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A fixed-effects model was used when the heterogeneity was considered to be significant (, when represented the sum of identical heterogeneity across all studies and represented the sum of sampling error across all studies ( Quality of evidence We evaluated the quality and strength of the evidence for each outcome based on the Graded Recommendations Assessment, Development and Evaluation (GRADE) method

Unlike stimulant laxatives, fiber supplements do not cause dependency or reduce natural bowel function over time

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We hope that in the future, policymakers will integrate sustainability metrics into health technology assessments, drug coverage decisions and procurement frameworks. Researchers next plan to validate their model using real-world emissions data and clinical outcomes