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Dr. Katerina Stylianou
University of Michigan, Ann Arbor

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0 Food
0 Impact Assessment
0 Public Health
0 Risk Assessment
0 life cycle assessment (LCA)

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Journal article
Published: 17 May 2021 in Environmental Research
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Climate change is expected to increase heat-related mortality across the world. Health Impact Assessment (HIA) studies are used to quantify the impact of higher temperatures, taking into account the effect of population adaptation. Although air-conditioning (AC) is one of the main drivers of technological adaptation to heat, the health impacts associated with AC-induced air pollution have not been examined in detail. This study uses the city of Thessaloniki, Greece as a case study and aims to estimate the future heat-related mortality, the residential cooling demand, and the adaptation trade-off between averted heat-related and increased air pollution cardiorespiratory mortality. Using temperature and population projections under different Coupled Model Intercomparison Project Phase 6 (CIMP6) Shared Socioeconomic Pathways scenarios (SSPs), a HIA model was developed for the future heat and air pollution cardiorespiratory mortality. Counterfactual scenarios of either black carbon (BC) or natural gas (NG) being the fuel source for electricity generation were included in the HIA. The results indicate that the heat-related cardiorespiratory mortality in Thessaloniki will increase and the excess of annual heat-related deaths in 2080–2099 will range from 2.4 (95% CI: 0.0–20.9) under SSP1-2.6 to 433.7 (95% CI: 66.9–1070) under SSP5-8.5. Population adaptation will attenuate the heat-related mortality, although the latter may be counterbalanced by the higher air pollution-related mortality due to increased AC, especially under moderate SSP scenarios and coal-fired power plants. Future studies examining the health effects of warmer temperatures need to account for the impact of both adaptation and increased penetration and use of AC.

ACS Style

Panayiotis Kouis; Kyriaki Psistaki; George Giallouros; Antonis Michanikou; Maria G. Kakkoura; Katerina S. Stylianou; Stefania I. Papatheodorou; Anastasia Κ. Paschalidou. Heat-related mortality under climate change and the impact of adaptation through air conditioning: A case study from Thessaloniki, Greece. Environmental Research 2021, 199, 111285 .

AMA Style

Panayiotis Kouis, Kyriaki Psistaki, George Giallouros, Antonis Michanikou, Maria G. Kakkoura, Katerina S. Stylianou, Stefania I. Papatheodorou, Anastasia Κ. Paschalidou. Heat-related mortality under climate change and the impact of adaptation through air conditioning: A case study from Thessaloniki, Greece. Environmental Research. 2021; 199 ():111285.

Chicago/Turabian Style

Panayiotis Kouis; Kyriaki Psistaki; George Giallouros; Antonis Michanikou; Maria G. Kakkoura; Katerina S. Stylianou; Stefania I. Papatheodorou; Anastasia Κ. Paschalidou. 2021. "Heat-related mortality under climate change and the impact of adaptation through air conditioning: A case study from Thessaloniki, Greece." Environmental Research 199, no. : 111285.

Journal article
Published: 13 November 2020 in Sustainability
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Food and diet life cycle assessment (LCA) studies offer insights on the environmental performance and improvement potential of food systems and dietary patterns. However, the influence of ingredient resolution in food-LCAs is often overlooked. To address this, four distinct decomposition methods were used to determine ingredients for mixed dishes and characterize their environmental impacts, using the carbon footprint of the U.S. daily pizza intake as a case study. Pizza-specific and daily pizza intake carbon footprints varied substantially between decomposition methods. The carbon footprint for vegetarian pizza was 0.18–0.45 kg CO2eq/serving, for meat pizza was 0.56–0.73 kg CO2eq/serving, and for currently consumed pizzas in the U.S. (26.3 g/person/day; 75 pizzas types) was 0.072–0.098 kg CO2eq/person/day. These ranges could be explained by differences in pizza coverage, ingredient resolution, availability of ingredient environmental information, and ingredient adjustability for losses between decomposition methods. From the approaches considered, the USDA National Nutrient Database for Standard Reference, which reports standardized food recipes in relative weights, appears to offer the most appropriate and useful food decompositions for food-LCAs. The influence and limitations of sources of reference flows should be better evaluated and acknowledged in food and diet LCAs.

ACS Style

Katerina Stylianou; Emily McDonald; Victor Fulgoni Iii; Olivier Jolliet. Standardized Recipes and Their Influence on the Environmental Impact Assessment of Mixed Dishes: A Case Study on Pizza. Sustainability 2020, 12, 9466 .

AMA Style

Katerina Stylianou, Emily McDonald, Victor Fulgoni Iii, Olivier Jolliet. Standardized Recipes and Their Influence on the Environmental Impact Assessment of Mixed Dishes: A Case Study on Pizza. Sustainability. 2020; 12 (22):9466.

Chicago/Turabian Style

Katerina Stylianou; Emily McDonald; Victor Fulgoni Iii; Olivier Jolliet. 2020. "Standardized Recipes and Their Influence on the Environmental Impact Assessment of Mixed Dishes: A Case Study on Pizza." Sustainability 12, no. 22: 9466.

Journal article
Published: 09 September 2020 in Nutrients
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The first Swiss national dietary survey (MenuCH) was used to screen disease burdens and greenhouse gas emissions (GHG) of Swiss diets (vegan, vegetarian, gluten-free, slimming), with a focus on gender and education level. The Health Nutritional Index (HENI), a novel disease burden-based nutritional index built on the Global Burden of Disease studies, was used to indicate healthiness using comparable, relative disease burden scores. Low whole grain consumption and high processed meat consumption are priority risk factors. Non-processed red meat and dairy make a nearly negligible contribution to disease burden scores, yet are key drivers of diet-related GHGs. Swiss diets, including vegetarian, ranged between 1.1–2.6 tons of CO2e/person/year, above the Swiss federal recommendation 0.6 ton CO2e/person/year for all consumption categories. This suggests that only changing food consumption practices will not suffice towards achieving carbon reduction targets: Systemic changes to food provisioning processes are also necessary. Finally, men with higher education had the highest dietary GHG emissions per gram of food, and the highest disease burden scores. Win–win policies to improve health and sustainability of Swiss diets would increase whole grain consumption for all, and decrease alcohol and processed meat consumption especially for men of higher education levels.

ACS Style

Alexi Ernstoff; Katerina S. Stylianou; Marlyne Sahakian; Laurence Godin; Arnaud Dauriat; Sebastien Humbert; Suren Erkman; Olivier Jolliet. Towards Win–Win Policies for Healthy and Sustainable Diets in Switzerland. Nutrients 2020, 12, 2745 .

AMA Style

Alexi Ernstoff, Katerina S. Stylianou, Marlyne Sahakian, Laurence Godin, Arnaud Dauriat, Sebastien Humbert, Suren Erkman, Olivier Jolliet. Towards Win–Win Policies for Healthy and Sustainable Diets in Switzerland. Nutrients. 2020; 12 (9):2745.

Chicago/Turabian Style

Alexi Ernstoff; Katerina S. Stylianou; Marlyne Sahakian; Laurence Godin; Arnaud Dauriat; Sebastien Humbert; Suren Erkman; Olivier Jolliet. 2020. "Towards Win–Win Policies for Healthy and Sustainable Diets in Switzerland." Nutrients 12, no. 9: 2745.

Journal article
Published: 05 October 2018 in Nutrients
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Disability adjusted life years (DALYs) is a health burden metric that combines years of life lost due to disease disability and premature mortality. The Global Burden of Disease (GBD) has been using DALYs to determine the health burden associated with numerous health risks, including risks associated with dietary intakes, at the global and national level. To translate such information at the food level in the U.S., variables in What We Eat in America (WWEIA) need to be aligned with those in the GBD. In this paper, we develop the necessary new variables needed to account for differences in definitions and units between WWEIA and the GBD. We use the Food Patterns Equivalents Database, Food Patterns Equivalents Ingredient Database, Food and Nutrient Database for Dietary Studies, and Standard Reference databases that provide data for WWEIA to develop food group and nutrient variables that align with definitions and units used in the GBD. Considerable effort was needed to disaggregate mixed dishes to GBD components. We also developed a new “non-starchy” vegetable variable, since the GBD vegetables do not include potatoes and corn, and we report fruits and vegetables in grams instead of household measures. New fiber variables were created to avoid double counting of fiber from legumes, whole grains, fruits, and vegetables. Regression analyses were used to predict trans-fat content for foods in WWEIA with missing or incomplete information. The majority of foods in various U.S. Department of Agriculture (USDA) categories contain multiple GBD food groups (e.g., vegetables, whole grains, and processed meat). For most nutrients considered in the GBD, composition is more evenly distributed across the main food categories; however, seafood omega-3 fats were predominantly from either protein foods or mixed dishes and sugar sweetened beverages were from a single category. Dietary intakes in the U.S. fall short of recommendations for all food groups/nutrients with established theoretical minimum-risk targets in GBD. To our knowledge, this is the first approach that aligns WWEIA intake variables with those used in the health burden-based GBD reports. These methods will facilitate researchers to begin comparing data from the U.S. with that from other countries, as well as assess food sustainability performances by concomitantly evaluating DALYs for environmental and nutritional impacts.

ACS Style

Victor L. Fulgoni; Taylor C. Wallace; Katerina S. Stylianou; Olivier Jolliet. Calculating Intake of Dietary Risk Components Used in the Global Burden of Disease Studies from the What We Eat in America/National Health and Nutrition Examination Surveys. Nutrients 2018, 10, 1441 .

AMA Style

Victor L. Fulgoni, Taylor C. Wallace, Katerina S. Stylianou, Olivier Jolliet. Calculating Intake of Dietary Risk Components Used in the Global Burden of Disease Studies from the What We Eat in America/National Health and Nutrition Examination Surveys. Nutrients. 2018; 10 (10):1441.

Chicago/Turabian Style

Victor L. Fulgoni; Taylor C. Wallace; Katerina S. Stylianou; Olivier Jolliet. 2018. "Calculating Intake of Dietary Risk Components Used in the Global Burden of Disease Studies from the What We Eat in America/National Health and Nutrition Examination Surveys." Nutrients 10, no. 10: 1441.

Journal article
Published: 01 September 2017 in Journal of Cleaner Production
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ACS Style

Alexi Sara Ernstoff; Katerina Stylianou; Benjamin Paul Goldstein. Response to: Dietary strategies to reduce environmental impact must be nutritionally complete. Journal of Cleaner Production 2017, 162, 568 -570.

AMA Style

Alexi Sara Ernstoff, Katerina Stylianou, Benjamin Paul Goldstein. Response to: Dietary strategies to reduce environmental impact must be nutritionally complete. Journal of Cleaner Production. 2017; 162 ():568-570.

Chicago/Turabian Style

Alexi Sara Ernstoff; Katerina Stylianou; Benjamin Paul Goldstein. 2017. "Response to: Dietary strategies to reduce environmental impact must be nutritionally complete." Journal of Cleaner Production 162, no. : 568-570.

Journal article
Published: 19 August 2017 in Journal of Cleaner Production
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International trade separates the consumption of goods and services from their production as well as human health impacts associated with production-based environmental emissions. It is one of the drivers of fine particulate matter (PM2.5), particles <2.5 μm diameter, which is a leading environmental health risk factor associated with several adverse effects on human health, but its importance is not fully characterized. This study quantifies global economic output and PM2.5-related human health impacts caused by the consumption of 189 nations. The results show that in 2010, 23% of global economic output and 26% of global PM2.5-related human health impacts (4.1 million DALY, disability-adjusted life year losses) were caused by the production induced by other nations. Developed nations (e.g., the U.S., Japan, and Germany) outsource not only economic production but also PM2.5-related human health impacts (14%) to Asia (e.g., China and India). An average North American consumer induced nearly as much economic output in Asia as an average Asian consumer. North American consumers induced 596 thousand DALY in Asia in 2010, while Asian consumers induced only 19 thousand DALY in North America. International joint efforts between developed nations and Asia are important to effectively reduce global PM2.5-related human health impacts.

ACS Style

Sai Liang; Katerina S. Stylianou; Olivier Jolliet; Sarang Supekar; Shen Qu; Steven J. Skerlos; Ming Xu. Consumption-based human health impacts of primary PM2.5: The hidden burden of international trade. Journal of Cleaner Production 2017, 167, 133 -139.

AMA Style

Sai Liang, Katerina S. Stylianou, Olivier Jolliet, Sarang Supekar, Shen Qu, Steven J. Skerlos, Ming Xu. Consumption-based human health impacts of primary PM2.5: The hidden burden of international trade. Journal of Cleaner Production. 2017; 167 ():133-139.

Chicago/Turabian Style

Sai Liang; Katerina S. Stylianou; Olivier Jolliet; Sarang Supekar; Shen Qu; Steven J. Skerlos; Ming Xu. 2017. "Consumption-based human health impacts of primary PM2.5: The hidden burden of international trade." Journal of Cleaner Production 167, no. : 133-139.

Research article
Published: 19 July 2017 in Environmental Science & Technology
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Exposure to fine particulate matter (PM2.5) from indoor and outdoor sources is a leading environmental contributor to global disease burden. In response, we established under the auspices of the UNEP/SETAC Life Cycle Initiative a coupled indoor-outdoor emission-to-exposure framework to provide a set of consistent primary PM2.5 aggregated exposure factors. We followed a matrix-based mass balance approach for quantifying exposure from indoor and ground-level urban and rural outdoor sources using an effective indoor-outdoor population intake fraction and a system of archetypes to represent different levels of spatial detail. Emission-to-exposure archetypes range from global indoor and outdoor averages, via archetypal urban and indoor settings, to 3646 real-world cities in 16 parametrized subcontinental regions. Population intake fractions from urban and rural outdoor sources are lowest in Northern regions and Oceania and highest in Southeast Asia with population-weighted means across 3646 cities and 16 subcontinental regions of, respectively, 39 ppm (95% confidence interval: 4.3–160 ppm) and 2 ppm (95% confidence interval: 0.2–6.3 ppm). Intake fractions from residential and occupational indoor sources range from 470 ppm to 62 000 ppm, mainly as a function of air exchange rate and occupancy. Indoor exposure typically contributes 80–90% to overall exposure from outdoor sources. Our framework facilitates improvements in air pollution reduction strategies and life cycle impact assessments.

ACS Style

Peter Fantke; Olivier Jolliet; Joshua S. Apte; Natasha Hodas; John Evans; Charles J. Weschler; Katerina Stylianou; Matti Jantunen; Thomas E. McKone. Characterizing Aggregated Exposure to Primary Particulate Matter: Recommended Intake Fractions for Indoor and Outdoor Sources. Environmental Science & Technology 2017, 51, 9089 -9100.

AMA Style

Peter Fantke, Olivier Jolliet, Joshua S. Apte, Natasha Hodas, John Evans, Charles J. Weschler, Katerina Stylianou, Matti Jantunen, Thomas E. McKone. Characterizing Aggregated Exposure to Primary Particulate Matter: Recommended Intake Fractions for Indoor and Outdoor Sources. Environmental Science & Technology. 2017; 51 (16):9089-9100.

Chicago/Turabian Style

Peter Fantke; Olivier Jolliet; Joshua S. Apte; Natasha Hodas; John Evans; Charles J. Weschler; Katerina Stylianou; Matti Jantunen; Thomas E. McKone. 2017. "Characterizing Aggregated Exposure to Primary Particulate Matter: Recommended Intake Fractions for Indoor and Outdoor Sources." Environmental Science & Technology 51, no. 16: 9089-9100.

Review
Published: 10 February 2017 in Critical Reviews in Toxicology
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The ILSI Health and Environmental Sciences Institute (HESI) Risk Assessment in the Twenty-first Century (RISK21) project was initiated to address and catalyze improvements in human health risk assessment. RISK21 is a problem formulation-based conceptual roadmap and risk matrix visualization tool, facilitating transparent evaluation of both hazard and exposure components. The RISK21 roadmap is exposure-driven, that is, exposure is used as the second step (after problem formulation) to define and focus the assessment. This paper describes the exposure tiers of the RISK21 matrix and the approaches to adapt readily available information to more quickly inform exposure at a screening level. In particular, exposure look-up tables were developed from available exposure tools (European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) Targeted Risk Assessment (TRA) for worker exposure, ECETOC TRA, European Solvents Industry Group (ESIG) Generic Exposure Scenario (GES) Risk and Exposure Tool (EGRET) for consumer exposure, and USEtox® for indirect exposure to humans via the environment) and were tested in a hypothetical mosquito bed netting case study. A detailed WHO risk assessment for a similar mosquito net use served as a benchmark for the performance of the RISK21 approach. The case study demonstrated that the screening methodologies provided suitable conservative exposure estimates for risk assessment. The results of this effort showed that the RISK21 approach is useful for defining future assessment efforts, focusing assessment activities and visualizing results.

ACS Style

M. Dellarco; R. Zaleski; B. J. Gaborek; H. Qian; C. A. Bellin; P. Egeghy; N. Heard; O. Jolliet; D. R. Lander; N. Sunger; Katerina Stylianou; J. Y. Tanir. Using exposure bands for rapid decision making in the RISK21 tiered exposure assessment. Critical Reviews in Toxicology 2017, 47, 317 -341.

AMA Style

M. Dellarco, R. Zaleski, B. J. Gaborek, H. Qian, C. A. Bellin, P. Egeghy, N. Heard, O. Jolliet, D. R. Lander, N. Sunger, Katerina Stylianou, J. Y. Tanir. Using exposure bands for rapid decision making in the RISK21 tiered exposure assessment. Critical Reviews in Toxicology. 2017; 47 (4):317-341.

Chicago/Turabian Style

M. Dellarco; R. Zaleski; B. J. Gaborek; H. Qian; C. A. Bellin; P. Egeghy; N. Heard; O. Jolliet; D. R. Lander; N. Sunger; Katerina Stylianou; J. Y. Tanir. 2017. "Using exposure bands for rapid decision making in the RISK21 tiered exposure assessment." Critical Reviews in Toxicology 47, no. 4: 317-341.

Journal article
Published: 23 September 2015 in The International Journal of Life Cycle Assessment
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Purpose While there has been considerable effort to understand the environmental impact of a food or diet, nutritional effects are not usually included in food-related life cycle assessment (LCA). Methods We developed a novel Combined Nutritional and Environmental Life Cycle Assessment (CONE-LCA) framework that evaluates and compares in parallel the environmental and nutritional effects of foods or diets. We applied this framework to assess human health impacts, expressed in Disability Adjusted Life Years (DALYs), in a proof-of-concept case study that investigated the environmental and nutritional human health effects associated with the addition of one serving of fluid milk to the present average adult US diet. Epidemiology-based nutritional impacts and benefits linked to milk intake, such as colorectal cancer, stroke, and prostate cancer, were compared to selected environmental impacts traditionally considered in LCA (global warming and particulate matter) carried to a human health endpoint. Results and discussion Considering potential human health effects related to global warming, particulate matter, and nutrition, within the context of this study, findings suggest that adding one serving of milk to the current average diet could result in a health benefit for American adults, assuming that existing foods associated with substantial health benefits are not substituted, such as fruits and vegetables. The net health benefit is further increased when considering an iso-caloric substitution of less healthy foods (sugar-sweetened beverages). Further studies are needed to test whether this conclusion holds within a more comprehensive assessment of environmental and nutritional health impacts. Conclusions This case study provides the first quantitative epidemiology-based estimate of the complements and trade-offs between nutrition and environment human health burden expressed in DALYs, pioneering the infancy of a new approach in LCA. We recommend further testing of this CONE-LCA approach for other food items and diets, especially when making recommendations about sustainable diets and food choices.

ACS Style

Katerina S. Stylianou; Martin C. Heller; Victor L. Fulgoni; Alexi S. Ernstoff; Gregory A. Keoleian; Olivier Jolliet; Victor L. Fulgoni Iii. A life cycle assessment framework combining nutritional and environmental health impacts of diet: a case study on milk. The International Journal of Life Cycle Assessment 2015, 21, 734 -746.

AMA Style

Katerina S. Stylianou, Martin C. Heller, Victor L. Fulgoni, Alexi S. Ernstoff, Gregory A. Keoleian, Olivier Jolliet, Victor L. Fulgoni Iii. A life cycle assessment framework combining nutritional and environmental health impacts of diet: a case study on milk. The International Journal of Life Cycle Assessment. 2015; 21 (5):734-746.

Chicago/Turabian Style

Katerina S. Stylianou; Martin C. Heller; Victor L. Fulgoni; Alexi S. Ernstoff; Gregory A. Keoleian; Olivier Jolliet; Victor L. Fulgoni Iii. 2015. "A life cycle assessment framework combining nutritional and environmental health impacts of diet: a case study on milk." The International Journal of Life Cycle Assessment 21, no. 5: 734-746.