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The next decade is likely to produce any number of global challenges that will affect health and health care, including pan-national infections such as the new coronavirus COVID-19 and others that will be related to global warming. Nurses will be required to react to these events, even though they will also be affected as ordinary citizens. The future resilience of healthcare services will depend on having sufficient numbers of nurses who are adequately resourced to face the coming challenges.

Agricultural water requirements differ between foods. Population-level dietary preferences are therefore a major determinant of agricultural water use. The “water footprint” (WF) represents the volume of water consumed in the production of food items, separated by water source; blue WF represents ground and surface water use, and green WF represents rain water use. We systematically searched for published studies using the WF to assess the water use of diets. We used the available evidence to quantify the WF of diets in different countries, and grouped diets in patterns according to study definition. “Average” patterns equated to those currently consumed, whereas “healthy” patterns included those recommended in national dietary guidelines. We searched 7 online databases and identified 41 eligible studies that reported the dietary green WF, blue WF, or total WF (green plus blue) (1964 estimates for 176 countries). The available evidence suggests that, on average, European (170 estimates) and Oceanian (18 estimates) dietary patterns have the highest green WFs (median per capita: 2999 L/d and 2924 L/d, respectively), whereas Asian dietary patterns (98 estimates) have the highest blue WFs (median: 382 L/d per capita). Foods of animal origin are major contributors to the green WFs of diets, whereas cereals, fruits, nuts, and oils are major contributors to the blue WF of diets. “Healthy” dietary patterns (425 estimates) had green WFs that were 5.9% (95% CI: −7.7, −4.0) lower than those of “average” dietary patterns, but they did not differ in their blue WFs. Our review suggests that changes toward healthier diets could reduce total water use of agriculture, but would not affect blue water use. Rapid dietary change and increasing water security concerns underscore the need for a better understanding of the amount and type of water used in food production to make informed policy decisions.

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