The impacts of the current global food system are already visible in the environment and in the health of the population. The promotion of sustainable diets is key to counter the negative consequences. The healthcare system could be a powerful tool to educate patients by guiding their diets towards sustainability. This study aimed to assess the size and scope of the available literature regarding the promotion of sustainable diets in the healthcare system and to obtain a reliable approximation of the processes and roles related to sustainable diet promotion within healthcare systems. A scoping review where online databases were used to identify English written scientific and grey literature published between 2000–2019 was carried out. The analytical–synthetic approach was used for data charting. Twelve studies were included that were published between 2007–2020. The data highlight education, community and clinical health services, community engagement and policy advocacy, and governance as main action areas along with two transversal aspects, social support, and gender. A systemic approach to the food system is emphasized. Evidence suggests that health professionals have the potential to drive a paradigm shift in food–health environments. Currently, however, their role and potential impact is underestimated within healthcare systems. This review has identified a framework with key areas where processes need to be developed to guarantee sustainable diet promotion in healthcare services.

Farmers' markets are a traditional exchange space for local peasants, around which alternative agri-food networks (AFNs) are being built on a local scale. These AFNs seek to establish quality and trust-based equitable relationships within value chains. The main objective of this paper is to measure the economic impact of 10 farmers' markets on the local economy in the Basque province of Gipuzkoa (Northern Spain). To calculate the degree of impact, we use the tools of input-output analysis, adapting the SEED & NEED & FEED (Sticky Economic Evaluation Device & Neighborhood Exchange Evaluation Device & Food Environment Evaluation Device) approach to the specific context of the Basque Country. The results obtained give an economic value of the impact of these marketing spaces, including direct and indirect effects on other economic sectors. Furthermore, the results show that markets present other factors, not just economic, that add value for both producers and consumers, as well as for the local economy.

La Vía Campesina organisations have identified the area of education and training as a strategic and priority arena of intervention to bring about change in the political-pedagogical perspective. This involves rethinking and redesigning the conventional training processes towards the collective experiences of learning, organisation, exchange and living. With this approach in mind, and based on the experiences and educational contributions made by peasant organisations, this paper presents the systematisation of the Baserritik Mundura experience, analysing and sharing the learning derived from this case study and establishing the integral role of the pedagogic proposal as an axis for systematisation. This analysis, from the logic of the systematisation of processes, promulgates the learnings of this agroecological training experience while exposing both its strengths and weaknesses. We present the learning linked to the pedagogic dimensions that, through a cross-over method, aim to create a multidimensional educational environment which transforms our subjectivities, practices and the beliefs that sustain them. This learning is presented in eight main areas related to: (1) organicity, (2) alternation, (3) the mystical and ludic-cultural dimension, (4) the contents, subjects and teaching team, (5) the proposal as a whole and its perspective of popular education and action research, (6) the transversality of the feminist perspective, (7) linguistic plurality and (8) the pedagogic political support of the process. In addition, we present considerations related to the learning identified in the systematisation itself. On the one hand, we look at the lack of training processes in the official university context related to an alternation system with an organicity linked to the territory, and the need for the practical development of a dynamic of the collective construction of knowledge with a view toward transforming the logics that underpin the existing hegemonic ideologies. On the other hand, we point out the need for a debate regarding the epistemological perspective and integral, experiential and emancipatory pedagogical perspectives. Even with their limitations and challenges, these proposals have great potential to train, organise, politicise, excite and connect people from different fields towards the construction of a fairer, healthier and more sustainable agroecological agri-food system, based on food sovereignty and the everyday lives of people

The healthcare system’s climate footprint is equivalent to 4.4% of global net emission. The food service offered, with subsequent food waste production and energy consumption, falls within the spectrum of environmentally harmful activities. The development of a Sustainable Food Procurement Strategy is an opportunity to counteract these negative effects. This article aims to identify the nature and extent of the evidence found in the literature on the processes related to food procurement within healthcare systems and analyse them from the perspective of sustainability dimensions. A scoping review is carried out using online databases to identify scientific and grey literature published in English during the period 2000–2019. An analytical-synthetic approach is used for charting the data. Twenty-six studies are included; 65% of them published in the last five years. These include research articles (n 11), an opinion article (n 1), policy handbooks and guides (n 2), project reports (n 4) and technical reports (n 3), policy forums (n 1), factsheet documents (n 3), and legislative directives (n 1). The outcomes framework highlights multilevel governance, a sustainable food supply system, and healthy and sustainable food services as the main action areas for a sustainable food procurement strategy, along with six transversal features: long-term commitment, investment, evaluation, communication, gender, and a holistic approach.

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Las consecuencias a escala local del sistema agroalimentario global, las necesidades de ejecutar saltos de escala en las experiencias de producción y comercialización agroecológicas y sus relaciones de poder intrínsecas, evidencian la oportunidad de la reflexión y el debate en torno a la construcción de sistemas y estrategias de gobernanza que faciliten prácticas sociales y organizativas sostenibles para las personas productoras y consumidoras, principalmente mediante la creación de Redes Agroalimentarias Alternativas (RAA). En este artículo se describe una experiencia innovadora en el ámbito de la comercialización de productos agroecológicos locales que se está desarrollando en Gipuzkoa: el proyecto piloto SAREKO, un Centro de Acopio (CA) de producción agroecológica que abastece al sector de la restauración en la comarca de Donostialdea. Mediante una metodología basada en la Investigación Acción Participativa, se parte de la sistematización de procesos para ordenar la información recogida en la dinamización del proyecto y para realizar una reflexión crítica colectiva sobre el mismo. Los resultados principales constatan que el salto de escala tiene que apoyarse en iniciativas híbridas, en las que se debe prestar atención a la comunicación y a la negociación que se establece dentro de la red y a la construcción de confianza entre los participantes. Se constata que la cooperación entre los actores y la estructura organizativa emergente se convierten en piezas clave para conformar la identidad del CA. Así, la orientación colaborativa en los espacios de decisión y la generación de procesos basados en la toma de decisiones por consenso determinan la forma de redistribuir el valor añadido a lo largo de toda la cadena alimentaria.

Participatory guarantee systems (PGSs) have emerged as a response to exclusion and intermediation processes involving third-party certification, which is currently the only guarantee system recognised by the European Union for organic food. Despite their unofficial recognition, PGSs are developing and generating shared frameworks of action. In this research, through three certification bodies (two public and one private) and eight PGSs in Spain, we investigate the similarities and differences between the procedures and tasks that both systems develop in order to generate trust in the decision-making structures involved and the responsibilities on which they are based. While the overall organisation of the systems is very similar, there are profound differences in their decision-making: their procedures and who participates in them. The differences we highlight lead us to argue that PGSs effectively solve the exclusion problems that third-party certification generates. Specifically, they offer lower costs and more accessible bureaucracy. They also generate and strengthen, through trust-building, the links and processes of local self-management and empowerment. However, developing PGSs demands much time and dedication, and their official regulation is complex, so it is difficult to predict that they will be widely adopted.

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