One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature review

Unhealthy diets are proven risks for non-communicable diseases and mortality globally. Low- and Middle-Income Countries (LMICs) are equally faced with food/nutrition insecurity, poor health outcomes, and the need for sustainable food systems transformation to cater for the growing population within...

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Main Authors: Edith Monica Esievo, Louise Whatford, Sarah Nájera Espinosa, Oche Abraham Awulu, Aliyu Nuhu Ahmed, Kris A. Murray, Zakari Ali
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Sustainable Food Systems
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Online Access:https://www.frontiersin.org/articles/10.3389/fsufs.2025.1567245/full
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author Edith Monica Esievo
Edith Monica Esievo
Edith Monica Esievo
Edith Monica Esievo
Louise Whatford
Sarah Nájera Espinosa
Oche Abraham Awulu
Oche Abraham Awulu
Aliyu Nuhu Ahmed
Kris A. Murray
Zakari Ali
author_facet Edith Monica Esievo
Edith Monica Esievo
Edith Monica Esievo
Edith Monica Esievo
Louise Whatford
Sarah Nájera Espinosa
Oche Abraham Awulu
Oche Abraham Awulu
Aliyu Nuhu Ahmed
Kris A. Murray
Zakari Ali
author_sort Edith Monica Esievo
collection DOAJ
description Unhealthy diets are proven risks for non-communicable diseases and mortality globally. Low- and Middle-Income Countries (LMICs) are equally faced with food/nutrition insecurity, poor health outcomes, and the need for sustainable food systems transformation to cater for the growing population within safe planetary boundaries. Despite significant progress globally, persistent challenges necessitate a more holistic and systemic approach to healthy sustainable diets, particularly in LMICs which are often underrepresented in global studies. This review conceptualizes sustainable diets looking at LMICs by assessing sustainability through the One Health approach which considers the interdependencies among humans, animals, plants, and the environment. Using the preferred reporting items of systematic reviews and meta-analyses (PRISMA) guidelines and the checklist for One Health epidemiological reporting of evidence (COHERE) standards, four databases were searched (Embase, Global Health, Web of Science, and Scopus) between 1947 and June 2023. Dietary sustainability was assessed in LMICs by evaluating coverage across the four One Health pillars (human, animal, plant, and environmental health) and five dietary sustainability dimensions (diet/nutrition, health, environment, economic, and social). Extracted data were analyzed qualitatively. The database searches yielded 3,122 studies. After removing duplicates and screening for eligibility, 35 studies were selected for inclusion. Most studies were from upper (77%) and lower (20%) middle-income countries. While 20 studies (57%) assessed human and environmental health, none assessed plant or animal health, nor all four One Health pillars combined. No study assessed all five dietary sustainability dimensions. Most studies assessed two (54%) or three (34%) dimensions, and the most frequently assessed dimension was the environment (71%). Thus, highlighting the non-comprehensive nature and the dearth of research on sustainable diets conducted in LMICs, particularly, low-income countries, and that the research so far mainly focuses on environmental impacts. Overall, studies found that LMICs’ diets, particularly middle-income countries, are unsustainable due to low quality, low diversity, and high environmental effects, with associated inequities. The underrepresentation of LMICs, particularly low-income countries, in this review is a wake-up call urging the generation of more country-specific data incorporating more dietary sustainability dimensions and One Health pillars (especially plant and animal health) for progress and monitoring toward attaining global dietary sustainability.
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spelling doaj-art-2eacb046be7a4d59a9e05bc2d63adc492025-08-20T01:51:54ZengFrontiers Media S.A.Frontiers in Sustainable Food Systems2571-581X2025-05-01910.3389/fsufs.2025.15672451567245One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature reviewEdith Monica Esievo0Edith Monica Esievo1Edith Monica Esievo2Edith Monica Esievo3Louise Whatford4Sarah Nájera Espinosa5Oche Abraham Awulu6Oche Abraham Awulu7Aliyu Nuhu Ahmed8Kris A. Murray9Zakari Ali10Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, United KingdomLondon School of Hygiene and Tropical Medicine, University of London, London, United KingdomCentre on Climate Change and Planetary Health, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, GambiaCollege of Veterinary Medicine, Federal University of Agriculture, Zuru, NigeriaPathobiology and Population Sciences, Royal Veterinary College, University of London, London, United KingdomLondon School of Hygiene and Tropical Medicine, University of London, London, United KingdomPathobiology and Population Sciences, Royal Veterinary College, University of London, London, United KingdomLondon School of Hygiene and Tropical Medicine, University of London, London, United KingdomCentre on Climate Change and Planetary Health, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, GambiaCentre on Climate Change and Planetary Health, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, GambiaCentre on Climate Change and Planetary Health, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, GambiaUnhealthy diets are proven risks for non-communicable diseases and mortality globally. Low- and Middle-Income Countries (LMICs) are equally faced with food/nutrition insecurity, poor health outcomes, and the need for sustainable food systems transformation to cater for the growing population within safe planetary boundaries. Despite significant progress globally, persistent challenges necessitate a more holistic and systemic approach to healthy sustainable diets, particularly in LMICs which are often underrepresented in global studies. This review conceptualizes sustainable diets looking at LMICs by assessing sustainability through the One Health approach which considers the interdependencies among humans, animals, plants, and the environment. Using the preferred reporting items of systematic reviews and meta-analyses (PRISMA) guidelines and the checklist for One Health epidemiological reporting of evidence (COHERE) standards, four databases were searched (Embase, Global Health, Web of Science, and Scopus) between 1947 and June 2023. Dietary sustainability was assessed in LMICs by evaluating coverage across the four One Health pillars (human, animal, plant, and environmental health) and five dietary sustainability dimensions (diet/nutrition, health, environment, economic, and social). Extracted data were analyzed qualitatively. The database searches yielded 3,122 studies. After removing duplicates and screening for eligibility, 35 studies were selected for inclusion. Most studies were from upper (77%) and lower (20%) middle-income countries. While 20 studies (57%) assessed human and environmental health, none assessed plant or animal health, nor all four One Health pillars combined. No study assessed all five dietary sustainability dimensions. Most studies assessed two (54%) or three (34%) dimensions, and the most frequently assessed dimension was the environment (71%). Thus, highlighting the non-comprehensive nature and the dearth of research on sustainable diets conducted in LMICs, particularly, low-income countries, and that the research so far mainly focuses on environmental impacts. Overall, studies found that LMICs’ diets, particularly middle-income countries, are unsustainable due to low quality, low diversity, and high environmental effects, with associated inequities. The underrepresentation of LMICs, particularly low-income countries, in this review is a wake-up call urging the generation of more country-specific data incorporating more dietary sustainability dimensions and One Health pillars (especially plant and animal health) for progress and monitoring toward attaining global dietary sustainability.https://www.frontiersin.org/articles/10.3389/fsufs.2025.1567245/fullOne Healthsustainable dietslow- and middle-income countriesfood systemdietarysustainability
spellingShingle Edith Monica Esievo
Edith Monica Esievo
Edith Monica Esievo
Edith Monica Esievo
Louise Whatford
Sarah Nájera Espinosa
Oche Abraham Awulu
Oche Abraham Awulu
Aliyu Nuhu Ahmed
Kris A. Murray
Zakari Ali
One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature review
Frontiers in Sustainable Food Systems
One Health
sustainable diets
low- and middle-income countries
food system
dietary
sustainability
title One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature review
title_full One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature review
title_fullStr One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature review
title_full_unstemmed One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature review
title_short One Health conceptualization of sustainable diets looking at low- and middle-income settings: a systematic literature review
title_sort one health conceptualization of sustainable diets looking at low and middle income settings a systematic literature review
topic One Health
sustainable diets
low- and middle-income countries
food system
dietary
sustainability
url https://www.frontiersin.org/articles/10.3389/fsufs.2025.1567245/full
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