Lancet Planetary Health最新文献

{"title":"Climate-smart public health for global health resilience","authors":"Christopher D Golden PhD ,&nbsp;Marissa L Childs PhD ,&nbsp;Oladimeji E Mudele PhD ,&nbsp;F Adolphe Andriamizarasoa MPH ,&nbsp;Timothy A Bouley MD ,&nbsp;Giacomo De Nicola PhD ,&nbsp;Max A Fontaine BBA ,&nbsp;Peter J Huybers PhD ,&nbsp;Paubert T Mahatante PhD ,&nbsp;Rija Rabemananjara PhD ,&nbsp;Norohasina Rakotoarison MD ,&nbsp;H Rakoto Ramambason MPH ,&nbsp;Herlyne Ramihantaniarivo MD ,&nbsp;Hervet J Randriamady MS ,&nbsp;Hanitra Randriatsara MD ,&nbsp;M Ando Ravelomanantsoa DVM ,&nbsp;A K Symphonia Razafinimanana BA ,&nbsp;Angela J Rigden PhD ,&nbsp;Joy Shumake-Guillemot PhD ,&nbsp;Lethicia L Yasmine PhD ,&nbsp;Francesca Dominici PhD","doi":"10.1016/j.lanplh.2025.101293","DOIUrl":"10.1016/j.lanplh.2025.101293","url":null,"abstract":"<div><div>Climate change poses urgent public health risks from rising global temperatures and extreme weather events, including heatwaves, droughts, and floods, which disproportionately affect vulnerable populations. To address the current silos embedded in climate, environmental, and public health monitoring and surveillance systems, climate-smart public health (CSPH) creates an integrated platform for action across these sectors, enabling more rapid and efficient responses to climate-related public health challenges. In this Personal View, we introduce the concept of CSPH, a data-driven framework designed to monitor, assess, and adapt to climate-related health impacts. CSPH incorporates surveillance, risk assessment, early warning systems, and resilient health-care infrastructure to address the evolving challenges of climate change. The framework adopts an iterative, community-centred model that responds to local needs and incorporates feedback from health-care providers and policy makers. CSPH also leverages data science and artificial intelligence to address a wide range of health concerns, including infectious diseases, non-communicable diseases, nutrition, and mental health. We applied this framework in Madagascar, a region highly vulnerable to climate impacts, where poverty, malnutrition, and frequent extreme weather events make climate adaptation particularly urgent. Early data analysis has shown strong climate sensitivity in important diseases such as malaria and diarrhoea, which could enable preparedness efforts to target some regions more efficiently. CSPH provides a pathway to enhance resilience in such settings by improving the capacity of public health systems to withstand and respond to climate-related stressors.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 8","pages":"Article 101293"},"PeriodicalIF":21.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call for evidence-based adaptation: mitigating the rising global health burden of extreme heat.","authors":"Tiantian Li, Yirong Liu, Peng Du, Wenjia Cai, Yuming Guo","doi":"10.1016/j.lanplh.2025.101287","DOIUrl":"https://doi.org/10.1016/j.lanplh.2025.101287","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":"101287"},"PeriodicalIF":24.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Planetary boundaries under a land-based climate change mitigation scenario with a food demand transformation: a modelling study.","authors":"Felicitas D Beier, Jan Philipp Dietrich, Jens Heinke, Gabriel Abrahao, Patrick von Jeetze, Benjamin Leon Bodirsky, Michael Crawford, Florian Humpenöder, Leon Merfort, Isabelle Weindl, Mario Herrero, Daniel Mason-D'Croz, Johan Rockström, Marina Sundiang, Sofie Te Wierik, Anna Norberg, David Klein, Christoph Müller, Hermann Lotze-Campen, Alexander Popp","doi":"10.1016/S2542-5196(25)00087-7","DOIUrl":"https://doi.org/10.1016/S2542-5196(25)00087-7","url":null,"abstract":"<p><strong>Background: </strong>Ambitious climate change mitigation in all economic sectors is crucial for limiting global warming. Cost-effective mitigation pathways to keep global average temperature increases below 1·5°C by the end of the 21st century often rely on land-based greenhouse gas (GHG) emission reductions, increased land-based carbon uptake and biomass supply to other sectors (eg, energy and transport), and demand-side changes in the food system. To evaluate the broader sustainability of land-based climate change mitigation action, we evaluated synergies and trade-offs of individual and combined supply-side mitigation measures across five planetary boundaries. We also examined the role of a food demand transformation aligned with the dietary recommendations of the updated planetary health diet defined in the forthcoming EAT-Lancet Commission 2.0 report in shaping planetary boundary outcomes.</p><p><strong>Methods: </strong>In this modelling study, we used the dynamic land-system modelling framework MAgPIE to assess the consequences of land-based GHG reductions, increased land-based carbon uptake, increased biomass supply to other sectors, and a food-system transformation towards the planetary health diet including food waste reductions on five planetary boundary domains (climate change, nitrogen, land-system change, freshwater use, and biosphere integrity) relative to a reference scenario without land-system mitigation throughout the century. For each planetary boundary control variable, we calculated the level of planetary boundary transgression (ie, the extent to which scenario outcomes exceeded the defined safe operating space) and assessed the contributions of land-based mitigation strategies to reducing planetary boundary transgressions projected for the reference scenario.</p><p><strong>Findings: </strong>Our projections show that a food-system transformation together with ambitious land-system and energy-system climate change mitigation can limit global warming to below 1·5°C by 2100, while also reducing planetary boundary transgression (particularly for the climate change, land-system change, biosphere integrity, and nitrogen planetary boundaries). However, a safe operating space was not achieved through these mitigation measures, as most planetary boundaries were still projected to remain transgressed by the end of the 21st century. Increased bioenergy supply alone worsened planetary boundary transgression when only looking at land-system impacts, but combining increased bioenergy supply with GHG pricing in the land system alleviated these trade-offs. Food waste reductions and dietary shifts towards the planetary health diet were projected to ease pressures on the land system and reduce planetary boundary transgression of all assessed planetary boundaries.</p><p><strong>Interpretation: </strong>This research highlights the importance of considering multiple planetary boundaries and the interactions between various mitigatio","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":" ","pages":""},"PeriodicalIF":24.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extreme heat and heatwaves: hazard awareness and impact mitigation","authors":"John Nairn ,&nbsp;Simon J Mason","doi":"10.1016/j.lanplh.2025.06.006","DOIUrl":"10.1016/j.lanplh.2025.06.006","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 7","pages":"Article 101282"},"PeriodicalIF":21.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving heat adaptation with integrated scientific approaches","authors":"Evelyn Song ,&nbsp;Yao Wu ,&nbsp;Shanshan Li ,&nbsp;Yuming Guo","doi":"10.1016/j.lanplh.2025.101284","DOIUrl":"10.1016/j.lanplh.2025.101284","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 7","pages":"Article 101284"},"PeriodicalIF":21.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term air pollution exposure and incident dementia: a systematic review and meta-analysis","authors":"Clare B Best Rogowski MPhil ,&nbsp;Christiaan Bredell MB BChir ,&nbsp;Yan Shi MB BChir ,&nbsp;Alexandra Tien-Smith MPhil ,&nbsp;Magdalena Szybka MB BChir ,&nbsp;Kwan Wai Fung MB BChir ,&nbsp;Lucy Hong MB BChir ,&nbsp;Veronica Phillips PhD ,&nbsp;Prof Zorana Jovanovic Andersen PhD ,&nbsp;Stephen J Sharp MSc ,&nbsp;Prof James Woodcock PhD ,&nbsp;Prof Carol Brayne MD ,&nbsp;Annalan Navaratnam MFPH ,&nbsp;Haneen Khreis PhD","doi":"10.1016/S2542-5196(25)00118-4","DOIUrl":"10.1016/S2542-5196(25)00118-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;A rapidly evolving evidence base suggests that exposure to outdoor air pollution is a risk factor for the onset of dementia, with an upturn in publications since 2022. We sought to synthesise and critically assess this evidence base accounting for the latest studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this systematic review and meta-analysis, we searched MEDLINE, Embase, Cochrane Library, CINAHL, Global Health, PsycINFO, Scopus, and Web of Science Core Collection from database inception up to Oct 23, 2023, for primary observational studies of adults (aged ≥18 years) that provided a quantitative analysis of the association between long-term (≥1 year) exposure to outdoor air pollutants and a subsequent physician diagnosis of dementia. When three or more independent studies reported an exposure–outcome pair, effect estimates of the association were extracted and harmonised to a prespecified exposure increment, and included in inverse-variance weighted random-effects meta-analyses. Between-study inconsistency was assessed using the &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; statistic and the Cochran &lt;em&gt;Q&lt;/em&gt; test. Study-level risk of bias and confidence in the overall body of evidence were assessed with the Office of Health Assessment and Translation tool, and publication bias was examined. The protocol for this review was registered with PROSPERO, CRD42023414413.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The search generated 15 619 records, of which 51 studies met the inclusion criteria for data extraction. After excluding studies due to population overlap and missing continuous effect estimates, 32 studies reported on exposure–outcome pairs that met the threshold of three or more studies, and were included in meta-analyses of adjusted effect estimates for incident dementia and/or in subgroup analyses of dementia subtypes. In meta-analyses of incident dementia, we identified a dementia diagnosis to be significantly associated with long-term exposure to PM&lt;sub&gt;2·5&lt;/sub&gt; (21 studies, n=24 030 527, pooled adjusted hazard ratio (HR) per 5 μg/m&lt;sup&gt;3&lt;/sup&gt; increase in exposure, 1·08 [95% CI 1·02–1·14]; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=95%), nitrogen dioxide (16 studies, n=17 228 429, pooled adjusted HR per 10 μg/m&lt;sup&gt;3&lt;/sup&gt; increase, 1·03 [1·01–1·05]; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=84%), and black carbon/PM&lt;sub&gt;2·5 absorbance&lt;/sub&gt; (six studies, n=19 421 865, pooled adjusted HR per 1 μg/m&lt;sup&gt;3&lt;/sup&gt; increase, 1·13 [1·01–1·27]; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=97%). We found no significant association for exposure to nitrogen oxides (five studies, n=241 409, pooled adjusted HR per 10 μg/m&lt;sup&gt;3&lt;/sup&gt; increase, 1·05 [0·97–1·13]; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=44%), PM&lt;sub&gt;10&lt;/sub&gt; (four studies, n=246 440, pooled adjusted HR per 15 μg/m&lt;sup&gt;3&lt;/sup&gt; increase, 1·52 [0·80–2·87]; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=82%), or annual ozone (four studies, n=419 972, pooled adjusted HR per 45 μg/m&lt;sup&gt;3&lt;/sup&gt; increase, 0·82 [0·35–1·92]; &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=69%), with moderate to considerable het","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 7","pages":"Article 101266"},"PeriodicalIF":21.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of shifting work hours for reducing heat-related loss and regional disparities in China: a modelling analysis","authors":"Mengzhen Zhao PhD ,&nbsp;Yuyou Chen PhD ,&nbsp;Jing Shang PhD ,&nbsp;Shihui Zhang PhD ,&nbsp;Bo Lu PhD ,&nbsp;Yanqing Miao PhD ,&nbsp;Mingyu Lei PhD ,&nbsp;Ruiyao Li BSc ,&nbsp;Prof Wenjia Cai PhD ,&nbsp;Prof Chi Zhang PhD","doi":"10.1016/S2542-5196(25)00079-8","DOIUrl":"10.1016/S2542-5196(25)00079-8","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;As climate change intensifies, the economic losses caused by heat-related labour productivity loss are gaining increasing attention. Shifting work hours has become a prevalent practice to reduce outdoor workers' heat exposure. However, both the potential of this adaptation measure for reducing labour productivity and economic loss and how this potential will change in the future remain unclear. Answers to these questions at the subnational level are important for decision makers to promote the implementation of adaptations and the development of comprehensive strategies to tackle the residual consequences of climate change. This study aimed to model the potential of shifting work hours for reducing labour productivity and economic loss at the national and provincial level in China.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We did a modelling study to estimate the potential of shifting work hours for reducing heat-related labour productivity loss in China under different climate change scenarios. We used the China Hybrid Energy and Economic Research model, a dynamic multiregional computable general equilibrium model, to quantify the economic impacts of heat-related labour productivity loss from 2020 to 2100, with an exposure–response function between heat stress and labour productivity loss and bias-corrected climate change projections from the US National Aeronautics and Space Administration Earth Exchange Global Daily Downscaled Projections dataset conducted under the Coupled Model Intercomparison Project Phase 6 (CMIP6). We used nine different scenarios: three climate change scenarios consistent with the shared socioeconomic pathway (SSP)–representative concentration pathway scenarios used in CMIP6 (SSP1–2·6, SSP2–4·5, and SSP5–8·5); three adaptation scenarios (SSP1–2·6_shift, SSP2–4·5_shift, and SSP5–8·5_shift); and three counterfactual scenarios (SSP1–2·6cf, SSP2–4·5cf, and SSP5–8·5cf). SSP1–2·6 is a scenario with less than 2°C warming by 2100 and low carbon emissions. SSP2–4·5 is a middle scenario with a 2·7°C rise in global mean temperature, representing current emission trends. SSP5–8·5 is an extreme scenario, with a 4·4°C rise in global mean temperature and high carbon emissions. The climate change scenarios and adaptation scenarios considered heat-related labour productivity loss caused by climate change in the future, whereas the counterfactual scenarios held loss constant at the 2020 level. The adaptation scenarios considered the impact of shifting work hours earlier when estimating labour productivity loss. We assumed that outdoor work hours could maximally be rescheduled to sunrise time. The economic growth pathways in the SSP1–2·6cf, SSP2–4·5cf, and SSP5–8·5cf scenarios were derived from SSP1, SSP2, and SSP5, respectively. We compared results for the different adaptation and climate change scenarios to evaluate the reduction potential of the adaptation measure. By comparing the climate, adaptation, and counte","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 7","pages":"Article 101241"},"PeriodicalIF":21.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Planet Health 2022; 6: e243–56","authors":"","doi":"10.1016/S2542-5196(24)00233-X","DOIUrl":"10.1016/S2542-5196(24)00233-X","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 7","pages":"Article 101144"},"PeriodicalIF":21.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the urban heat-related mortality burden due to greenness: a global modelling study","authors":"Yao Wu MSc ,&nbsp;Bo Wen MSc ,&nbsp;Tingting Ye PhD ,&nbsp;Wenzhong Huang PhD ,&nbsp;Yanming Liu PhD ,&nbsp;Prof Antonio Gasparrini PhD ,&nbsp;Francesco Sera PhD ,&nbsp;Prof Shilu Tong PhD ,&nbsp;Prof Eric Lavigne PhD ,&nbsp;Dominic Roye PhD ,&nbsp;Souzana Achilleos PhD ,&nbsp;Niilo Ryti PhD ,&nbsp;Mathilde Pascal PhD ,&nbsp;Ariana Zeka PhD ,&nbsp;Francesca de'Donato PhD ,&nbsp;Susana das Neves Pereira da Silva MSc ,&nbsp;Joana Madureira PhD ,&nbsp;Malcolm Mistry PhD ,&nbsp;Prof Ben Armstrong PhD ,&nbsp;Prof Michelle L Bell PhD ,&nbsp;Prof Shanshan Li PhD","doi":"10.1016/S2542-5196(25)00062-2","DOIUrl":"10.1016/S2542-5196(25)00062-2","url":null,"abstract":"<div><h3>Background</h3><div>Heat exposure poses a substantial public health threat. Increasing greenness has been suggested as a mitigation strategy due to its cooling effect and potential to modify the heat–mortality association. This study aimed to comprehensively estimate the effects of increased greenness on heat-related deaths.</div></div><div><h3>Methods</h3><div>We applied a multistage meta-analytical approach to estimate the potential reduction in global heat-related deaths by increasing greenness in the warm season in 2000–19 in 11 534 urban areas. We used the enhanced vegetation index (EVI) to indicate greenness and a random forest model to predict daily temperatures in counterfactual EVI scenarios. In the factual EVI scenarios, daily mortality and weather variables from 830 locations in 53 countries were extracted from the Multi-Country Multi-City Collaborative Research Network and used to assess heat–mortality associations. These associations were then extrapolated to each urban area under both factual and counterfactual EVI scenarios based on meta-regression models.</div></div><div><h3>Findings</h3><div>We estimated that EVI increased by 10% would decrease the global population-weighted warm-season mean temperature by 0·08°C, EVI increased by 20% would decrease temperature by 0·14°C, and EVI increased by 30% would decrease temperature by 0·19°C. In the factual scenario, 3 153 225 (2·48%) of 127 179 341 total deaths could be attributed to heat exposure. The attributable fraction of heat-related deaths (as a fraction of total deaths) in 2000–19 would decrease by 0·67 (95% empirical CI 0·53–0·82) percentage points in the 10% scenario, 0·80 (0·63–0·97) percentage points in the 20% scenario, and 0·91 (0·72–1·10) percentage points in the 30% scenario, compared with the factual scenario. South Europe was modelled to have the largest decrease in attributable fraction of heat-related mortality.</div></div><div><h3>Interpretation</h3><div>This modelling study suggests that increased greenness could substantially reduce the heat-related mortality burden. Preserving and expanding greenness might be potential strategies to lower ambient temperature and reduce the health impacts of heat exposure.</div></div><div><h3>Funding</h3><div>Australian Research Council and Australian National Health and Medical Research Council.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 7","pages":"Article 101235"},"PeriodicalIF":21.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary quality and environmental footprint of health-care foodservice: a quantitative analysis using dietary indices and lifecycle assessment data","authors":"Lisa M Pörtner MD ,&nbsp;Leon Schlenger BSc ,&nbsp;Sabine Gabrysch PhD ,&nbsp;Nathalie J Lambrecht PhD","doi":"10.1016/j.lanplh.2025.05.004","DOIUrl":"10.1016/j.lanplh.2025.05.004","url":null,"abstract":"<div><h3>Background</h3><div>Despite the key role of diets for individual and planetary health, the food offered in health-care institutions has received very limited attention to date. An assessment of the overall healthiness of foodservice in health-care institutions is missing from the literature, as is detailed information on its environmental footprint. This study aims to provide a comprehensive assessment of the healthiness, nutritional adequacy, and the environmental footprint of foodservice in a sample of German hospitals and nursing homes.</div></div><div><h3>Methods</h3><div>We investigated the dietary quality and environmental footprint of foodservice in two hospitals and three nursing homes in Germany (two in northern Germany, two in eastern Germany, and one in southern Germany). Average daily meals were derived from meal plans and recipes and analysed for dietary quality, using the Healthy Eating Index-2020; adherence to the Planetary Health Diet; and nutritional adequacy. The environmental footprint was analysed by allocating procured foods to 50 food groups and using an environmental database to estimate impacts on land use, greenhouse gas emissions, eutrophication, acidification, and water use.</div></div><div><h3>Findings</h3><div>Dietary quality was low, with institutions scoring 39–57 of 100 points on the Healthy Eating Index-2020. Adherence to the Planetary Health Diet was also low, reflected in Planetary Health Diet Index scores of 30–44 of 150. Most calories were from animal-source foods and unhealthy plant-based foods, with less than 20% of calories from wholesome plant-based foods. Meals were consistently high in saturated fat and salt, and low in fibre, while protein was insufficient in nursing homes. Micronutrient provision varied, with several B vitamins, vitamin C, potassium, and magnesium critically low in almost all institutions. Animal-source foods were responsible for three-quarters of the environmental impact, with meat alone contributing 38% of greenhouse gas emissions and 33–45% of other environmental impacts. About 60% of procured protein was from animal-source foods, while legumes made up less than 1% of procurement by weight.</div></div><div><h3>Interpretation</h3><div>Meals served in health-care institutions such as hospitals and nursing homes might compromise both short-term and long-term health of patients and residents and contribute unfavourably to the institutional environmental footprint. This study highlights the urgent need to regularly assess foodservice in health-care settings, align it with recommendations for healthy and sustainable diets, and improve nutritional care.</div></div><div><h3>Funding</h3><div>German Federal Environmental Foundation (Deutsche Bundesstiftung Umwelt).</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 7","pages":"Article 101274"},"PeriodicalIF":21.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}