Lancet Planetary Health最新文献

{"title":"Integrating environmental sustainability in clinical counselling: a randomised, double-blind, experimental vignette study in the Netherlands","authors":"Egid M van Bree MD ,&nbsp;Laurens C van Gestel PhD ,&nbsp;Eva H Visser MD ,&nbsp;Jiska J Aardoom PhD ,&nbsp;Evelyn A Brakema PhD ,&nbsp;Prof Marieke A Adriaanse PhD","doi":"10.1016/j.lanplh.2025.101328","DOIUrl":"10.1016/j.lanplh.2025.101328","url":null,"abstract":"<div><h3>Background</h3><div>Integrating environmental sustainability in health-care decision making might be a key strategy to achieve greener clinical practice. We aim to explore whether advising environmentally sustainable treatment options with or without explicitly mentioning sustainability as an argument in clinical counselling affects patients’ trust in care, compared with less sustainable standard treatment options, while accounting for differences in severity and types of medical problems.</div></div><div><h3>Methods</h3><div>This randomised, double-blind, experimental vignette study was conducted at the Leiden University Medical Center (Leiden, Netherlands). We recruited a representative sample (based on sex, age, education level, and geographical distribution) of the general Dutch adult population. Participants were masked, randomised, and allocated to one of the eight study groups (four types of advice × two levels of severity) using automatic online software. We used an online survey tool to provide participants with five short descriptions (vignettes) of hypothetical patient–physician interactions based on their allocation to high severity or low severity scenarios and their physician’s type of advice; varying in the level of environmental sustainability and whether sustainability is mentioned explicitly. Low severity scenarios described a general practice setting and high severity scenarios described a hospital setting where the patient had been referred. The primary outcome was a practice-based composite score labelled as trust in care (seven-point Likert scale from 1 [strongly disagree] to 7 [strongly agree]).</div></div><div><h3>Findings</h3><div>Between May 16 and 31, 2024, 2694 participants were invited to participate, of whom 1536 were included in the final sample size of the study. The mean age of participants was 51·7 years (SD 17·1). 762 (50%) participants were female and 774 (50%) were male. Participants receiving the Less Sustainable advice (mean 5·6 [SD 1·2]) generally had higher trust scores than participants receiving one of the other three types of advice (p&lt;0·0001). Participants receiving the Sustainable made Explicit advice (mean 4·8 [1·6]) generally had lower trust scores than those receiving one of the other three types of advice (p&lt;0·0001). Post-hoc analysis indicated that differences in trust scores were primarily driven by high severity conditions and varied across medical problems.</div></div><div><h3>Interpretation</h3><div>Advising more sustainable treatment options for low severity scenarios generally does not affect patients’ trust in care, including when sustainability is mentioned explicitly. For high severity scenarios, advising more sustainable treatment options might negatively affect patients’ trust; however, the size and presence of the observed effect varied across medical problems.</div></div><div><h3>Funding</h3><div>Leiden University.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 11","pages":"Article 101328"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145641386","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":"Building climate resilience in health systems: a climate vulnerability and capacity assessment in a rural hospital in Chad","authors":"Patricia Nayna Schwerdtle ,&nbsp;Didier Tokoumnogo Zidouemba ,&nbsp;Alexi Reouhiri Dermbaye ,&nbsp;Kiran Jobanputra ,&nbsp;Melissa Mcrae ,&nbsp;Melanie Tarabbo ,&nbsp;Mohamed Njouonkou ,&nbsp;Marius Madjissem ,&nbsp;Alexandre Robert ,&nbsp;Zia Haider","doi":"10.1016/j.lanplh.2025.101354","DOIUrl":"10.1016/j.lanplh.2025.101354","url":null,"abstract":"<div><h3>Background</h3><div>Chad is highly vulnerable to climate change, with rising temperatures, irregular rainfall, droughts, and resource scarcity driving food insecurity, malnutrition, and vector-borne diseases. In Ngouri, in the Lac Region, these climate stressors have led to worsening health outcomes and strained health-care services. Without adaptation measures, facilities will struggle to sustain essential services. In this case study, we present a facility-adapted climate vulnerability and capacity assessment (VCA) for a rural hospital, identifying key risks and prioritising solutions for climate resilience.</div></div><div><h3>Methods</h3><div>This study used a participatory mixed-methods design including a literature review on climate hazards and vulnerabilities; facility audit of infrastructure and service delivery gaps; focus groups to refine risk identification; solution-matrix development with costs and feasibility analysis; and participatory prioritisation to produce a multiyear improvement plan.</div></div><div><h3>Findings</h3><div>The VCA identified elevated malarial mortality and power outages disrupting oxygen supply as key risks. 35 solutions were generated, with 22 priority actions selected for implementation, including anticipatory planning, community sensitisation, supplementary feeding programmes, and improved waste management. The process highlighted the importance of community engagement, multidisciplinary collaboration, and staff motivation for climate-resilient and sustainable health care.</div></div><div><h3>Interpretation</h3><div>The adapted VCA offers a replicable approach to assess climate-related vulnerabilities and capacities in health-care facilities. The approach used in Ngouri hospital informed feasible adaptation measures and showed relevance for similar contexts, supporting health system resilience and alignment with global sustainability goals.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101354"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617224","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":"Local bodies, global goals: The frontline health workforce as agents of planetary health in India’s tribal regions","authors":"Sonal Mobar Roy","doi":"10.1016/j.lanplh.2025.101357","DOIUrl":"10.1016/j.lanplh.2025.101357","url":null,"abstract":"<div><h3>Background</h3><div>Planetary health, which emphasises the interconnection between human health and environmental systems, requires localised, culturally sensitive, and gender-responsive strategies for effective implementation. In the tribal regions of Telangana, the frontline health workforce—comprising Accredited Social Health Activists (ASHAs), (Auxiliary Nurse Midwives (ANMs), and Anganwadi Workers (AWWs)—serves as the crucial interface between state-led nutrition programmes, such as Poshan Abhiyan, and indigenous communities. This study examined how these women negotiate their roles within the sociocultural landscape of tribal areas to implement nutrition and health interventions that are ecologically and socially grounded.</div></div><div><h3>Methods</h3><div>Qualitative methods, including semistructured interviews, field observations, and participatory rural appraisal tools across six tribal-dominated blocks, were used to understand the lived experiences of these frontline workers and the communities they serve.</div></div><div><h3>Findings</h3><div>These workers act as cultural mediators who adapt state mandates to local contexts—promoting indigenous food knowledge, initiating community-based nutrigardens, and creating awareness around maternal and child health through participatory tools. Their work strengthens community engagement, promotes food diversity, and fosters ecologically aligned dietary practices. However, they face systemic barriers such as irregular incentives, poor training in environmental health, and gendered undervaluation of their labour.</div></div><div><h3>Interpretation</h3><div>Recognising and investing in the agency of female frontline workers is essential not only for the success of the Poshan Abhiyan but also for advancing planetary health in culturally diverse and ecologically sensitive regions. The efforts of these frontline workers exemplify how gendered grassroots labour is central to sustainable health futures.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101357"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617305","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":"Tracking dietary shifts towards lower carbon footprint in Italian households: a longitudinal analysis","authors":"Anouk Reuzé ,&nbsp;Tony W Carr ,&nbsp;Sara Nájera Espinosa ,&nbsp;Beatrice Biondi ,&nbsp;Elena Benedetti ,&nbsp;Mario Mazzocchi ,&nbsp;Rosemary Green ,&nbsp;Pauline Scheelbeek","doi":"10.1016/j.lanplh.2025.101359","DOIUrl":"10.1016/j.lanplh.2025.101359","url":null,"abstract":"<div><h3>Background</h3><div>Dietary shifts are recognised as major pathways to curb greenhouse gas emissions (GHGE). Although studies have assessed the environmental footprint of diets, few have explored the various strategies consumers use to reduce their carbon footprint through dietary changes. This study aims to examine the dietary shifts of consumers in Italy who have successfully reduced their carbon footprint over time.</div></div><div><h3>Methods</h3><div>Food purchase data from approximately 6000 Italian households were collected between 2019 and 2024. Food-related GHGE were assessed using life-cycle assessment. Households that successfully reduced their food-related GHGE during this period were identified as champions. The total volume of food purchases, associated energy intake, GHGE, and expenses were evaluated at both timepoints. Patterns of dietary changes among the champions were identified through hierarchical cluster analysis based on food purchase changes. In addition, sociodemographic characteristics were described.</div></div><div><h3>Findings</h3><div>Two distinct patterns of dietary shifts were identified among the 162 champions, reflecting different strategies for reducing dietary carbon footprints. The GHGE reduction was primarily achieved through decreased consumption of animal-based foods, particularly raw ruminant meat. Clusters were associated with specific sociodemographic factors, notably the household composition. Although food expenditures of champions increased slightly, they remained lower than those of non-champions.</div></div><div><h3>Interpretation</h3><div>Despite Italy’s strong culinary traditions, more environmentally sustainable dietary patterns have emerged over the past decade. Reductions in consumption of animal-based foods are essential for lowering diet-related carbon footprints. To encourage broader adoption of this shift in dietary pattern, targeted strategies tailored to specific sociodemographic groups, such as family households, are necessary.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101359"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617302","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":"Environmental vulnerability of older patients with end stage renal disease: using a nationwide claim data of South Korea","authors":"Min-Hee Heo ,&nbsp;Soon-Hyo Kwon ,&nbsp;Huiwon Jeon ,&nbsp;Sujin Ma ,&nbsp;Jung-Won Lee ,&nbsp;Jin-Won Noh","doi":"10.1016/j.lanplh.2025.101360","DOIUrl":"10.1016/j.lanplh.2025.101360","url":null,"abstract":"<div><h3>Background</h3><div>There is a trend of older adults undergoing haemodialysis. This trend is likely to increase health-care expenditure and extend into broader social burdens. This study aimed to identify factors associated with mortality risk in older patients with end stage renal disease (ESRD).</div></div><div><h3>Methods</h3><div>This study analysed data from the Korean National Health Information Database for individuals with ESRD who were older than 55 years in 2022. Mortality risk was estimated using Kaplan–Meier survival curves and cox proportional hazard models, stratified into urban and rural residence. Model 1 included socioeconomic and demographic characteristics (n=5463), and Model 2 additionally adjusted for clinical characteristics (n=768).</div></div><div><h3>Findings</h3><div>In Model 1, 45·34% of patients were censored, with a mean survival of 1126·75 days (±631·89). Among urban patients, women (hazard ration [HR]=0·99, p&lt;0·01) and medical aid beneficiaries (HR=0·84, p=0·04), and more than two sessions of haemodialysis per week (HR=0·85, p&lt;0·001) were associated with lower mortality risk, whereas older age (HR=1·11, p&lt;0·001) and mild disability (HR=1·19, <em>p</em>&lt;0·01) were associated with higher mortality risk. In rural patients, older age (HR=1·16, p&lt;0·001) and severe disability (HR=1·61, p&lt;0·05) were associated with higher mortality risk, whereas employee insurance (HR=0·75, p&lt;0·05) was associated with lower mortality risk. In Model 2, 50·26% of patients were censored, with a mean survival of 1681·44 days (±347·53). In urban patients, older age (HR=1·05, p&lt;0·001), higher triglyceride levels (HR=1·00, p=0·01), and elevated LDL cholesterol (HR=1·02, p=0·04) showed higher mortality risk. In rural patients, older age (HR=1·09, p&lt;0·001) was linked to higher mortality, whereas more than two sessions of haemodialysis per week (HR=0·33, p=0·01) was associated with a lower mortality risk.</div></div><div><h3>Interpretation</h3><div>Planetary crises worsen health-care accessibility in rural areas. These findings highlight the need to integrate environmental vulnerability and social determinants to address health disparities among patients with ESRD.</div></div><div><h3>Funding</h3><div>Project was supported by the Patient-Centred Clinical Research Coordinating Centre (PACEN) Funded by the Ministry of Health and Welfare, South Korea.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101360"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617301","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":"Exploring the significance of agroforestry and regenerative agriculture in farmer’s health and risk of zoonotic diseases","authors":"Athena Chlapowski ,&nbsp;Ruiyu Pu ,&nbsp;Catherine Smith ,&nbsp;Amy Y Vittor","doi":"10.1016/j.lanplh.2025.101368","DOIUrl":"10.1016/j.lanplh.2025.101368","url":null,"abstract":"<div><h3>Background</h3><div>Agroforestry and regenerative agriculture are emerging as promising sustainable farming approaches that intertwine economic, social, and environmental benefits. These practices are gaining traction globally due to their potential to enhance soil health, biodiversity, and ecosystem integrity. However, the agroforestry and regenerative agriculture forest–farm edge might give rise to pathogen spillover from wildlife into livestock and humans. This pilot project examines the effects of these practices on farmworkers' health and susceptibility to arthropod-borne zoonotic diseases.</div></div><div><h3>Methods</h3><div>We interviewed Florida farmers to assess agricultural practices, zoonotic risk factors, and climate perspectives. Serum of the farmers was tested for exposure to West Nile, dengue, chikungunya, Venezuelan equine encephalitis subtype II (Everglades virus, EVEV) viruses, as well as <em>Borrelia burgdorferi</em>. Land cover was analysed keep original usage please using Esri Sentinel-2 Land Cover Explorer.</div></div><div><h3>Findings</h3><div>We surveyed 31 farmers from 25 farms, of whom 32·3% (95% CI 17·7–51·4) reported fevers in the previous year and 48·4% (30·8–66·4) were concerned about zoonoses. Heat exposure was considered a problem for 71·0% (95% CI 51·8–84·8) of farmers. Farmers noted an average of 1·7 (95% CI 2·9–11·6) ticks in the week before the survey. Farmers were positive for <em>B burgdorferi</em> (10, 95% CI 3·0–28·3%), dengue (6·9, 1·6–25·4), and EVEV (3·3, 0·4–22·2). All farmers tested negative for chikungunya and West Nile viruses. Tree cover was greater at farms with <em>B burgdorferi</em>-positive participants (55·3% [95% CI 26·2–84·4] <em>vs</em> 33·3% [22·1–45·4]).</div></div><div><h3>Interpretation</h3><div>Agroforestry and regenerative agriculture were not associated with pathogen exposure. Research should focus on expanding the sample size and testing for Ehrlichiosis, Rickettsiosis, and orthobunyaviruses.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101368"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617386","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":"Attainable and marginalised domains of the planetary health education framework in an action-oriented transdisciplinary course of a graduate programme","authors":"Kaoruko Seino ,&nbsp;Keiko Nakamura ,&nbsp;Sharifullah Alemi","doi":"10.1016/j.lanplh.2025.101367","DOIUrl":"10.1016/j.lanplh.2025.101367","url":null,"abstract":"<div><h3>Background</h3><div>Effective learning environment plays a key role in fostering planetary stewardships, particularly in transdisciplinary fields such as planetary health. This study presents the domains of the planetary health education framework (PHEF) addressed by a Master of Public Health course in Japan, offered between 2018 and 2024.</div></div><div><h3>Methods</h3><div>Over 50 graduate students with diverse academic and professional backgrounds participated in the course, which consisted of lectures, group discussions and presentations, and field visits to a national research institution. Team projects were designed to develop action-oriented proposals addressing planetary and human health topics chosen through literature review. All topics covered in the course were documented and categorised into the five domains and 45 conceptual components of PHEF.</div></div><div><h3>Findings</h3><div>Lectures and team projects included air pollution, green space, yellow dust, food insecurity, heatwave, and emerging infectious diseases as topics. The course addressed components within the domains of Interconnections Within Nature, The Anthropocene and Health, and selected components of Systems Thinking and Movement Building, whereas components of the Equity and Social Justice domain were under-represented.</div></div><div><h3>Interpretation</h3><div>The action-oriented, transdisciplinary graduate course successfully integrated elements of four PHEF domains and highlighted opportunities to strengthen educational content through case studies emphasising Equity and Social Justice.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 ","pages":"Article 101367"},"PeriodicalIF":21.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617388","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":"Integrating food loss and waste reduction policies with global dietary shifts: an economic modelling study","authors":"Alessandro Gatto PhD ,&nbsp;Maksym Chepeliev PhD","doi":"10.1016/j.lanplh.2025.101285","DOIUrl":"10.1016/j.lanplh.2025.101285","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Food loss and waste undermine the resilience and sustainability of global food systems, jeopardising progress toward the Sustainable Development Goals (SDGs). Adopting healthier and more sustainable diets could help reduce global food loss and waste, but the potential trade-offs on food loss and waste trends and interactions with standalone reduction policies remain largely unexplored. We aimed to investigate the effects of reducing food loss and waste within the context of a global dietary transition by 2050, shedding light on the synergies and trade-offs between two crucial policy areas for the food systems of the future.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this economic modelling study, we linked the economic and technical modelling of food loss and waste by adding consistent tracing of food loss and waste in physical quantities along global (ie, domestic and international) food supply chains within a global computable general equilibrium (CGE) modelling framework. This framework captures the behavioural responses of economic actors along food and non-food supply chains. We built on the Global Trade Analysis Project (GTAP) Data Base, incorporating data extensions for energy, nutritional accounts, and food loss and waste flows along stages of global supply chains. We first investigated the impact of halving global food loss and waste through technological developments by 2050, in line with the SDG 12.3 target. We then analysed the impact of transitioning to healthier and more sustainable diets by 2050, promoting a global dietary transition through behavioural changes. We explored this dietary transition both with and without the goal of halving global food loss and waste, highlighting how food loss and waste targets interact with dietary changes on a global scale. Our scenarios were chosen to show how the magnitude, composition, location, and reuse potential of food loss and food waste could evolve under different scenarios compared with business-as-usual dietary developments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Food loss and waste along global supply chains were projected to rise by 52·0% by 2050 under the continuation of historical trends. Diet shifts alone were projected to be insufficient to curb this rise in food loss and waste, with demographic trends and growing incomes driving the total volume of lost and discarded food. Regional spillover effects of healthier diets—whereby low-income countries increase plant-based food production to meet growing demand in high-income countries—exacerbated food loss and waste trends, especially in sub-Saharan Africa and the Middle East and north Africa. In sub-Saharan Africa, rapid population growth and increased per-capita gross domestic product drove food loss and waste when dietary changes were implemented (an increase of 132·2% from 2014 to 2050) and when standalone food loss and waste reduction targets were applied (an increase of 61·8% from 2014 to 2050). Globall","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 10","pages":"Article 101285"},"PeriodicalIF":21.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428465","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 centre of gravity: Asia–Pacific leadership in global food systems transformation","authors":"Claudia Fernandez de Cordoba Farini ,&nbsp;Francesco Branca ,&nbsp;Ji-Hyun Yoon ,&nbsp;Shenggen Fan ,&nbsp;Jessica Fanzo ,&nbsp;Susan P Mercado ,&nbsp;Sandro Demaio","doi":"10.1016/j.lanplh.2025.101338","DOIUrl":"10.1016/j.lanplh.2025.101338","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 10","pages":"Article 101338"},"PeriodicalIF":21.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309444","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":"Exploring environmental and distributional impacts of different transition pathways for healthier and sustainable diets: an economic modelling study","authors":"Marijke Kuiper PhD ,&nbsp;Thijs de Lange MSc ,&nbsp;Willem-Jan van Zeist PhD ,&nbsp;Prof Hans van Meijl PhD","doi":"10.1016/j.lanplh.2025.101327","DOIUrl":"10.1016/j.lanplh.2025.101327","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The EAT–&lt;em&gt;Lancet&lt;/em&gt; (EL) report made a convincing case that a transformative diet shift could yield substantial health benefits while helping to respect key planetary boundaries. Shifting to a more plant-based EL diet requires an unprecedented break from historic trends of rising meat consumption. By exogenously shifting diets, existing studies do not provide guidance on how to shift diets. In this study, we model specific policies that might achieve such a dietary shift and their potential economic, environmental, and distributional impacts.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this economic modelling study, we used MAGNET, a global computable general equilibrium model, to explore how diets might be shifted from the business-as-usual trend of increased meat consumption between 2025 and 2050. We defined a policy bundle of three types of context-specific interventions: (1) nudging and information to shift consumer decisions, (2) adjusting fiscal policies by removing taxes on encouraged foods and subsidies on discouraged ones, and (3) introducing new price signals, such as taxes on high-emission foods and subsidies for encouraged foods. To evaluate how choice of interventions affects economic, environmental, and distributional outcomes, we analysed interactions of combined interventions and compared the policy bundle to an exogenous shift to the EL diet.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The EL diet recommendations cannot be reached by the policy bundle. While reducing overconsumption and underconsumption, the policy bundle left a big gap with EL diet recommendations (3 times the recommended intake for red meat, and only 80% of recommended fruit and vegetable intake, 50% for pulses and nuts). No single intervention from the policy bundle shifted all diet components in the desired direction. Decomposition of the policy bundle showed the importance of regional context. In low-income regions, taxes and subsidies accounted for the largest share in the diet shift. In other regions, nudging and information had a stronger effect than did subsidies. The exogenous EL diet scenario assumed a shift in diets beyond the range observed in empirical studies and produced a counterproductive feedback by reducing the affordability of the EL diet. GHG emissions from the primary sector (agriculture and fisheries) decreased more with the policy bundle (–4 GTon CO&lt;sub&gt;2&lt;/sub&gt; equivalent), as GHG taxes provided incentives to reduce fossil-based inputs lacking in the consumer-focused exogenous EL diet scenario (–3 GTon CO&lt;sub&gt;2&lt;/sub&gt; equivalent). The shift away from fossil-based inputs also led to an increase in agricultural land area (27 million ha) with the policy bundle, while the exogenous EL diet scenario resulted in a decrease in agricultural land (–35 million ha). Affordability for the average household decreased when exogenously shifting the EL diet (EL diet costs increased 26·1%, household income 0·2%), but it increased wit","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"9 10","pages":"Article 101327"},"PeriodicalIF":21.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145428578","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}