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Dietary shifts from staples toward meats, fruits, and vegetables increase environmental impacts. Excessive red meat intake and micro-nutrient deficiencies also raise health concerns. Previous research examined environmental and health consequences of alternative diets but overlooked impacts on air pollution and land use change. Here we examine implications of four potential Chinese dietary shifts on ammonia and particulate matter (PM_2.5) air pollution, greenhouse gas (GHG) emissions, carbon storage loss associated with land-use change, water use, and human health. We show that a diet that replaces red meat with soy benefits the environment and avoids 57,000 PM_2.5-related premature deaths annually. Dietary health benefits, however, appear larger with adoption of the Chinese Dietary Guideline (CDG) and EAT-Lancet diets, which prevent over one million premature deaths annually. However, both …