Abstract: Global food systems face mounting pressure from intersecting crises of food
insecurity, malnutrition (affecting over 2.8 billion people), and climate change, necessi
tating transformative solutions. Agroforestry systems (AFS), integrating trees with crops
and/or livestock, offer a promising pathway by synergistically enhancing food produc
tion, ecological stability, and public health outcomes. However, realizing this potential
is hindered by gaps in understanding the complex interactions and trade-offs between
these domains, limiting policy and practice effectiveness. This comprehensive review
aimed to synthesize current evidence on how agroforestry integrates food security, public
health, and environmental sustainability and to identify critical research gaps that limit its
widespread adoption and optimization. Following the SPAR-4-SLR protocol, a systematic
literature search was conducted across Web of Science and Scopus, with thematic analysis
using VosViewer and quantitative synthesis of key metrics. The review confirms agro
forestry’s multifaceted benefits, including enhanced dietary diversity, improved micronu
trient intake (e.g., 18% reduction in vitamin A deficiency), significant carbon sequestration
(0.5–2 Mg C/ha/year), soil health improvements (50–70% less erosion), income generation
(+40%), and climate resilience (2–5 ◦C cooling). Key gaps identified include the need for
longitudinal health studies, better quantification of climate–health interactions and non
material benefits, policy–health integration strategies, and analyses of economic–nutritional
trade-offs.
