Integration of Nutritional and Sustainability Metrics in Food Security Assessment: A Scoping Review

Abstract

Background: Food security and sustainability are interconnected, yet the integration of nutritional and environmental metrics into food security assessments remains insufficiently explored. Objectives: This scoping review maps the literature on the integration of nutritional and sustainability metrics in food security, investigating the methods used, existing findings, and research gaps. A special focus is placed on Eastern Europe, including the Republic of Moldova, due to shared challenges in food security and the potential for adapting validated methodologies from this region. Eligibility Criteria and Sources of Evidence: His study includes articles from Web of Science and Scopus (2015–2025), published in English and Romanian, that analyze food security alongside nutritional and sustainability factors, following the Population, Concept, Context (PCC) framework. Charting Methods: The extracted data were synthesized narratively and visualized thematically, analyzing temporal trends and the geographical distribution of studies. Results: Out of 247 identified publications, 115 were included. The use of sustainability indicators has increased since 2020; however, economic and social dimensions remain underexplored. Conclusions: Developing an integrated methodological framework is essential for correlating the nutritional, ecological, and economic impact of food consumption. Future research should prioritize the development of standardized methodologies and broaden the scope of analysis, particularly in underrepresented regions such as Eastern Europe.

1. Introduction

Food security and sustainability are critical themes in global policy, with profound implications for public health, the economy, and the environment. While the environmental dimension of sustainability focuses on reducing the ecological footprint, sustainability also encompasses economic viability and social equity. Therefore, an integrated approach is essential to address all the dimensions of sustainability in food systems [1,2,3]. According to the Food and Agriculture Organization (FAO), food security means that all individuals should have access—physically, socially, and economically—to enough safe and nutritious food to meet their dietary needs and preferences for a healthy and active life [3,4]. Sustainability in food systems means providing food while protecting the environment, supporting economic growth, and ensuring social equity [5].

Food production and consumption account for approximately 30% of the greenhouse gas (GHG) emissions and 70% of the freshwater use [6]. Imbalances in the distribution of food resources cause both food insecurity and food waste. This situation emphasizes the urgent need to reform global food systems. In recent decades, challenges such as climate change, population growth, and rapid urbanization have made it even more necessary to adopt sustainable food strategies.

Rationale: However, in the scientific literature, the integration of nutrition and sustainability remains insufficient. Currently, research approaches are predominantly fragmented: studies either focus on the environmental dimension of sustainability by analyzing metrics such as carbon footprint (CF), resource use, and biodiversity impact [7,8,9,10,11,12], or assess the nutritional quality of diets based on macronutrient and micronutrient profiles [13,14,15,16,17]. However, sustainability also requires the inclusion of economic and social dimensions to ensure comprehensive and effective food policies. This methodological separation limits the ability to develop coherent and effective food policies that balance nutritional requirements with sustainability goals [18,19,20,21].

The Need for an Integrated Framework: The need for an integrated approach is emphasized by recent research trends, which highlight the importance of correlating nutritional impact with environmental sustainability [22,23,24]. Nutritionally optimized diets are not always compatible with sustainability requirements, and the absence of integrated analytical models creates barriers to the development of effective policies [1,7,8].

Research Problem: Although both nutrition and sustainability are essential for the development of a resilient food system, there is a lack of integrated methodologies that allow for the simultaneous evaluation of these dimensions. Currently, there is no clear consensus on the optimal metrics to correlate nutritional and environmental impact, and the methods used vary significantly depending on regional contexts and policy objectives [25]. This methodological fragmentation poses challenges in designing coherent policies that can be adapted to diverse socio-economic contexts.

Study Objective: This scoping review aims to systematically map the literature on the integration of nutritional and sustainability metrics in food security assessments. The study seeks to explore the methodologies used for integrating these metrics, synthesize relevant findings, and identify the existing gaps in the field. Additionally, the analysis will place a particular emphasis on regions such as Eastern Europe and the Republic of Moldova, highlighting regional specificities and research needs. The focus on Eastern European countries, including the Republic of Moldova, is motivated by common challenges in food security and sustainability. Many of these countries are former members of the Commonwealth of Independent States (CIS) and share similar cultural, economic, and geographical characteristics. The geographical and cultural proximity to Romania, as well as the shared challenges in food security, suggest that methodologies and indicators validated in these regions could be more easily adapted for the Republic of Moldova. This contextual focus aims to enhance the relevance and applicability of the study’s findings to national policies. The study is guided by a set of research questions formulated according to the Population, Concept, Context (PCC) framework, detailed in the Methodology Section.

Study Contribution: Through this approach, the research aims to contribute to the development of a clearer methodological framework that supports the formulation of balanced food policies, enhancing both public health and environmental sustainability.

2. Methodology

2.1. Protocol and Registration

This scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Checklist [26]. The protocol was registered in the Open Science Framework (OSF) (DOI: 10.17605/OSF.IO/PSRV7).

2.2. Eligibility Criteria

The analyzed period (2015–2025) was selected to capture recent trends in the integration of nutritional and sustainability metrics, reflecting major changes in global food policies and food security assessment strategies. The eligibility criteria were established according to the PCC framework:

Population: Studies addressing food security and sustainability.

Concept: Integration of nutritional and environmental indicators in food security assessment.

Context: Studies at the global and regional levels, with particular relevance to Eastern Europe, including the Republic of Moldova.

Studies published in English and Romanian that employ quantitative, qualitative, or mixed-method approaches relevant to the integrated analysis of nutritional and sustainability metrics were included.

Studies focusing exclusively on economic or agricultural aspects, without providing an integrated perspective on nutrition and sustainability, were excluded.

2.3. Information Sources

The searches were conducted in two major databases—Web of Science and Scopus—using Boolean operators to formulate efficient queries. The last search was performed on 1 January 2025, including only peer-reviewed publications.

2.4. Search Strategy

The search strategy was applied in Web of Science and Scopus and was structured in two stages:

Initial Stage: This stage involved applying selected keywords based on domain standards, incorporating Boolean operators: (“sustainability” OR “sustainable diets” OR “sustainable food systems”) AND (“nutrition indicators” OR “nutritional quality” OR “dietary quality”) AND (“food security” OR “food systems evaluation”). Filters were applied to restrict the time range to 2015–2025, limiting the selection to scientific articles and policy reports published in English.

Refinement Stage: This phase included manual removal of duplicates and exclusion of articles that did not meet the pre-established eligibility criteria.

2.5. Evidence Source Selection

The selection of articles was conducted manually in two stages. In the first stage, title and abstract screening was performed independently by two authors applying the predefined eligibility criteria. In the next stage, the articles deemed eligible were fully assessed to confirm their compliance with the inclusion criteria. Discrepancies between reviewers were resolved through consensus. The study selection process is illustrated in the PRISMA-ScR diagram (Figure 1).

However, the screening process encountered several challenges. Firstly, despite setting filters to include only full-text articles, some were inaccessible, limiting the comprehensiveness of the review. Secondly, the classification of indicators posed difficulties due to ambiguities in differentiating sustainability, ecological, and other types of indicators. Additionally, the absence of a standardized methodology for integrating these indicators further complicated the screening process.

2.6. Data Extraction Process

Data extraction was carried out manually by two authors following the PCC framework. The form included predefined fields designed to capture bibliographic information, study characteristics, and relevant data on nutritional and sustainability metrics comprehensively, as detailed in Section 2.7. To minimize bias, each author performed extraction independently. Discrepancies were resolved through discussions to reach consensus, and if necessary, a third author acted as an arbiter. This approach aligns with the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines.

In cases of unclear or incomplete data, the authors referred back to the original sources for clarification. If uncertainties persisted, these were documented, and a collective decision was made regarding their inclusion. The standardized form ensured consistent and transparent data extraction. This approach was intended to enhance the transparency and reproducibility of the data extraction process.

2.7. Data Elements

The data extracted from the included publications were organized into three main categories: bibliographic information, relevant variables for analyzing nutritional and sustainability metrics, and gaps identified in the scientific literature. The collected bibliographic information includes the title, authors, year of publication, DOI, document type, source, and indexing in databases (Web of Science or Scopus), as well as the abstract of each analyzed work. The relevant variables for metric analysis were extracted according to the PCC model, which guided the selection of data related to the studied population, the investigated concept (including nutritional and sustainability indicators), and the geographical context of the study. The gaps identified in the scientific literature were extracted from each study, focusing on aspects insufficiently addressed in the application and integration of metrics at both global and regional levels. For studies with missing or incomplete variables, predefined data harmonization rules were applied to ensure their consistency. The data were thematically grouped, thus facilitating the identification of emerging trends and the comparison of the methodologies used.

2.8. Synthesis of Results

In this scoping review, the data extracted from the included studies were synthesized using a thematic approach, organizing information based on nutritional and sustainability indicators, the geographical distribution of studies, and their evolution over time. The synthesis process was structured as follows:

The selection and organization of data were conducted based on the use of nutritional and sustainability metrics, grouping studies according to their typology (empirical studies, systematic reviews, and regional case studies) and the themes addressed.

For the visual synthesis methodology, the data were synthesized narratively, in tabular form, and visually. To generate visual analyses, VOSviewer (Version 1.6.20 (0)) was used to create graphs and maps illustrating the geographical distribution of the studies and the evolution of indicator usage.

The classification and analysis of the indicators involved categorizing them into nutritional, ecological, sustainable, economic, and social domains. These categories were synthesized to identify emerging trends and gaps in the existing research.

Significant gaps were identified in the literature, particularly in underexplored regions. These gaps are detailed in the Supplementary Material (Table S1) (see Appendix A).

3. Results

3.1. Selection of Sources of Evidence

The selection process for the studies included in this review was conducted following the PRISMA-ScR methodology. Systematic searches in the Web of Science and Scopus databases initially identified a total of 247 publications, which were screened according to the predefined eligibility criteria.

After the removal of 58 duplicate records, a total of 189 articles proceeded to the screening stage. At this stage, titles and abstracts were independently evaluated by two authors to identify the publications that met the inclusion criteria. The articles that did not clearly integrate the nutritional and sustainability metrics or were irrelevant to the field of food security were excluded, resulting in a selection of 135 studies for full-text evaluation. The exclusion of 20 articles after the full-text analysis was based on two main reasons: the lack of an integrated approach to nutritional and sustainability indicators (n = 13) and the inaccessibility of the primary source (n = 7).

In the final selection, 115 studies were included in this scoping review. The detailed selection process is illustrated in Figure 1 (PRISMA-ScR diagram).

3.2. Characteristics of Sources of Evidence

Based on the information extracted from the analyzed literature, the main study typologies, major research directions, and their distribution by region and year were identified.

3.2.1. Study Typology

The analysis of sources of evidence indicates three main categories of studies. Empirical studies, accounting for 49.1% of the total (n = 56), use quantitative methods to investigate the nutritional and environmental impact of food consumption. These include sustainability assessments, such as life cycle analysis and CF evaluation; epidemiological studies examining the correlation between diets and public health indicators; and economic models focused on the impact of food systems on natural resources. Systematic and narrative reviews, representing 36.8% (n = 42), synthesize the existing literature on methodologies used to integrate nutrition and sustainability metrics, providing a comparative analysis of different approaches. Regional case studies, totaling 16 studies (14.1%), examine the impact of local policies on food security and sustainable dietary strategies, with a focus on regions vulnerable to food insecurity.

Regarding thematic areas, the analyzed literature falls into four major research directions. A significant number of studies (n = 38, 33.3%) investigate diet sustainability, assessing the impact of food consumption on the environment, health, and the economy. Sustainable dietary models, explored in 25.4% of the studies (n = 29), examine the structure of diets and strategies for optimizing them in the context of food security, including local food sources, dietary biodiversity, and the effects of diets on public health. Food supply chains and food waste represent another major theme, analyzed in 19.3% of the studies (n = 22), through research that assesses the efficiency of food distribution systems, food losses, and measures to reduce waste at both industrial and household levels. A distinct research direction focuses on the impact of climate change on food production and consumption, addressed in 22% of the studies (n = 25), where sustainable solutions to mitigate environmental effects on agri-food systems are examined. The types of studies and publications included are presented in the Supplementary Material (Table S1).

3.2.2. Geographical Distribution of Studies

The geographical distribution of the studies included in this review indicates a significant dominance of research with a global approach, accounting for 39.4% of the total. These studies investigate the interaction between food security and sustainability within a broad framework, analyzing global trends and strategies rather than focusing exclusively on a specific region. At the regional level, research is predominantly concentrated in Europe, Africa, and Asia, while Eastern Europe and Latin America remain considerably underrepresented.

In Africa, the included studies (7.8%) focus on Sub-Saharan countries, including Ghana, Benin, Burkina Faso, Kenya, Zambia, and Zimbabwe. The studies focusing on Asia constitute 6.7% of the analyzed literature, primarily covering India, Japan, Iran, China, the Himalayas, and Thailand. In Europe, although 8.9% of the included research examines food systems, the studies are concentrated on Turkey, the United Kingdom, and the Mediterranean region, with only one study focusing on Romania [27]. North America is analyzed in 3.3% of the included studies, which evaluate food policies and the impact of supply chains on diet sustainability, with a focus on the United States, Canada, and the Arctic region. South America is even less represented, with only 2.2% featuring studies related to Brazil, Chile, and Uruguay.

Central America and the Caribbean are represented by a single study, which examines food systems in Cuba, reflecting the insufficient coverage of the region in the scientific literature. Oceania is also underrepresented, with only one study exploring the impact of climate change on agriculture in Australia.

The geographical distribution of the studies highlights a significant concentration on food systems in developed countries, while certain regions vulnerable to food insecurity, such as Eastern Europe and Latin America, remain underrepresented in the literature. Figure 2 provides a detailed visualization of the geographical distribution of the included studies generated using the VOSviewer cartographic analysis.

The analysis of temporal trends indicates a significant increase in the number of studies after 2020. Between 2015 and 2019, only 20% of the included studies addressed the integration of nutritional and sustainability metrics, whereas between 2020 and 2025, this percentage rose to 80%. The growing interest in this field reflects an increasing concern for developing food strategies that balance nutritional requirements with sustainability objectives.

3.3. Results of Individual Sources of Evidence

This section presents the relevant findings extracted from each source of evidence, with a focus on temporal trends, paradigm shifts, and methodologies used.

3.3.1. Evolution of Indicator Usage over Time

The analysis of extracted data reveals a sharp increase in the use of sustainability and nutritional quality indicators between 2015 and 2025. During the 2015–2019 period, the total number of indicators used remained relatively low and stable, ranging between 7 and 30 mentions annually. However, after 2020, a significant rise was observed, with the number of indicators increasing by more than 4.4 times compared to the previous period. The highest use of indicators was recorded in 2023, with 115 reported indicators, followed by a decline in 2024, where usage dropped to 67 indicators (Figure 3).

The obtained results indicate that CF, GHG emissions, and land use (LU) were the most frequently used indicators in the analyzed literature. Additionally, the Dietary Diversity Index (DDI), Nutrient Adequacy Index (NAI), water footprint (WF), and food accessibility maintained a consistent presence in the included studies. Their evolution over time shows that GHG emissions and WF increased significantly after 2020, reflecting a growing emphasis on the environmental impact of food consumption. Meanwhile, DDI and NAI remained among the most commonly used metrics for assessing diet quality, suggesting a continued focus on dietary diversity and nutritional adequacy.

A comparative analysis between periods highlights significant shifts in indicator usage. Before 2020, the most utilized metrics were DDI and NAI, frequently applied to evaluate dietary diversity and nutritional quality. After 2020, a notable increase in the use of environmental indicators such as GHG emissions and WF was observed, establishing them as key metrics in sustainability assessments. Significant growth was also noted in indicators related to integrated sustainability, the impact of extraction technologies on the environment, and increases in crop yields, which were more frequently incorporated into recent studies due to the heightened focus on sustainable production and environmental impact.

Some metrics emerged only after 2020, such as AA bioavailability and the inclusion of women in agri-food value chains, reflecting an expansion of research toward issues related to nutritional accessibility and equity in food systems. This diversification of indicators underscores the transition toward a holistic approach to sustainability and food security.

3.3.2. Distribution of Indicator Categories in the Scientific Literature

The analysis of the distribution of indicator categories used in the scientific literature reveals a clear predominance of nutritional and environmental indicators, while economic and social indicators are significantly less represented. Figure 4 illustrates the proportion of each category within the analyzed studies, providing a clear perspective on research priorities in this field.

Nutritional indicators hold the largest share, reflecting the ongoing interest in assessing diet quality and nutrient intake within the context of food security. However, environmental and sustainability indicators also occupy a significant position, emphasizing concerns regarding the impact on the environment. Among these, CF water consumption and land use are among the most frequently analyzed metrics.

In contrast, economic indicators have a noticeably lower share, suggesting a limited integration of food costs, economic efficiency, or market impact in food security studies. Social indicators are the least represented, indicating that aspects such as equity in food access, benefit distribution within supply chains, and socio-cultural implications are rarely addressed.

This distribution reveals that while research increasingly focuses on the correlation between nutrition and sustainability, economic and social dimensions remain marginalized. A more balanced integration of these factors could contribute to a more comprehensive understanding of food systems and support the development of policies that consider all aspects of sustainability.

Methodologies Used for Indicator Integration: From the perspective of quantitative methodologies, Life Cycle Assessment (LCA) stands out as one of the most widely used techniques for evaluating the ecological impact of food, providing an integrated perspective on resource consumption and emissions across different stages of the food supply chain. Additionally, methods such as Monte Carlo modeling, Linear Inverse Modeling (LIM), Ecopath with Ecosim (EwE), and Ecological Network Analysis (ENA) are applied to simulate scenarios and quantify the interdependencies between nutritional and ecological variables. These methods contribute to a better understanding of food sustainability by modeling energy and resource flows within agri-food ecosystems.

On the other hand, qualitative approaches, although less common, are essential for complementing the findings obtained through quantitative methods. Among these, semi-structured interviews, focus groups, and the Delphi technique are used to identify the perceptions of stakeholders involved in the food supply chain. These methods provide a deeper understanding of the challenges within food systems and the socio-economic implications of sustainability strategies.

Regarding indicator integration in assessment models, predictive models and economic analyses have been employed to correlate ecological, economic, and nutritional factors. For instance, cost–benefit analysis, combined with data on food consumption and ecological footprint, offers insights into the economic viability of sustainable diets. Additionally, the use of Geographic Information System tools has enabled the mapping of food access and regional disparities in food security.

3.3.3. Gap Analysis: Gaps in the Scientific Literature

The analysis of the literature on nutritional and sustainability metrics has highlighted several major gaps that limit the comparability of studies and their applicability in effective public policies. Figure 5 provides a summary of these gaps, indicating that nearly half of the analyzed studies (48.7%) emphasize the lack of an integrated methodology to correlate nutritional impact and sustainability.

One of the main deficiencies identified is the absence of an integrated methodology that enables the correlation of nutritional impact and sustainability in food security assessment, observed in 48.7% of the analyzed studies. Another significant limitation is the lack of necessary data for comparative analysis of food systems, mentioned in 23.5% of the sources. The difficulty of correlating global and regional factors affects the coherence of trans-regional analyses and appears in 15.7% of the examined studies.

The findings confirm the absence of standardized frameworks that correlate nutritional, environmental, and economic impacts in a unified manner. Establishing internationally accepted standards and harmonized databases should be a key focus for future research to enable meaningful trans-regional comparisons. At the same time, the scarcity of longitudinal studies on the effects of diets on health and sustainability is highlighted in the same proportion. The low number of regional studies restricts the applicability of sustainability metrics in specific local contexts, being identified in 1.7% of the articles. Additionally, the lack of integrated analyses on the impact of diets on human health is another issue reported in 1.7% of the sources.

3.4. Synthesis of Results

The data extracted from the included studies were synthesized using a thematic approach, organizing them based on the nutritional and sustainability indicators used, the geographical distribution of studies, and their evolution over time.

Figure 1 presents the selection process of the included studies following the PRISMA model, providing clarifications on the steps taken in choosing sources for the analysis of nutritional and sustainability metrics.

Figure 2 illustrates the geographical distribution of the included studies between 2015 and 2025, highlighting the most frequently investigated regions.

Figure 3 reflects the evolution of indicator usage in the scientific literature, showing how research interests in this field have developed over the past decade.

Figure 4 details the proportion of the analyzed indicator categories, offering insights into the distribution and focus of the existing studies.

Figure 5 presents the identified gaps in the scientific literature, highlighting the methodological limitations and identifying areas requiring further development (Supplementary Material (Table S1)).

4. Discussion

4.1. Summary of Evidence

This review explored the integration of nutritional and sustainability metrics in food security assessments, highlighting the current trends and methodological challenges. The findings indicate an increasing use of sustainability indicators; however, the absence of a unified approach complicates the correlation between nutritional, environmental, and economic impacts of food consumption.

Table S1 highlights the need for longitudinal studies to assess the cumulative effects of diets on health and sustainability. Additionally, it highlights the lack of standardized methodologies for integrating economic and social dimensions into sustainability assessments. The absence of consensus on key indicators limits the comparability of studies across regions, hindering the development of coherent food security policies.

The analysis reveals significant gaps in the existing methodologies, particularly the lack of integrated frameworks capable of simultaneously assessing nutritional, environmental, and economic impacts. Although methodologies such as LCA and n-LCA provide valuable insights into the ecological and nutritional aspects of food systems, they insufficiently address the economic dimension. Thus, future research should focus on developing multi-dimensional models that offer a balanced perspective for policy recommendations.

Moreover, the review indicates a fragmented research landscape where environmental and nutritional assessments are often conducted separately. Addressing this requires harmonized databases and integrated methodologies that evaluate both ecological and nutritional impacts coherently. A promising direction for future research is the development of frameworks that assess the nutritional quality, environmental sustainability, and economic feasibility of food systems concurrently.

Additionally, exploring the adaptation of methodologies validated in Eastern European countries to the specific context of the Republic of Moldova could enhance the applicability of these frameworks at the national level.

4.2. Challenges in Integrating Nutritional and Sustainability Metrics into Food Security Assessments

An analysis of the gaps in the scientific literature reveals several systemic issues with the use of nutritional and sustainability metrics. The most significant problem, reported in 48.7% of the articles, is the lack of an integrated methodology to link nutrition and sustainability. Most studies address these aspects separately, hindering the development of coherent food security policies [28].

The main gaps identified in the scientific literature include the absence of integrated methodologies linking nutritional and sustainability metrics, significant regional methodological discrepancies, limited access to harmonized databases, and a lack of longitudinal studies to assess the long-term impact of diets. These challenges are particularly pronounced in resource-limited regions, such as Eastern Europe, including the Republic of Moldova.

The integration of nutritional and sustainability metrics into food security assessments presents several challenges:

• Data Availability and Quality: Inconsistencies in the availability and quality of data on both nutritional and sustainability indicators across regions, as well as the lack of extensive and harmonized databases, reported in 23.5% of the sources [29].
• Standardization and Methodological Discrepancies: Absence of universally accepted methodologies for integrating diverse metrics, coupled with methodological discrepancies between countries. Developed countries predominantly use advanced quantitative methods, such as LCA and multi-criteria analysis, whereas resource-limited regions rely primarily on qualitative methods and incomplete data, thereby limiting the validity of global comparisons [22].
• Resource Limitations: Limited financial and human resources, along with challenges in data collection and analysis.
• Policy and Regulatory Gaps: Absence of coherent policies and regulatory frameworks to support the adoption of integrated metrics.
• Measurement Challenges: Difficulty in measuring and continuously monitoring the combined impact of nutritional and sustainability metrics.
• Longitudinal Data Limitations: Lack of longitudinal studies to assess the long-term impact of diets on health and the environment. Most existing research is cross-sectional, lacking detailed assessments of cumulative effects of different diet types, which limits the formulation of evidence-based sustainable policies [11].
• Lack of Clear Criteria for Evaluating Nutritional and Environmental Sustainability of Diets: The absence of universally accepted criteria to assess whether nutritionally optimized diets are also environmentally sustainable remains a significant challenge. Essential criteria include ensuring nutritional adequacy, evaluating environmental impact through carbon footprint, water footprint, and land use, and promoting biodiversity preservation. Additionally, resource efficiency, effective waste reduction, and economic feasibility are crucial. Social acceptability and the long-term health impact of diets should also be considered to ensure comprehensive and sustainable assessments.

4.3. Adapting Methodologies and Implications for the Republic of Moldova

4.3.1. Challenges in Implementing International Methodologies in the Republic of Moldova

Assessing food system sustainability and food security requires robust and harmonized methodologies. However, the Republic of Moldova and other Eastern European countries face significant challenges in adopting these approaches. While LCA and n-LCA are widely used in Western Europe to measure the ecological and nutritional impact of food consumption, their application in Moldova remains limited. The primary obstacles include a lack of adequate infrastructure for data collection and analysis, insufficiently harmonized databases, and limited institutional resources [30].

In Germany and France, the use of LCA has led to the optimization of supply chains, the reduction in food waste, and a decrease in GHG emissions, demonstrating its effectiveness in developing a more sustainable food system [31]. In contrast, Central and Eastern European countries, including Moldova, Ukraine, and Belarus, have struggled to adopt these methodologies on a large scale, encountering methodological and technical difficulties [32,33]. The lack of harmonized databases and a well-established institutional framework hinders the comparability of evaluations and the formulation of effective policies [34,35].

4.3.2. Adapting Methodologies to the Specific Context of the Republic of Moldova

Adapting international methodologies to the socio-economic and ecological context of the Republic of Moldova is essential for accurate sustainability assessments. A customized framework should integrate local indicators.

In this context, applying the LCA and n-LCA methodologies requires specific adaptations, such as simplifying the indicators used, employing more accessible datasets, and developing hybrid methodologies that combine qualitative and quantitative analyses. Key areas for adaptation include economic access to food, the impact of climate change on agriculture, reliance on traditional fuels, supply chain resilience, and food waste reduction. Training local specialists and investing in infrastructure are also essential to facilitate the collection and analysis of relevant data.

Economic food accessibility should be analyzed in relation to the average population income and price variability between urban and rural areas. The cost of a healthy diet relative to the average income is a crucial indicator, already assessed in national studies [2,16,36]. The impact of climate change on agricultural production is a critical issue, as Moldova is considered the most climate-vulnerable country in Europe [37]. The lack of detailed climate risk assessments hinders the adaptive capacity of local producers, highlighting the need for in-depth analyses of climate change effects on agriculture.

The dependence of rural households on traditional fuels, such as firewood, affects both environmental sustainability and food security. International studies on GHG emissions offer solutions for reducing this reliance and implementing sustainable energy strategies [38]. Food supply chains should be analyzed in terms of resilience to economic and climate crises. The absence of efficient supply systems makes Moldova vulnerable to price fluctuations and supply disruptions. Food loss and waste remain insufficiently studied at the national level, and the lack of monitoring indicators limits the effectiveness of policies aimed at reducing them [36].

4.3.3. Establishing an Institutional and Infrastructure Framework for Sustainability Assessment

The implementation of sustainability methodologies requires strengthening institutional capacities and developing harmonized databases to ensure that evaluations are comparable at an international level. Integrating international methodologies into national policies would facilitate Moldova’s alignment with global standards and contribute to better management of food resources. The European Union has implemented Product Environmental Footprint (PEF) and LCA using digital tools to assess the sustainability of food products [39].

Moldova could adopt and adapt these models, but their success depends on modernizing data collection infrastructure and developing strategic partnerships with international research centers.

Integrating these solutions into the national food security strategy would enable better alignment with European practices and enhance transparency in evaluating the ecological impact of food production and consumption.

4.3.4. Implications for Public Policies and Sustainability

A customized methodological framework is essential for developing sustainable food policies that address both the population’s nutritional needs and the region’s environmental challenges.

Investments in data collection infrastructure and integrated databases are critical for the effective monitoring of food systems. These improvements will enable more precise correlations between nutrition, sustainability, and the economy, facilitating evidence-based decision making and strategic planning.

Without these adjustments, the use of international metrics will remain limited, and the development of effective policies will be compromised. Moldova has the opportunity to adapt internationally validated methodologies, but the success of this endeavor depends on the ability of institutions to integrate these tools into a coherent legislative and operational framework.

A coordinated approach based on robust data and internationally validated practices is essential for ensuring a long-term sustainable and resilient food system.

4.4. Future Research Directions

To advance the integration of nutritional and sustainability metrics in food security assessments, future research should prioritize the development of comprehensive methodologies that simultaneously evaluate the nutritional, environmental, and economic impacts of food systems. The lack of harmonized databases and integrated models remains a significant barrier. The absence of integrated databases complicates the ability to perform reliable international comparisons, as discrepancies in data availability and quality between countries can lead to biased assessments. To address this gap, it is essential to develop harmonized databases that incorporate nutritional, environmental, and economic metrics, facilitating more accurate and comparable evaluations of food systems. Strengthening data collection infrastructure and enhancing institutional capacities, particularly in resource-limited regions, could significantly improve the availability of high-quality data. Additionally, the adoption of digital tools for the real-time monitoring of these metrics would enable timely and evidence-based decision making. Establishing international collaborations focused on standardizing data collection methods could further support the creation of integrated databases, promoting more consistent and actionable insights for policy development. Developing a multi-dimensional framework that includes standardized indicators for all three dimensions could facilitate cross-regional comparisons and policy development.

However, creating a standardized methodological framework for food security assessment poses significant challenges. One of the main obstacles is the harmonization of diverse data sources and indicators across different countries, which often employ varying methodologies and metrics for assessing nutritional, ecological, and economic impacts. Additionally, the lack of consensus on universally accepted indicators complicates efforts to establish a coherent and comparable framework. Addressing these challenges requires significant investments in data standardization, the development of flexible indicators that can be adapted to regional specificities, and international collaborations aimed at aligning data collection protocols. Moreover, balancing the complexity of integrated assessments with the need for accessibility in resource-limited contexts is essential to ensure that such frameworks are both applicable and practical on a global scale. Simplifying the methodology while maintaining accuracy and investing in capacity-building for local institutions could enhance the feasibility and acceptance of standardized frameworks.

Future research should prioritize the creation of integrated assessment models that incorporate longitudinal data to evaluate the cumulative effects of diets on health, environment, and economy. Moreover, exploring the applicability of validated methodologies from Eastern European countries in the specific context of the Republic of Moldova could enhance the relevance and practicality of these approaches at a national level. Additionally, the inclusion of economic factors, such as the cost of sustainable diets relative to income levels and regional disparities, would provide a more holistic view of food security challenges. Advancing digital tools and data infrastructure to support the real-time monitoring of nutritional and sustainability metrics could also play a critical role in policy-making and implementation.

4.5. Practical Recommendations for Aligning Nutritional and Sustainability Goals

Reconciling nutritional goals with sustainability objectives requires an integrated approach that considers both environmental and health-related factors. Shifting towards diets rich in vegetables, fruits, whole grains, and plant-based proteins can significantly reduce carbon and water footprints while ensuring nutritional adequacy.

However, as highlighted in Table S1, the economic feasibility of such dietary shifts remains a significant challenge, especially in regions with limited financial resources, such as Eastern Europe. Ensuring access to sustainable diets necessitates the integration of cost indicators into sustainability assessments, as well as targeted subsidies and policies to lower the cost of nutritionally adequate and environmentally friendly foods.

Reducing food waste across all the stages of the food supply chain is also essential for enhancing sustainability. The integration of Life Cycle Assessment (LCA) and nutritional Life Cycle Assessment (n-LCA) methods provides a comprehensive framework for evaluating both environmental and nutritional impacts. Supporting biodiversity and local food systems can further mitigate environmental impacts and promote dietary sustainability.

Developing coherent policies that align nutritional and sustainability objectives is crucial for advancing sustainable diets globally. Increasing public awareness about the benefits of sustainable diets, combined with education, can positively influence consumer behavior. Additionally, investing in digital technologies for the real-time monitoring of sustainability and nutrition metrics can facilitate evidence-based policy-making and help track progress towards sustainable food systems.

4.6. Limitations

This review provides a comprehensive analysis of the integration of nutritional and sustainability metrics in food security assessments. However, certain methodological and structural limitations may influence the interpretation of the results.

One major limitation is the availability and heterogeneity of the sources, which differ in methodologies, regions analyzed, and study periods. Additionally, as highlighted in Table S1, the lack of harmonized databases and standardized indicators poses significant challenges to cross-regional comparisons. This issue particularly affects low-income and underrepresented regions, such as Eastern Europe, where access to detailed and harmonized datasets is limited. Addressing these limitations is essential for improving the comparability and applicability of sustainability assessments globally.

Furthermore, most studies rely on quantitative methods, leaving the socio-cultural aspects of sustainability metrics underexplored. The restricted access to extensive databases also limits the identification of all the relevant studies, potentially leading to an underrepresentation of certain regions and food systems. The absence of centralized datasets complicates efforts to create a holistic picture of sustainability and nutrition metrics.

In terms of applicability, the review’s conclusions cannot be generalized to all national contexts without adaptations specific to each food system. Additionally, the exclusion of unpublished studies and gray literature may limit the scope of perspectives included, potentially omitting alternative approaches to the integration of sustainability metrics.

These limitations underscore the need for future systematic reviews based on extensive and harmonized datasets, as well as more rigorous comparative methodologies. Such efforts could provide a more precise assessment of the interactions between nutritional and sustainability metrics in food security contexts.

5. Conclusions

This scoping review highlighted that the integration of nutritional and sustainability metrics in food security assessment remains limited and fragmented, despite the increasing interest in this field. Although the adoption of ecological indicators has significantly increased after 2020, their correlation with nutritional and economic dimensions remains insufficient. The main gaps identified include the lack of a standardized methodological framework, variations in the use of metrics, and the absence of integrated databases that would enable relevant international comparisons.

These findings underscore the need for clear future research directions, including the development of integrated methodologies that allow for the simultaneous assessment of the nutritional, ecological, and economic impact of food systems. Establishing a unified approach that effectively correlates nutritional, environmental, and economic dimensions is essential for advancing food security assessments. The adaptation of integrated methodologies validated in EU member states, particularly those addressing the specific challenges of Eastern European countries, could serve as a viable pathway for enhancing the robustness of national food policies in the Republic of Moldova.

Longitudinal studies are needed to evaluate the long-term effects of diets on health and the environment, as well as trans-regional comparisons that provide a broader perspective on the sustainability of diets at a global level.

For underrepresented regions, such as Eastern Europe and the Republic of Moldova, it is essential to develop assessment tools tailored to local specificities, considering socio-economic factors and food infrastructure. The focus on Eastern Europe is justified by shared historical and socio-economic challenges, including the legacy of the Commonwealth of Independent States (CIS) and the geographical and cultural proximity to Romania. These commonalities suggest that the methodologies and indicators validated in these regions could be more easily adapted for the Republic of Moldova, enhancing the relevance and applicability of the findings. The implementation of well-established methodologies, such as LCA and n-LCA, can contribute to a more accurate quantification of the environmental impact of food. However, their application requires standardization and adaptation to local realities.

The results obtained emphasize the necessity of a coherent methodological framework and extensive research on underexplored regions to support evidence-based food policies. Additionally, the adaptation of validated methodologies from Eastern European countries, particularly those that are members of the European Union, can facilitate Moldova’s alignment with EU standards, providing a pathway for integrating sustainability and nutritional security into national policies.