This study aimed to develop a shared understanding about the drivers of nutrition security in Puerto Rico (PR) from the collective perspective of multi-sector stakeholders in the agri-food, environmental and the health/disease systems.

A participatory community-based system dynamics approach (group model building) engaged stakeholders during one 4-h workshop March 2023 (followed by two 2.5-h member checking sessions).

San Juan, PR.

Stakeholders (n 22) in PR representing the agri-food, environmental and health/disease systems from multiple sectors (commercial food retail and technology, food production, public servants, academia and civil society) participated in the workshop.

Stakeholders collectively framed nutrition security as an outcome of six interconnected subsystems exacerbated by climate change: (1) governance and public policy; (2) demographic change and rural disinvestment; (3) climate change and adaptive capacity; (4) local food production economy; (5) food culture; and (6) nutrition security and health. Stakeholders identified leverage points mostly focused on strengthening information flow within and across subsystems and expanding cross-sectoral collaboration (systems structures and elements). We identified three paradigms that have the potential to transform the system structure and function: ecological conscience, traditional and healthy food culture, and social cohesion.

These findings deepened the collective understanding of systemic interdependencies that drive nutrition security as stakeholders identified locally feasible leverage points.

The food system is a major contributor to the global burden of disease, ecosystem destruction and climate change, posing considerable threats to human and planetary health and economic stability. Evidence-based food policy is fundamental to food system transformation at global, national and local or institutional levels. This study aimed to critically review the content of universities’ food sustainability policy documents.

A systematic search of higher education institutions’ policies, using targeted websites and internet searches to identify food sustainability policy documents, was conducted between May and August 2023. A quantitative content analysis of the identified documents was conducted independently by multiple researchers using a coding template. Inconsistencies in coding were subsequently checked and amended through researcher consensus.

163 UK higher education institutions.

N/A.

Approximately 50 % of universities had a publicly available food sustainability policy. The most common food sustainability commitments therein were communication and engagement (95·2 %), food waste (94·0 %) and quality standards and certification (91·7 %). The scope of policy commitments varied between institutions; however, comprehensive documents included multifaceted commitments tackling more than one dimension of sustainability, for example, waste mitigation strategies that tackled food insecurity through food redistribution. Few (17·9 %) policies included a commitment towards research and innovation, suggesting university operations are considered in isolation from academic and educational activities.

Multifaceted policy commitments are capable of uniting numerous food-related actions and institutional activities. As such, they are likely to support food system transformation, with broader positive outcomes for the university, students and the wider community.

Household food insecurity (HFI) is a social determinant of health globally. Rates of HFI have risen in many high-income countries in recent years, particularly in households with children. The health outcomes associated with HFI for children and adolescents have not been systematically synthesised. This review was conducted to support advocacy efforts for meaningful policy action to reduce HFI in households with children.

A systematic search was conducted in Medline, Embase and PsycInfo databases. Primary studies measuring the association between physical or mental health outcomes and HFI were included. Studies were appraised and population, setting, measures and outcomes were extracted. Findings were grouped by related outcomes. Due to heterogeneity, findings were synthesised narratively. Rapid review methodology was used to accommodate resource constraints.

High-income countries.

Youth aged less than 18 years.

Thirty-six studies were included. Most were cross-sectional studies conducted in the USA. Outcomes included general health, early childhood, cardiometabolic, asthma, dental caries, mental health, sleep, diet and anaemia. Despite substantial heterogeneity in HFI measures and analysis, findings support associations between HFI and negative outcomes for general health status, asthma, dental caries and mental health. Findings for other outcomes were mixed.

This review clarifies the effects of HFI on children and adolescents. Findings highlight trends for negative physical and mental health outcomes associated with HFI during youth, particularly related to mental health, oral health, asthma and general health status. Policy-level action should address rising rates of HFI and long-term effects on these vulnerable populations.