Abstract
Global food systems face mounting pressure from intersecting crises of food insecurity, malnutrition (affecting over 2.8 billion people), and climate change, necessitating transformative solutions. Agroforestry systems (AFS), integrating trees with crops and/or livestock, offer a promising pathway by synergistically enhancing food production, 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 agroforestry's multifaceted benefits, including enhanced dietary diversity, improved micronutrient 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.