings looked fine at first but produced dramatically fewer flowers in their second year when reproduction would normally peak.

Interestingly, the researchers also found that male plants suffered much higher costs for disease resistance than female plants. Bruns noted that this may be because male plants produce many more flowers than females to spread their pollen as widely as possible — making the cost of diverting resources to disease resistance especially steep for males.

Bruns believes that the team’s findings have implications beyond wild plants. Because juvenile susceptibility drives disease epidemics across many species, understanding the evolutionary mechanisms behind this pattern could inform disease management strategies in agriculture, conservation and public health.

Next, Bruns and the team hope to investigate whether disease resistance costs can be reduced by introducing pathogens to plants slightly later in life when plants establish their first true leaves and no longer rely on stored energy. They also plan to explore whether adult plants with higher disease resistance might protect nearby seedlings by reducing the overall presence of disease presence in a specific area.

“Nature is full of infectious diseases,” Bruns said. “Understanding the different checks and balances between hosts and pathogens helps us understand how evolution has shaped these relationships over millions of years.”

Published in the academic journal Aquaculture, the research compares two scallop farming methods, ear-hanging and lantern net culture, over a complete grow-out cycle to determine which approach yields the best results for commercial growers. The study, led by UMaine postdoctoral researcher Christopher Noren, provides new insights into how each method influences scallop size and adductor muscle weight, a key factor in market value.

Evaluating Two Common Farming Methods

Maine’s scallop aquaculture industry is still in its early stages, and growers are looking for efficient ways to scale up production. Suspended culture is the most common approach, with farmers typically using multi-tiered lantern nets to grow scallops to a harvestable size. However, this method requires frequent maintenance to manage biofouling — an unwanted accumulation of microorganisms, plants and animals — and to optimize growth conditions.

Ear-hanging, a technique adapted from Japanese scallop farming, offers a potential alternative. This method involves drilling a small hole in the scallop’s shell and suspending it on a line, allowing for better water flow and potentially reducing maintenance needs.

To evaluate the effectiveness of each method, researchers partnered with two commercial scallop farms in Maine’s Penobscot Bay and Frenchman Bay. Over four years, they measured scallop growth and the weight of their adductor muscles, the primary product from scallops that are sold in U.S. seafood markets.

Findings to inform Maine’s aquaculture industry

The study found that scallops grown with ear-hanging culture had slightly larger shell heights, about 1-4% greater than those in lantern nets. More significantly, ear-hanging scallops had up to 12% more adductor muscle weight, which is the primary product sold in U.S. seafood markets and commands a higher price per pound when larger. This suggests a potential advantage for growers aiming to maximize profitability within that market.

“We wanted to provide growers with data they could actually use on the water,” said Christopher Noren, doctoral researcher at UMaine and lead author of the study. “By comparing these two methods across a full grow-out cycle, we were able to identify where the biological advantages lie and how they might translate to better yields and more efficient operations.”

The results also highlight the role of temperature in scallop growth. Ear-hanging scallops grew more quickly in optimal conditions, which are between 50 and 59 degrees Farhenheit, but were more affected by colder winter temperatures than those in lantern nets.

“These findings give scallop farmers a clearer picture of how different methods impact growth and harvest timing. Understanding the trade-offs between techniques will help inform decisions about production strategies.” says co-author Damian Brady, a professor of oceanography at UMaine.

Supporting a sustainable, domestic seafood supply

The U.S. imports the majority of its seafood, including scallops, from foreign markets. As interest in domestic scallop aquaculture grows, studies like this can help Maine farmers refine their operations and improve profitability.

“This research gives us real-world numbers to work with,” said Andrew Peters, owner of Vertical Bay LLC and co-author on the study. “Understanding how small changes in gear choice impact growth and market value helps us make smarter decisions as we scale up scallop farming in Maine.”

By identifying methods that balance growth efficiency with labor demands, UMaine researchers are contributing to the development of a sustainable scallop aquaculture industry in the Gulf of Maine.

The study, published in Nature, involves hydrogenation — adding the diatomic hydrogen molecule, H₂, to other compounds.

“Hydrogenation is a critical and diverse reaction used to create food products, fuels, commodity chemicals and pharmaceuticals,” said Zhenxing Feng, associate professor of chemical engineering. “However, for the reaction to be economically viable, a catalyst such as palladium or platinum is invariably required to increase its reaction rate and thus lower cost.”

Feng, OSU doctoral students Alvin Chang and Mason Lyons and researchers at four institutions in China took a deep dive into single-atom catalysts; a catalyst is anything that speeds the rate of a chemical reaction without being consumed by the reaction, and a single-atom catalyst is one in which the metal catalytic sites exist as isolated single atoms on a supporting substrate.

“SACs are a rising star among hydrogenation catalysts and demonstrate excellent catalytic activities compared to nanoparticle catalysts,” Feng said. “Interactions between the metal catalyst and support material lead to unique synergies that improve catalytic activity and stability, but the reason for this enhanced performance had not been understood.”

In a project led by collaborators at the Chinese Academy of Sciences and the University of Science and Technology of China, researchers created and characterized 34 palladium SACs on 14 semiconductor supports.

Advanced X-ray, infrared and electrochemical characterization techniques showed the SACs’ effectiveness depended on how well a substrate could accept electrons, a connection that was consistent and predictable.

“The catalytic abilities of palladium SACs have a universal linear relationship with the molecular orbital position of their supporting substrates,” Feng said. “This opens a new avenue for the screening of metal-support pairs for high activity and stability. We also found that this molecular orbital position can be tuned by reducing support particle size, leading to SACs with record high activities and excellent stabilities.”

For this study, researchers looked at the semihydrogenation of acetylene in excess ethylene, a common industrial process. In hydrogenation, hydrogen molecules are added to unsaturated bonds in organic compounds, converting them to saturated compounds. For example, hydrogenation is used to convert vegetable oils, which are unsaturated fats, into margarine and shortening.

Hydrogenation is also important for the refining of petroleum products, including converting alkenes like ethylene into alkanes to make cleaner-burning fuels such as propane and butane.

The OSU China Experience Fund and the National Natural Science Foundation of China Center for Single-Atom Catalysis were among the funders of this project, which also featured researchers from the National University of Defense Technology and Suzhou Laboratory.

Oxygen, the most critical resource for life on Earth, plays an important role in other nutrient cycles such as carbon and nitrogen. Oxygen depletion in water, called hypoxia, is causing problems. They are piling up in various coastal and freshwater systems. The result? Dying fish, disrupted food webs, poor water quality and more which is already affecting freshwater ecosystems across the globe. This study shows it’s not just a local problem — it’s a planetary one.

Behind oxygen depletion: accelerated oxygen cycle

A group of researchers, led by Utrecht Earth scientists Junjie Wang and Jack Middelburg, have developed for the first time a global model that describes the entire oxygen cycle of inland waters around the world. ‘With this model, we offer the most complete possible understanding of this cycle on a large scale, so that one can see oxygen related problems coming, get to know the causes, and hopefully intervene in time,’ Jack Middelburg explains.

Inland waters have become much busier places when it comes to oxygen. The team found that the global “oxygen turnover” — that is how much oxygen is produced and consumed — has increased. But here’s the twist: these waters are consuming more oxygen than they produce, making them a growing sink of atmospheric oxygen.

Cause

‘More farming, more wastewater, more dams, and a warmer climate — they all change how our freshwater ecosystems function,’ says Junjie Wang. With more nutrients flowing into rivers, lakes and reservoirs, algae grow faster, but when they die and decompose, they use up huge amounts of oxygen. ‘We found that the main causes lay in these direct human activities. First, it turns out that nutrient input through, for example, over-fertilization, is a major driver of this acceleration. Secondly, the longer travel time of freshwater to the sea through the construction of dams and reservoirs has proven to be just as important’, says Jack Middelburg.

At the same time, indirect human impacts like rising temperatures make oxygen less soluble in water, transport slower vertically across the water column, and speed up processes that burn through it even faster. ‘Until now, the consensus in the scientific literature has always been that the rise in temperature is primarily causing this acceleration. But our model shows that warming only contributes about 10-20% to this phenomenon,’ Junjie Wang says.

The Anthropocene fingerprint

This study showed that the modern oxygen cycle in inland waters looks nothing as it did in the early 1900s. ‘Even though these waters cover just a tiny fraction of Earth’s surface, they now remove nearly 1 billion tonnes of oxygen from the atmosphere each year — overall half of what the entire ocean emits back,’ says Middelburg. ‘We can’t ignore inland waters in global climate and oxygen budgets anymore,’ Junjie Wang adds. ‘They’re changing faster than we thought, and they’re crucial pieces of the Earth system puzzle.’

Diet contributes significantly to cardiovascular disease mortality, with estimates indicating that across the European region, one in every five premature deaths could be prevented by an optimised diet.

“In 2019, the Planetary Health Diet (PHD) was developed to optimise global dietary quality while keeping the environmental impacts of food production within sustainable planetary boundaries,” said study author Dr. Mercedes Sotos Prieto of the Autonomous University of Madrid, Spain. “However, there was a lack of evidence on how the PHD compares with the Mediterranean Diet, a plant-based diet with established health and environmental benefits, that is well rooted in Mediterranean countries. We evaluated the effects of both diets on all-cause mortality and environmental impact in a large representative Spanish population.”

The PHD involves energy intake of around 2,500 kcal/day and focuses primarily on high consumption of fruits and vegetables, whole grains, legumes, nuts and unsaturated oils; moderate intake of dairy, starchy vegetables, poultry and fish; and low consumption of saturated fats, red meat and added sugars.

The Mediterranean Diet is characterised by a pattern rich in fruits and vegetables (seasonal), legumes, whole grains and nuts, with olive oil as the main dietary fat, greater consumption of white or lean meats than of red or processed meats, and with moderate consumption of dairy products, fish and eggs.

In the analysis, data on food intake were collected from 11,488 participants in the Study on Nutrition and Cardiovascular Risk in Spain (ENRICA), a prospective cohort study of individuals recruited between June 2008 and October 2010. The PHD Index (0-140 points) was calculated for each participant based on their consumption of 15 food groups: whole grains, starchy vegetables, vegetables, whole fruits, dairy foods, red/processed meat, chicken and other poultry, eggs, fish/shellfish, nuts, non-soy legumes, soybean/soy foods, added saturated and trans-fat, added unsaturated oils, and added sugar and fruit juice. Adherence to the Mediterranean Diet was assessed using the 14-item MEDAS score (0-14 points), which is based on components such as using olive oil for cooking and dressings, eating white meat and seafood over red meat, the consumption of fruits, vegetables, legumes and nuts, and low intake of high-fat dairy products, commercial baked goods and sugar-sweetened/carbonated beverages. The environmental impact of each diet was assessed using the SHARP-Indicators Database (SHARP-ID), which includes data on greenhouse gas emissions and land use. Mortality data were obtained from the National Death Index of Spain. Analyses were performed across tertiles of adherence to the diets, with adjustment for confounders.

Study participants had a mean age of 47.5 years (range, 18-96 years) and around a half (52.5%) were women. A total of 1,157 all-cause deaths occurred during a mean follow-up of 14.4 years.

Higher adherence to the PHD and Mediterranean Diet was similarly associated with lower all-cause mortality. Participants in the top third for adherence to the PHD had a 22% lower chance of dying than those in the lowest third (adjusted hazard ratio [HR] 0.78; 95% confidence interval [CI] 0.66-0.91). For the Mediterranean Diet, participants in the top third for adherence had a 21% lower chance of dying than those in the lowest third (adjusted HR 0.79; 95% CI 0.68-0.93). Adherence to some components of the PHD (fruits, dairy and unsaturated oils) and the Mediterranean Diet (nuts, low consumption of soda and pastries) was independently associated with lower mortality.

In terms of environmental impact, both diets had similarly low footprints. For the PHD, the average level of greenhouse gas emissions was 4.15 kg of CO₂ per day and average level of land use was 5.54 m2 per daily food intake. The average level of greenhouse gas emissions for the Mediterranean Diet including dairy was 4.36 kg of CO₂ per day and the average level of land use was 5.43 m2 per daily food intake. Dairy and meat products were the largest footprint contributors.

Dr. Sotos Prieto concluded: “Higher adherence to both diets was similarly associated with lower all-cause mortality and with comparable low environmental impact, highlighting the substantial health and planetary advantages of adopting one of these plant-based diets.”