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: Globalization and urbanization have accelerated the convergence of dietary patterns and increased interest in the One Health approach for simultaneously assessing human health and environmental sustainability. Despite the importance of integrated health–environment assessments, studies conducted in Iran have largely relied on limited questionnaire-based data. As a pioneering large-scale case study, this research provides a foundation for future environmental–nutritional assessments of food systems. To address this issue, a systematic approach was used to examine food consumption trends from 2004 to 2023 by integrating domestic production, imports, exports, and food waste within a unified framework. These datasets were combined with Life Cycle Assessment (LCA) indicators and USDA nutritional data to evaluate environmental impacts and nutrient status over a twenty-year period. During the study period, per-capita environmental indicators showed substantial increases: water footprint (+22%), land use (+10%), greenhouse gas emissions (+6%), acidification (+12%), eutrophication (+12%), biodiversity loss (+15%), and ecological footprint (+9%). The results also revealed significant nutritional imbalances, with energy intake exceeding twice the recommended level, while calcium intake remained below 50% of the daily requirement. Furthermore, by providing a cleaned and integrated national dataset, this study establishes a platform for future research on health, environmental sustainability, and food policy in Iran. These findings highlight the urgent need to redefine affordable and sustainable diets, particularly in populous countries with limited natural resources such as Iran.
Matini et al. (Wed,) studied this question.