Intervention development

The purpose of measuring the sustainability of diets for public health nutrition practice is to shift the study focus away from specific individual diets to that of planetary health to improve public health nutrition outcomes. For example, it is useful to identify which traditional culinary preparations are still consumed and liked in a population that can be subsequently used for nutrition intervention development related to healthy and sustainable diets. Ethnographic approaches are particularly valuable in this regard, as they uncover cultural meanings, taboos, and practices that shape food choices, thereby ensuring that interventions resonate with communities.⁽ Reference Wilson ^{36 )} Structured manuals, such as the Campaign for Rural England’s Mapping Local Food Webs Guide,⁽ Reference Willis ^{37 )} provide systematic frameworks for participatory research, while research guidelines establish principles for methodological rigour. These manuals should, however, be complemented by other sources of data, such as national food balance sheets, agricultural harvest statistics, and dietary surveys, to ensure that interventions are both culturally relevant and evidence based.⁽ Reference Thar, Jackson, Swinburn and Mhurchu ^{38 )} By triangulating ethnographic insights with quantitative data, policymakers and practitioners can design culturally competent, sustainable programmes, as demonstrated in contexts where sustainability principles have been integrated into national FBGDs, such as in Mexico.⁽ Reference Unar-Munguía, Cervantes-Armenta, Rodríguez-Ramírez, Bonvecchio Arenas, Fernández Gaxiola and Rivera ^{39 ,} Reference Curi-Quinto, Unar-Munguía, Rodríguez-Ramírez, Rivera, Fanzo and Willett ^{40 )}

However, intervention development should not only focus on designing culturally relevant strategies but must also consider the realities of people’s everyday food choices and the environments in which they live. For example, in many low- and middle-income settings, diets are often based on starchy staples, with limited access to diverse food groups or high dependence on animal-sourced foods.⁽ Reference Erokhin, Diao, Gao, Andrei, Ivolga and Zong ^{41 )} Additionally, local environmental conditions such as water availability, soil fertility, and biodiversity also shape what foods are produced and consumed.⁽ Reference Delgado-Baquerizo, Powell, Hamonts, Reith, Mele and Brown ^{42 )} Moreover, socio-economic realities (including income distribution, food affordability, and informal markets) can influence adoption of dietary recommendations.⁽ Reference Darmon and Drewnowski ^{43 )} By grounding interventions in both culture and context, programs can more effectively balance sustainability goals with feasibility and acceptability at the community level.

Monitoring and evaluation

Describing multiple aspects of sustainable diets can help identify what to monitor and subsequently, evaluate as part of public health nutrition programs. Monitoring should focus on realistic proxy indicators that reflect both dietary behaviours and food system dynamics. These include the roles of food system actors involved in the provision of fresh and seasonal products (e.g., farmers, local markets, and retailers), the physical and economic accessibility of culturally relevant and sustainable culinary preparations, and evidence of their consumption at household or community levels. For instance, changes in dietary habits, such as shifts towards more plant-based meals, can be assessed not only in terms of nutrient adequacy but also in relation to environmental impacts like GHG emissions and land use.⁽ Reference Willett, Rockström, Loken, Springmann, Lang and Vermeulen ^{12 )} Moreover, crises such as droughts, floods, or pandemics may trigger local food system resilience strategies, which can serve as additional indicators of adaptation and sustainability.⁽ Reference Rulli, Sardo, Ricciardi, Govoni, Galli and Chiarelli ^{44 )} Sustainable diets can therefore be monitored as potential indicators of change, particularly when social norms and agricultural practices evolve simultaneously.

Some of the most notable sustainable diet measurement studies related to monitoring and evaluation, come from using the EAT-Lancet diet as a reference.⁽ Reference Rulli, Sardo, Ricciardi, Govoni, Galli and Chiarelli ^{44 ,} Reference Hirvonen, Bai, Headey and Masters ^{45 )} While long-term improvements in human and planetary health are the ultimate goals, monitoring and evaluation frameworks must rely on intermediate, measurable dimensions. These metrics may include human health outcomes (such as obesity prevalence, micronutrient adequacy indices, and incidence of diet-related non-communicable diseases), environmental sustainability indicators (including GHG emissions, land use, and water footprint), and integrated indices that combine nutrition, environment, and affordability. Such multidimensional metrics ensure that monitoring frameworks capture the full complexity of sustainable diets. The EAT-Lancet 2.0 advances this work to promote securing a just transition to healthy, environmentally sustainable diets for all.⁽ Reference Rockström, Thilsted, Willett, Gordon, Herrero and Agustina ^{46 )}

Implementation and dissemination

Studies of sustainable diets and dietary practices are imperative for the development of effective strategies for the long-term feasibility of interventions and their sound dissemination. Feasibility includes figuring out in which institutions, often across different food systems sectors, to base a public health nutrition intervention, how to institutionalise the intervention within a particular setting, and perform capacity building, among other actions outlined in the Preparation, Implementation, Sustainment (EPIS) framework.⁽ Reference Moullin, Dickson, Stadnick, Rabin and Aarons ^{47 )} It follows that more culturally adapted public health nutrition strategies are more feasible as they are more likely to be acceptable and resonant within local settings.⁽ Reference Biesbroek, Kok, Tufford, Bloem, Darmon and Drewnowski ^{48 )}

How to measure sustainable diets

Often sustainability in diets has been measured or assessed through only one dimension or aspect. Tiboni-Oschilewski et al. ⁽ Reference Tiboni-Oschilewski, Corvalán and Kanter ^{49 )} summarise the main methods that have been used for the study of sustainable diets from one dimension; while emphasising the need for more research studies that consider multiple dimensions in the measurement of sustainable dietary patterns.⁽ Reference Tiboni-Oschilewski, Corvalán and Kanter ^{49 )} In their paper, they describe in detail the use of different methods and diverse data sources to measure sustainable diets. As the sociocultural dimension of sustainable diets is often the hardest to assess, prior to any data collection, a comprehensive literature search and related formative research about the food culture under study is recommended to provide an initial knowledge base for the researcher or observer.⁽ Reference Kanter and Gittelsohn ^{50 )}

The Mediterranean diet as a case study model

The incorporation of sustainability into dietary guidelines has gained increasing attention over recent decades, aiming to make diets healthier for consumers as well as for the environment. After the publication of the first dietary guidelines for sustainability by Gussow and Clancy⁽ Reference Gussow and Clancy ^{52 )}, criticisms have continued to ignite⁽ Reference Burlingame and Dernini ^{1 ,} Reference Gussow ^{53 )} controversial debates on definitions and assessments among ‘sustainable diets’,⁽ Reference Burlingame and Dernini ^{1 )} ‘sustainable healthy diets’,^{( 3 )} and ‘healthy diets’⁽ Reference Neufeld, Hendriks, Hugas, von Braun, Afsana, Fresco and Hassan ^{54 )} in the context of a SFSs transformation, which is still an ongoing debate.

Within this international debate on the sustainability of diets and food systems, the Mediterranean diet, predominantly a plant-based diet with low consumption of animal and industrial products, has been increasingly studied as a model of a sustainable diet, context-specific for the Mediterranean, and acknowledged by the United Nations Educational, Scientific and Cultural Organization (UNESCO) as an intangible cultural heritage of humankind under risk of erosion.^{( 55 )} The initial scientific interest in the Mediterranean diet was driven by its health-promoting characteristics, particularly its protective effect against cardiovascular disease and non-communicable diseases. Supported by epidemiological and clinical research,⁽ Reference Estruch, Ros, Salas-Salvadó, Covas, Corella and Arós ^{56 )} it quickly became established as a benchmark for healthy eating patterns. Over the last two decades, additional studies have expanded the perspective to highlight its multiple interdependent environmental, socio-cultural, and economic sustainability,⁽ Reference Gussow ^{53 )} showing that its predominantly plant-based structure, biodiversity support, and cultural traditions contribute also to lower ecological footprints.⁽ Reference Curi-Quinto, Unar-Munguía, Rodríguez-Ramírez, Rivera, Fanzo and Willett ^{40 )} This evolution underscores the Mediterranean diet’s dual role as both a health-dietary pattern as well as a sustainable diets model.^{( 55 )} Throughout the Mediterranean region, adherence to the Mediterranean diet is decreasing especially among young people. The Mediterranean diet is a widely accepted healthy diet supported by scientific evidence from epidemiology and clinical trials, including randomised control trials, and systematic reviews and meta-analyses. The Mediterranean diet dietary pattern with proven health benefits, especially regarding the prevention of non-communicable diseases at a time when their incidence is increasing worldwide.⁽ Reference Delarue ^{57 )} It has also been recognised as a sustainable diet model with multiple interdependent benefits.⁽ Reference Dernini, Berry, Serra-Majem, La Vecchia, Capone and Medina ^{58 )}

Throughout the Mediterranean region, the adherence to the Mediterranean diet is decreasing especially among young people, with proliferation of ultra-processed foods and negative accompanying effects on human health. Scientific evidence shows a tendency of Mediterranean populations to change their dietary patterns in favour of unhealthy dietary patterns and mainly among the young generation. Some Southern and Eastern Mediterranean countries are still experiencing the ‘nutritional transition’, in which problems of under-nutrition coexist with overweight, obesity, and diet-related chronic diseases.⁽ Reference Belahsen ^{59 )} The concept of the Mediterranean diet has undergone a progressive evolution, from a healthy dietary model to a sustainable dietary model,⁽ Reference Dernini and Berry ^{60 )} a lifestyle in continuous evolution, closely related through time to the particular historic and geographic mosaic that is the Mediterranean. Studies on the Mediterranean diet were/are mainly focused on health/nutrition impacts of its characteristic foods, while the importance of its cultural, social, and economic food dimensions is not taken fully into account on the ground, while it is shared by all Mediterranean people, beyond a simple physiological need for energy and health. In 2015, to address the growing erosion of the heritage of the Mediterranean Diet, due to the continued loss of its adherence by Mediterranean populations, a new multidimensional conceptual framework ‘the Med Diet 4.0’ was designed to highlight its multiples sustainable benefits, with country-specific variations, with the strategic purpose to attract a broader spectrum of interested stakeholders from other sectors.⁽ Reference Dernini and Berry ^{60 )} In the design of the Med Diet 4.0, country-specific variations and interdependences were highlighted to be adapted to different Med contexts, with four interdependent sustainable benefits of the Mediterranean diet characterised in parallel:

1. 1) Well-documented health and nutrition benefits. ⁽ Reference Guasch-Ferré and Willett ^{61 )} The Mediterranean diet was cited, in the EAT-Lancet Commission report on diet in the Anthropocene, as the most studied example of a healthy diet.⁽ Reference Willett, Rockström, Loken, Springmann, Lang and Vermeulen ^{12 )}

2. 2) Low environmental impacts and richness in biodiversity, essentially a plant-based diet with low consumption of animal products and a type of production that has less impact on natural resources than other diets.⁽ Reference Vanham, Leip, Galli, Kastner, Bruckner and Uwizeye ^{62 ,} Reference Aleksandrowicz, Green, Joy, Smith and Haines ^{63 )}

3. 3) Positive local economic returns, creation of new jobs, reduction of rural poverty and migration^{( 64 )}

4. 4) High socio-cultural food values, dialogue among different cultural identities and food traditions, mutual respect, and social inclusion.⁽ Reference Medina and Sole-Sedeno ^{65 )} Recognised by UNESCO as an «Intangible Cultural Heritage of Humanity».^{( 55 )}

As a case study for sustainable diets, the Mediterranean diet started to be investigated in 2011, through a dedicated international workshop on Guidelines for the Sustainability of the Mediterranean Diet, organised by FAO and International Centre for Advanced Mediterranean Agronomic Studies (CIHEAM), to assess the sustainability of the Mediterranean diet as a case study.⁽ Reference Lacirignola, Dernini, Capone, Meybeck, Burlingame and Gitz ^{66 )} This led to a consensus proposal for the identification of key nutritional indicators for the Mediterranean diet as a sustainable diet case study.⁽ Reference Donini, Dernini, Lairon, Serra-Majem, Amiot and Del Balzo ^{67 )} The first world Mediterranean diet conference on ‘The Revitalizing the Mediterranean Diet: from a healthy dietary pattern to a healthy Mediterranean sustainable lifestyle’ was organised in 2016 in Milan (IFMeD, 2016), with a session moderated by FENS (Federation of European Nutrition Societies) focused on ‘The Challenge of mainstreaming the sustainability of the Mediterranean diet within Mediterranean national dietary guidelines’. As an outcome an updated Mediterranean diet cultural framework, with frugality focused on its environmental benefits, was developed,⁽ Reference Serra-Majem, Tomaino, Dernini, Berry, Lairon and Ngo de la Cruz ^{68 )} followed in 2017 by an international workshop on Development of voluntary guidelines for the sustainability of the Mediterranean diet in the Mediterranean region, where common principles of the Mediterranean diet were highlighted and incorporated, such as: Variety and balanced food combination: Different food, with more fruits and vegetables of diverse colors; Seasonality: Fresh foods, minimally processed; Traditional, local food products, biodiversity, agro-eco-friendliness: Territorial linkages—sustainable rural development; Culinary activities: Preservation and transmission of food knowledge, skills, practices, and heritage and pleasure of eating; Conviviality: Pleasure of eating together—dialogues between people and cultures; Frugality and moderation: Small portion sizes—major public health challenge of obesity—food has value, do not waste; Active living: Physical activity—non-sedentary lifestyle.

In 2023, in continuation of this consensus process, as outcome of the Third World Mediterranean Diet Conference on ‘Change of route towards more sustainable and resilient food systems in the Mediterranean countries: The Mediterranean diet as a strategic resource for accelerating the Agenda 2030 in the Region’ organised at the CIHEAM Bari, a Joint Med Diet Task Force of CIHEAM, FENS, and IUNS was formed to set the path for reversing the erosion of the Mediterranean diet heritage, by promoting its benefits, as a way of living. The rationale for co-developing this joint collaborative effort was based on the recognition that the challenges threatening the adherence to the Mediterranean diet as a sustainable healthy diet are complex, interrelated, and context specific. The traditional ways of consuming and producing food in the Mediterranean area have changed considerably, due to economic, social, cultural, demographic, and technological trends, increasing globalisation, urbanisation, and shifting lifestyles with increased sedentary daily life. Therefore, a SFS approach, context-specific, is required for a sustainable revitalisation of the Mediterranean diet, grounded in multi-stakeholder collaborations and consensus, rather than fragmented sector-specific solutions.

The assessment of the sustainability of the Mediterranean diet is a challenge of complexity for its multiple dimensions and nutritional, environmental, economic, and socio-cultural interconnected impacts, with med country-specific variations. All of these impacts are interdependent so that changes in one can led to changes in others. The challenge is to fully take into account this systemic complexity without breaking it down into its different parts, which would cause it to lose its interactive characteristics. Reviews of indicators used to evaluate the sustainability of each dimension of the Mediterranean diet show that there was no uniformity in their assessments, mostly focused to health and environmental impacts, and less on socio-cultural and economic dimensions, often weak, fragmented and arbitrary, mainly quantitative and less qualitative.⁽ Reference Béné, Oosterveer, Lamotte, Brouwer, de Haan and Prager ^{69 )}

Mediterranean diet as a prototype for healthy sustainable diets: the case of the Lebanese traditional diet

In the last decade, within the SFS transformation process, the Mediterranean diet has been increasingly acknowledged as a sustainable diet model. As such, several countries, especially Mediterranean countries, became increasingly invested in examining the health benefits and the sustainability of their traditional dietary intake. In this section, the case of the Traditional Lebanese Diet (TLD) as a version of a sustainable Mediterranean diet is presented. Lebanon is a small middle-income country on the Eastern shore of the Mediterranean Sea. The three main aspects of this case study include 1) the characterisation of the TLD and its health benefits 2), the presentation of the TLD as a version of the Mediterranean diet from the east side of the Mediterranean basin, and 3) lastly its sustainability in terms of environmental footprints, social aspects, and cost.

Several research studies have examined the prevalent dietary patterns in Lebanon among adults and among adolescents and children.⁽ Reference Naja, Nasreddine, Itani, Chamieh, Adra and Sibai ^{70 –} Reference Nasreddine, Shatila, Itani, Hwalla, Jomaa and Naja ^{73 )} The number of data-driven patterns identified by these studies varied between 2 and 4 patterns, mainly a traditional Lebanese and a Western type. The TLD consisted mainly of fruits, vegetables, legumes olives, burghul (crushed wheat), whole milk and dairy products, starchy vegetables, eggs, dried fruits, in addition to olives and olive oil.⁽ Reference Naja, Nasreddine, Itani, Chamieh, Adra and Sibai ^{70 )} On the other hand, the Western type of diet included processed meat, red meat, refined grains, sugar sweetened beverages and sweets. These studies documented a positive association between TLD and several health benefits. For instance, a one unit increase in the score of the TLD was found to be associated with 54% lower odds of type 2 diabetes among Lebanese adults.⁽ Reference Naja, Hwalla, Itani, Salem, Azar and Zeidan ^{71 ,} Reference Capone, Fersino, Stamataki, Cerezo, Kessari and Dernini ^{74 )}

Similarly, another study examining metabolic health among obese adults, aged 18 years and older, showed that subjects with higher adherence to the TLD had higher odds of metabolic health (OR: 1.83, 95% CI: 1.09–3.91).⁽ Reference Matta, Nasreddine, Jomaa, Hwalla, Mehio Sibai and Czernichow ^{75 )} Among Lebanese older adults aged over 50 years, compared to other dietary patterns prevalent among the study participants, the TLD showed the highest correlations with diet quality indices such as the Diet Diversity Score, the alternate Healthy Eating Index (aHEI), and the DASH-stye Diet score.⁽ Reference Jomaa, Hwalla, Itani, Chamieh, Mehio-Sibai and Naja ^{76 )} Among preschool children, a national study showed that those with the highest adherence to the TLD pattern have 67% lower odds of being overweight or obese, compared to those with the lowest adherence to this dietary pattern (OR 0.33; 95% CI 0.11, 0.97).⁽ Reference Nasreddine, Shatila, Itani, Hwalla, Jomaa and Naja ^{73 )} On the other hand, adherence to the Western type of diet showed significant associations with obesity, hyperglycemia, and the metabolic syndrome among Lebanese adults and adolescents.⁽ Reference Naja, Nasreddine, Itani, Chamieh, Adra and Sibai ^{70 ,} Reference Naja, Nasreddine, Itani, Adra, Sibai and Hwalla ^{77 ,} Reference Naja, Hwalla, Itani, Karam, Mehio Sibai and Nasreddine ^{78 )} While no single country or definition of the Mediterranean diet exits, until 2015, all the available versions of the Mediterranean diet belonged to the West side of the basin, to countries such as Italy, Spain, Greece, Crete, and France.

The geographical location of Lebanon as a Mediterranean country, the composition its traditional dietary pattern as well as the positive health associations of this traditional dietary pattern with several health aspects led, in 2015, to proposing this diet as a version of what is known as the Mediterranean diet.⁽ Reference Hwalla, Jomaa, Hachem, Kharroubi, Hamadeh and Nasreddine ^{79 )} Using national dietary data, Naja et al. ⁽ Reference Naja, Hwalla, Itani, Baalbaki, Sibai and Nasreddine ^{80 )} developed a Lebanese Mediterranean Diet (LMD) index, comprised of nine key food groups; fruits, vegetables, legumes, olive oil, burghol, dairy products, starchy vegetables, dried fruits, and eggs. Belonging to the third tertile of the dietary intake of these foods/food groups corresponded to a ‘3’ point on the score, while belonging to the first tertile corresponded to 1 point of the score. As such, the score of the TLD ranged between 9 and 27, with higher values indicating a greater adherence to this dietary pattern. The scores of the TLD were positively associated with other Mediterranean diet scores from Greece, Italy, Spain, and France with the highest correlation being with the Italian Mediterranean diet.⁽ Reference Naja, Hwalla, Itani, Baalbaki, Sibai and Nasreddine ^{80 )} Positioning the Lebanese diet as an eastern Mediterranean variant can enrich Mediterranean diet definitions and complements research on its diversity and health impact.

Following the release of the SDGs and growing recognition of the Mediterranean diet as sustainable and healthy, dietary guidelines were revised to include sustainability, human health, and social acceptability. Notably, countries that have incorporated these criteria include Germany, Brazil, Sweden, Qatar, as well as the Nordic countries that include Denmark, Finland, Iceland, Norway, and Sweden. These updates reflect a growing trend towards integrating planetary health into national dietary guidance. In this context, a national examination of the environmental footprints (EFP) of the dietary patterns prevalent in Lebanon was conducted. The environmental footprints considered were water use, energy use, and GHG emissions which were calculated using a review of available life cycle analyses. Specifically, the three dietary patterns identified were the Traditional Lebanese, high protein and Western.⁽ Reference Naja, Jomaa, Itani, Zidek, El Labban and Sibai ^{72 )} Among these three dietary patterns, the TLD had the lowest water use and GHG per 1000 Kcal (Water (L/Kg): 443.61 ± 197.15, 243.35 ± 112.0, 264.72 ± 161.67; GHG (KG CO2 eq/day) 0.58 ± 0.32, 0.38 ± 0.24, 0.57 ± 0.37, for the Western, TLD and High-Protein, respectively). The scores of the TLD pattern were associated with lower odds of energy use, whereas those of the high-protein dietary pattern were associated with higher odds of the three EFPs.⁽ Reference Naja, Jomaa, Itani, Zidek, El Labban and Sibai ^{72 )} Since late 2019, Lebanon has faced a cascading series of crises, including detrimental economic, health and socio-political challenges, the COVID-19 pandemic, and the 2020 Beirut port explosion. These challenges took place while the country continues to struggle with a heavy burden of malnutrition and non-communicable diseases, all imposing serious repercussions on people’s livelihoods, food security, and health.⁽ Reference Guеchаti and Chаmi ^{81 )} Such circumstances have motivated a study to identify and characterise a Lebanese dietary pattern that also falls within the limits of three main constraints: human health, cost and environmental footprints.

In conclusion, TLD emerges as a culturally rooted, health-promoting, and environmentally sustainable dietary pattern. Its alignment with the broader Mediterranean diet adds valuable diversity to the concept, especially from the Eastern basin. Evidence consistently links adherence to the TLD with lower risk of overweight and obesity among preschool children (OR = 0.33; 95% CI: 0.11–0.97),⁽ Reference Nasreddine, Shatila, Itani, Hwalla, Jomaa and Naja ^{73 )} better metabolic health among overweight and obese adults (OR = 1.83; 95% CI: 1.09–3.91),⁽ Reference Matta, Nasreddine, Jomaa, Hwalla, Mehio Sibai and Czernichow ^{75 )} and higher diet quality scores among older adults.⁽ Reference Jomaa, Hwalla, Itani, Chamieh, Mehio-Sibai and Naja ^{76 )} From an environmental perspective, TLD is associated with lower water use, energy use, and GHG emissions per 1,000 kcal consumed, compared with Western and High-Protein dietary patterns.⁽ Reference Naja, Jomaa, Itani, Zidek, El Labban and Sibai ^{72 )} These findings underscore its potential as a model dietary pattern that simultaneously supports public health, cultural identity, and planetary sustainability.

African Indigenous foods as culturally rooted approaches to sustainable diet

In the African context, indigenous foods represent a critical but underutilised component of SFSs. These foods are not only ecologically adapted and nutritionally rich but also deeply rooted in local cultures and traditional knowledge systems.⁽ Reference Akinola, Pereira, Mabhaudhi, de Bruin and Rusch ^{82 )} This case study explores the integration of African indigenous foods into sustainable diets, drawing from examples across sub-Saharan Africa including Ethiopia, Nigeria, Kenya, Malawi, South Africa, and Zimbabwe. It assesses the ecological, nutritional, and cultural significance of these foods and provides scientific evidence of their contributions to dietary sustainability.

Indigenous foods and the sustainable diets framework

The FAO/Bioversity International Sustainable Diets Framework⁽ Reference Burlingame and Dernini ^{1 )} is multidimensional, encompassing health, environmental sustainability, affordability, and cultural acceptability. Indigenous foods, defined as plant and animal species that are native or have long been part of traditional African food systems,⁽ Reference Johns and Sthapit ^{83 )} align well with this framework. These foods include traditional grains such as sorghum (Sorghum bicolor), millet (Pennisetum glaucum), and teff (Eragrostis tef), legumes such as bambara groundnut (Vigna subterranea); root crops like yam (Dioscorea spp.), and leafy vegetables such as amaranth (Amaranthus spp.), cowpea leaves (Vigna unguiculata), and African nightshade (Solanum scabrum). Indigenous African foods have often been displaced by colonial-era and Green Revolution policies that favoured monoculture crops like maize and wheat.⁽ Reference Fischer ^{84 ,} Reference Kesselman ^{85 )} However, emerging research shows that traditional foods can support more resilient, equitable, and healthy food systems, especially under conditions of climate variability,⁽ Reference Naheed ^{86 )} land degradation, and changing food consumption patterns.

For example, African indigenous foods (food crops. wild harvested fruits and vegetables, and wild meat) contribute to sustainable diets through various pathways. Nutritionally, these foods are rich in micronutrients that are often lacking in modern diets dominated by refined grains and imported vegetables. For instance, indigenous vegetables such as amaranth and nightshade contain significantly higher levels of iron and provitamin A carotenoids than cabbage or lettuce.⁽ Reference Mampholo, Sivakumar and Thompson ^{87 ,} Reference Mazike, Chipurura and Macheka ^{88 )} Environmentally, indigenous crops are adapted to local climatic and soil conditions, requiring fewer external inputs such as synthetic fertilisers and irrigation water.⁽ Reference Singh and Singh ^{89 ,} Reference Ficiciyan, Loos, Sievers-Glotzbach and Tscharntke ^{90 )} This reduces their environmental footprint and supports ecosystem services such as soil conservation and biodiversity maintenance. Socially and culturally, indigenous foods support food sovereignty, intergenerational knowledge transfer, and community identity.⁽ Reference Abdul, Ingabire, Lam, Bennett, Menzel and MacKenzie-Shalders ^{91 )} They are often grown and prepared by women, who serve as custodians of traditional agricultural and culinary knowledge. Supporting indigenous food systems thus contributes to gender empowerment and community resilience. Moreover, these foods help buffer households against shocks such as droughts, supply chain disruptions, and price volatility, factors that are increasingly common under climate change.⁽ Reference Mazike, Chipurura and Macheka ^{88 )}

Traditional grains in the Sahel and horn of Africa

In the arid and semi-arid zones of the Sahel and the Horn of Africa, traditional cereals such as sorghum, millet, and teff are dietary staples that form the basis of SFSs. In Ethiopia, teff is the primary ingredient in injera, a fermented flatbread that is central to Ethiopian cuisine. Teff is rich in fibre, calcium, iron, and resistant starch, and is naturally gluten-free, making it a nutritionally superior alternative to many imported grains.⁽ Reference Gebremariam, Zarnkow and Becker ^{92 )} In Niger and Mali, millet and sorghum have sustained rural communities for centuries and are prized for their drought tolerance, requiring far less water than maize or rice.⁽ Reference Hadebe, Modi and Mabhaudhi ^{93 )} These crops also tolerate poor soils, are grown with minimal external inputs, and contribute to agro-biodiversity. Their continued cultivation supports climate resilience, while their consumption helps preserve culinary traditions and local food sovereignty.

Leafy vegetables in East and Southern Africa

African Indigenous Vegetables (AIVs), which are plant species, both wild and domesticated, that originate from Africa or have been cultivated in African agro-ecological zones for centuries, forming part of the continent’s traditional food systems,⁽ Reference Chivenge, Mabhaudhi, Modi and Mafongoya ^{94 )} are prominent in East and Southern Africa, where they are consumed regularly in both rural and peri-urban households. AIVs are characterised by their long history of local use, cultural significance, and adaptation to local climates, soils, and farming practices. These vegetables are often grown in home gardens and collected from the wild, embodying both ecological knowledge and culinary tradition.⁽ Reference Sangija, Martin and Matemu ^{95 )} In Kenya and Zimbabwe, vegetables such as spider plant (Cleome gynandra), amaranth, and African nightshade are integral to local diets and are rich sources of iron, calcium, folate, vitamin A, and antioxidants.⁽ Reference Mazike, Chipurura and Macheka ^{88 )} The African Leafy Vegetables Project in Kenya has successfully raised awareness and market access for these vegetables, resulting in increased agricultural production, dietary diversity, and incomes among smallholder women farmers.⁽ Reference Muhanji, Roothaert, Webo and Stanley ^{96 )} In Malawi, cowpea leaves are commonly consumed and incorporated into school feeding programmes to enhance micronutrient intake among children.⁽ Reference Stephenson, Agapova, Divala, Kaimila, Maleta and Thakwalakwa ^{97 )} Research by Uyogaet al. ⁽ Reference Uyoga, Mzembe, Stoffel, Moretti, Zeder and Phiri ^{98 )} demonstrated that incorporating AIVs into children’s meals significantly improved their vitamin A and iron status. South Africa and Zimbabwe also presents a culturally rich case, where dishes such as morogo, a mix of amaranth, spider plant, and blackjack (Bidens pilosa), are traditionally prepared and valued for both their taste and cultural symbolism.⁽ Reference Uyoga, Mzembe, Stoffel, Moretti, Zeder and Phiri ^{98 ,} Reference Mazike, Chipurura and Macheka ^{99 )}

Legumes and roots in West Africa

In West Africa, indigenous legumes such as bambara groundnut and African yam bean are gaining renewed attention. Bambara groundnut is highly drought-tolerant and nutritionally dense, with 15–20% protein content; specifically with high levels of lysine and methionine, amino acids often deficient in staple cereals.⁽ Reference Abberton, Paliwal, Faloye, Marimagne, Moriam and Oyatomi ^{100 )} The crop also improves soil fertility through nitrogen fixation and grows in marginal soils where other legumes struggle.⁽ Reference Dakora and Keya ^{101 )} African yam bean has similarly been used in subsistence farming systems to enhance protein intake and diversify cropping patterns. Yam and cassava are deeply engrained in the food cultures of Nigeria, Ghana, and Côte d’Ivoire. Yams, in particular, play important roles in festivals and life-cycle ceremonies, linking food systems to social structures and cultural meaning.⁽ Reference Ema, Obidiegwu, Chilaka and Akpabio ^{102 ,} Reference Owusu Danquah, Danquah, Frimpong, Dankwa, Weebadde and Ennin ^{103 )} These root crops provide significant caloric intake and are often prepared in ways that reflect regional identities, such as pounded yam or fufu. Their integration into sustainable diets ensures not only nutrient security but also cultural continuity. In summary, African indigenous foods in general, provide a compelling model for sustainable diets that are not only nutritionally adequate and environmentally sound, but also socially and culturally meaningful. Their promotion and continued integration into modern food systems require a holistic approach that values cultural identity, supports biodiversity, and enhances resilience in the face of climate change. As Africa seeks to achieve greater food security, improved nutrition, and environmental sustainability, indigenous food systems must be placed at the centre of the sustainable diets agenda.