Environmental sustainability and healthiness of nursing homes meals: an exploratory study from Italy

BACKGROUND: The food sector is responsible for more than the 30% of the total greenhouse gases emissions (GHGE), one of the leading causes of global warming. The adoption of healthy and sustainable food models has been identified as one of the possible effective interventions to face this challenge. In this regard, the healthcare sector's food chain is underinvestigated, with a lack of a global and comprehensive approach. Specifically, no research has been conducted yet in nursing homes. The aim of our study is to evaluate the environmental impact of the menu among residents of an Italian 130-beds nursing home, and to assess their adherence to the Planetary Health Diet (PHD), a dietary framework conceived by the EAT-Lancet Commission aimed to promote both human and environmental health. METHODS: We assessed a random sample of 20,000 combinations of servings. For each of them we estimated the Carbon Foodprint (CF) and the adherence to PHD using the life cycle assessment methodology and the Modified EAT-Lancet Diet Score, respectively. Threshold was set to 2.027 KgCO2eq/day for CF and to 23 for PHD adherence. Afterwards, we evaluated the composition of the menus and estimated the CF of each day with relative permutations given by the possibility of the different choices of dishes. RESULTS: We found a substantial variability of both CF and PHD adherence among permutations, with only a small proportion of them reaching the benchmarks. Furthermore, we found a negative association between CF and PHD adherence, with healthier menus generating less CO2eq emissions. CONCLUSIONS: To our knowledge, this is the first study specifically assessing the environmental impact of food in a nursing home. The observed variability suggests the possibility of improving the proposed menus, with a potential beneficial impact on both human and environmental health. Further studies are needed, to deeply explore the current situation and the strategies for improvements on this topic. KEY MESSAGES: • Despite the relevance of the topic, this is the first study assessing both the environmental and health aspects of meals served in a nursing home. • We found that healthier servings had a lower environmental impact, suggesting the possibility to improve menus with a beneficial impact for both human and environmental health.