Abstract

The interface between Climate Changes and Food and Nutrition Security (FNS) has been standing out in the sustainable development agenda since the early 1990’s. Since then, studies show that climate changes have negative effects on the FNS, aggravated by poverty and social inequality. The purpose of this paper is to perform a review evidencing the relationships between climate changes and FNS. The research was carried out in PubMed using the descriptors “climate change and food security” on the headline, selecting only papers in Portuguese, Spanish, and English languages, and with a direct relation to the themes. The main impacts of climate changes on the FNS were related to the access, production, nutritional quality, and volatility of food prices. The studies also indicated mitigation/adaptation strategies to the effects of climate changes on the FNS, as well as a geographic panorama of the publications with fields of study in Africa and Asia, continents marked by social inequality and poverty. Climate changes affect the dimensions of FNS, especially in poorer populations in situation of social inequality. The relevance of the themes raises concern on the urgency of higher investments in public policies, studies, and research on the subject around the world.

Key words:
Climate changes; Food and Nutrition Security; Poverty; Inequality

Introduction

The first studies on the impacts of Climate Changes on Food and Nutrition Security (FNS) appeared in the 1990’s and may be divided into: neutral phase (1994-2005): when the climate changes would not cause negative effects on FNS. It was believed that climate changes would create winners and losers, but, in the end, the food production would “get the job done”; and a negative phase (2005 to the present): increased assumption that climate changes and their effects are contributing for the world hunger¹1 Butler CD. Food security in the Asia-Pacific: climate change, phosphorus, ozone and other environmental challenges. Asia Pac J Clin Nutr 2009; 18(4):590-597..

Climate on the planet is clearly changing, characterized by events such as: heat waves, floods, droughts, increase of sea levels, and atmospheric pollution, which affect health either directly or indirectly, causing several impacts such as increased respiratory and transmissible diseases, countless damages, diseases, and harms against health caused by disasters, in addition to deaths, thus compromising the FNS in the medium and/or long term.

FNS is defined as the capacity to ensure that everyone has access to basic food with quality and in sufficient quantity, without compromising the other essential needs. It has four dimensions: access, availability, utilization, and stability²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017.^,33 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018..

In view of this context, studies affirm that climate changes have negative effects on the FNS. These are driven by multiple determiners: poverty, education level, unemployment, increase in food prices, poor access to food, faulty rights to property/land and work, besides the weather/environment⁴4 Gregory PJ, Ingram JS, Brklacich M. Climate change and food security. Philos Trans R Soc Lond B Biol Sci 2005; 360(1463):2139-2148.

5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.

6 Brasil. Ministério do Meio Ambiente (MMA). Plano Nacional de Adaptac¸a~o a` Mudanc¸a do Clima. Brasília: MMA; 2016.

7 Springmann M, Daniel Mason-D'croz MA, Sherman R, Tara G, Godfray HCJ, Gollin D, Rayner M, Ballon P, Scarborough P. Global and regional health effects of future food production under climate change: a modelling study. Lancet 2016; 387(10031):1937-1946.^-88 Ziska LH, Epstein PR, Schlesinger WH. Rising CO2, climate change and public change: exploring the links to plant biology. Environ Health Perspect 2009; 117:155-158., and will depend on the capacity to respond and/or adapt to the new scenario.

The number of extreme events, including extreme heat, droughts, floods, and storms, doubled since the early 1990’s, with an average of 213 occurrences/year in the period between 1990 and 2016³3 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018.. Some risks were identified: increase in precipitations variability (floods and droughts more frequent and extreme) and in river outflows; reduction in plantations productivity; global temperature rise (1.8ºC to 4ºC); soil composition⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,99 Intergovernmental Panel on Climate Change (IPPC). Climate Change 2014 Synthesis Report. Washington, D.C.: IPCC; 2014.^,1010 Su Y-Y, Weng Y-H, Chiu Y-W. Climate change and Food Security in East Asia. Asia Pac J Clin Nutr 2009; 18(4):674-678. and alterations in the cycles of disease vectors, thus affecting the health state of the population³3 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018.^,1111 Myers SS, Smith MR, Guth S, Golden CD, Vaitla B, Mueller ND, Dangour AD, Huybers P. Climate change and global food systems: potential impacts on food security and undernutrition. Annu Rev Public Health 2017; 38:259-277.

12 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^-1313 Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M. A comparative risk assessment of burden of disease and injury atributable to 67 risk factors and risk fator clusters in 21 regions, 1990-2010: a systematic review analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2224-2260.. In view of this new scenario, some cultivations appear as more sensitive than others: wheat is more sensitive to temperature changes than rice¹⁴14 Faisal IM, Parveen S. Food security in the face of climate change, population growth, and resource constraints: implications for Bangladesh. Environ Manage 2004; 34(4):487-498., for instance.

The negative effects of climate changes on the FNS have specially been studied in developing countries, with evidence of their contribution for the aggravation of the different faces of poor nutrition: malnutrition, nutritional deficiencies, and overweight/obesity. In developed countries, the focus lies on the quality and safety of food³3 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526..

Climate changes may cause risks to FNS through reductions in food availability, access, utilization, and stability of the food system, which, combined with the high demand, increases the price of food. An unstable food system, with a low offer of unprocessed food and high prices, increases the search for ultra-processed and processed food, which brings to light another strand of food and nutrition insecurity: overweight/obesity¹⁶16 Raiten DJ, Aimone AM. The intersection of climate/environment, food, nutrition and health: crisis and opportunity. Curr Opin Biotechnol 2017; 44:52-62.. Which means that climate changes interface with poor nutrition as well as food and nutrition insecurity: malnutrition/nutritional deficit and overweight/obesity, thus reinforcing the need for inter-sector public policies that comprise the determining factors influencing the food choices of the population and their consequences on poor nutrition, providing responses beyond the health sector¹⁷17 Jaime PC, Delmuè DCC, Campello T, Silva DO, Santos LMP. Um olhar sobre a agenda de alimentação e nutrição nos trinta anos do Sistema Único de Saúde. Cien Saude Colet 2018; 23(6):1829-1836..

The year 2017 registered a 25% increase in acute and chronic hunger in the world when compared to the 2 previous years, mainly due to climate-related factors (increased droughts, for instance)³3 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018..

Knowledge about the impacts of climate changes on agriculture has significantly expanded over the last 20 years. However, there is a perceived lack of studies on the interface between climate changes and FNS, especially in developing countries, indicated by the literature as the most vulnerable to such events. In view of this context, this paper has the purpose of carrying out a scientific literature review, drawing an outline of the relationship between climate changes and FNS, aimed at contributing to reach the sustainable development goals (SDG)¹⁸18 Organização das Nações Unidas (ONU). Transformando nosso mundo: a agenda 2030 para o desenvolvimento sustentável. Brasília: ONU; 2015..

Methodology

The research was carried out in PubMed (http://www.ncbi.nlm.nih.gov/pubmed) database in the period between August and October 2018, using a combination of the descriptors: [Climate change and food security] on the headline.

Considering that this review article has the purpose of making a first approach towards the topic of climate changes and FNS in the Health Sciences, we have chosen to use only PubMed as it is the main database of journals and books in the world within the field of Public/Collective Health.

The inclusion criteria were the following: (1) only original papers; (2) Portuguese, Spanish, and English languages; (3) direct relation with the established themes. Review articles, congress annals, monographs, thesis, dissertations, book chapters were excluded.

In order to prepare the review, the headlines were initially evaluated, followed by the abstracts reading and, further, full reading of the studies. At first, 38 original papers were identified, and after reading the abstracts, 1 was excluded. Thirty-seven papers were read in full and 3 were excluded as they did not present a direct relation with the defined themes. In total, 34 papers were deemed eligible for this review (Figure 1).

Results and discussion

The results found were organized into five (5) analytical categories: access, availability, utilization, stability, and adaptation/mitigation strategies. Next, a geographic panorama of the studies was organized.

Access

Access is one of the dimensions of FNS and covers the presence of both economic and physical resources to acquire the available food in order to meet one’s needs²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017.. Fifteen publications⁴4 Gregory PJ, Ingram JS, Brklacich M. Climate change and food security. Philos Trans R Soc Lond B Biol Sci 2005; 360(1463):2139-2148.^,55 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,1111 Myers SS, Smith MR, Guth S, Golden CD, Vaitla B, Mueller ND, Dangour AD, Huybers P. Climate change and global food systems: potential impacts on food security and undernutrition. Annu Rev Public Health 2017; 38:259-277.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,1919 Lauria V, Das I, Hazra S, Cazcarro I, Arto I, Kay S, Ofori-Danson, P, Ahmed M, Hossain MAR, Barange M, Fernandes JA. Importance of fisheries for food security across three climate change vulnerable deltas. Sci Total Environ 2018; 640:1566-1577.

20 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.

21 Mugambiwa SS, Tirivangasi HM. Climate change: A threat towards achieving 'Sustainable Development Goal number two' (end hunger, achieve food security and improved nutrition and promote sustainable agriculture) in South Africa. Jamba 2017; 9(1):350.

22 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465.

23 Mcelhinney J. Influencing the agricultural sector to embrace adaptation to climate change, for the sake of global food security. Environ Sci Pollut Res Int 2016; 23(9):9245-9246.

24 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.

25 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.

26 Douglas V, Chan HM, Wesche S, Dickson C, Kassi N, Netro L, Williams M. Reconciling traditional knowledge, food security, and climate change: experience from Old Crow, YT, Canada. Prog Community Health Partnersh 2014; 8(1):21-27.

27 Janes CR. Failed development and vulnerability to climate change in Central Asia: implications for food security and health. Asia Pac J Public Health 2010; 22(Supl. 3):236S-245S.^-2828 Brown ME, Funk CC. Food security under climate change. Science 2008; 319(5863):580-581. discussed how climate changes might cause direct impacts on plantations and consequently reduce the production of food. This might affect the access to food, mainly due to the lack of income arising from the unemployment of farmers who lose their animals (cattle raising)²⁷27 Janes CR. Failed development and vulnerability to climate change in Central Asia: implications for food security and health. Asia Pac J Public Health 2010; 22(Supl. 3):236S-245S., their lands and/or suffer from the reduced productivity of these¹²12 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,1919 Lauria V, Das I, Hazra S, Cazcarro I, Arto I, Kay S, Ofori-Danson, P, Ahmed M, Hossain MAR, Barange M, Fernandes JA. Importance of fisheries for food security across three climate change vulnerable deltas. Sci Total Environ 2018; 640:1566-1577.^,2020 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.^,2424 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.

25 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^-2626 Douglas V, Chan HM, Wesche S, Dickson C, Kassi N, Netro L, Williams M. Reconciling traditional knowledge, food security, and climate change: experience from Old Crow, YT, Canada. Prog Community Health Partnersh 2014; 8(1):21-27., the increase in prices of basic foods resulting from productivity decrease and demand increase¹²12 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,2020 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.^,2626 Douglas V, Chan HM, Wesche S, Dickson C, Kassi N, Netro L, Williams M. Reconciling traditional knowledge, food security, and climate change: experience from Old Crow, YT, Canada. Prog Community Health Partnersh 2014; 8(1):21-27., and the difficulties in distributing and storing the production²⁵25 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,2323 Mcelhinney J. Influencing the agricultural sector to embrace adaptation to climate change, for the sake of global food security. Environ Sci Pollut Res Int 2016; 23(9):9245-9246..

Fischer et al.²⁹29 Fischer G, Shah M, Van Velthuizen H. Climate Change and Agricultural Vulnerability, A Special Report Prepared as a Contribution to the World Summit on Sustainable Development. Laxenburg: IIASA Rep; 2002. indicate that both food prices and temperatures will increase simultaneously and moderately by 2050, thus negatively affecting the quantity, quality, and diversity of the food consumed worldwide³3 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018..

More broadly, Schmidhuber and Tubiello⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708. discuss the concept of access related to the guarantee of political, economic, and social rights so that the populations might acquire food that is adequate both in terms of nutritional quantity and quality. Thus, gathering economic and social factors and rights around the access to food.

A case study held in Madagascar (Africa) indicates that high levels of poverty, precarious infrastructure, and lack of both financial and technical support to farmers are factors that make them potentially more vulnerable to climate risks²⁴24 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.. In South Africa, rural communities that depend on agriculture also face an instantaneous risk of crop failure and cattle loss, what consequently increases hunger and malnutrition once the majority of these people gets their income from agricultural products³⁰30 Mugambiwa SS, Tirivangasi HM. Climate change: A threat towards achieving 'Sustainable Development Goal number two' (end hunger, achieve food security and improved nutrition and promote sustainable agriculture) in South Africa. Jamba 2017; 9(1):350..

That being said, the right to food through access is not guaranteed, especially in countries with socioenvironmental vulnerabilities (countries of low and medium income, that suffer with larger effects of climate changes), resulting in multiple types of poor nutrition (micronutrient deficiency, malnutrition, and obesity) in the population²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017.^,33 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018..

Malnutrition as a result of the lack of access to food is an expected effect, but obesity brings to the discussion a new standard of eating, with a larger consumption of ultra-processed foods, foods with low nutritional values, thus directly affecting the FNS¹⁵15 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526..

Availability

The availability category was the one with the least number of publications: 26 papers¹1 Butler CD. Food security in the Asia-Pacific: climate change, phosphorus, ozone and other environmental challenges. Asia Pac J Clin Nutr 2009; 18(4):590-597.^,55 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,1111 Myers SS, Smith MR, Guth S, Golden CD, Vaitla B, Mueller ND, Dangour AD, Huybers P. Climate change and global food systems: potential impacts on food security and undernutrition. Annu Rev Public Health 2017; 38:259-277.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,1919 Lauria V, Das I, Hazra S, Cazcarro I, Arto I, Kay S, Ofori-Danson, P, Ahmed M, Hossain MAR, Barange M, Fernandes JA. Importance of fisheries for food security across three climate change vulnerable deltas. Sci Total Environ 2018; 640:1566-1577.^,2020 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.

21 Mugambiwa SS, Tirivangasi HM. Climate change: A threat towards achieving 'Sustainable Development Goal number two' (end hunger, achieve food security and improved nutrition and promote sustainable agriculture) in South Africa. Jamba 2017; 9(1):350.

22 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465.

23 Mcelhinney J. Influencing the agricultural sector to embrace adaptation to climate change, for the sake of global food security. Environ Sci Pollut Res Int 2016; 23(9):9245-9246.

24 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.^-2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,2828 Brown ME, Funk CC. Food security under climate change. Science 2008; 319(5863):580-581.^,3131 Considine MJ, Siddique KH, Foyer CH. Nature's pulse power: legumes, food security and climate change. J Exp Bot 2017; 68(8):1815-1818.

32 Beerling DJ. Enhanced rock weathering: biological climate change mitigation with co-benefits for food security? Biol Lett 2017; 13(4):20170149.

33 Mayala BK, Fahey CA, Wei D, Zinga MM, Bwana VM, Mlacha T, Rumisha SF, Stanley G, Shayo EH, Mboera LE. Knowledge, perception and practices about malaria, climate change, livelihoods and food security among rural communities of central Tanzania. Infect Dis Poverty 2015; 4(1):21.

34 Rhodes CJ. Soil erosion, climate change and global food security: challenges and strategies. Sci Prog 2014; 97(2):97-153.

35 Godber OF, Wall R. Livestock and food security: vulnerability to population growth and climate change. Glob Chang Biol 2014; 20(10):3092-3102.

36 Ziska LH, Bunce JA, Shimono H, Gealy DR, Baker JT, Newton PC, Newton PCD, Reynolds MP, Jagadish KSV, Zhu C, Howden M, Wilson LT. Food security and climate change: on the potential to adapt global crop production by active selection to rising atmospheric carbon dioxide. Proc Biol Sci 2012; 279(1745):4097-4105.

37 Molyneux N, Da Cruz GR, Williams RL, Andersen R, Turner NC. Climate change and population growth in Timor Leste: implications for food security. Ambio 2012; 41(8):823-840.

38 Wesche SD, Chan HM. Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic. Eco Health 2010; 7(3):361-373.

39 Su YY, Weng YH, Chiu YW. Climate change and food security in East Asia. Asia Pac J Clin Nutr 2009; 18(4):674-678.

40 Gregory PJ, Johnson SN, Newton AC, Ingram JS. Integrating pests and pathogens into the climate change/food security debate. J Exp Bot 2009; 60(10):2827-2838.

41 Catford J. Food security, climate change and heath promotion: opening up the streams not just helping out down stream. Health Promot Int 2008; 23(2):105-108.

42 Lobell DB, Burke MB, Tebaldi C, Mastrandrea MD, Falcon WP, Naylor RL. Prioritizing climate change adaptation needs for food security in 2030. Science 2008; 319(5863):607-610.^-4343 Lal R. Soil carbon sequestration impacts on global climate change and food security. Science 2004; 304(5677):1623-1627., considering that most of these covers especially the direct and indirect effects of climate changes on food production⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,1919 Lauria V, Das I, Hazra S, Cazcarro I, Arto I, Kay S, Ofori-Danson, P, Ahmed M, Hossain MAR, Barange M, Fernandes JA. Importance of fisheries for food security across three climate change vulnerable deltas. Sci Total Environ 2018; 640:1566-1577.^,2020 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.^,2222 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465.

23 Mcelhinney J. Influencing the agricultural sector to embrace adaptation to climate change, for the sake of global food security. Environ Sci Pollut Res Int 2016; 23(9):9245-9246.

24 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.^-2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,3131 Considine MJ, Siddique KH, Foyer CH. Nature's pulse power: legumes, food security and climate change. J Exp Bot 2017; 68(8):1815-1818.^,3333 Mayala BK, Fahey CA, Wei D, Zinga MM, Bwana VM, Mlacha T, Rumisha SF, Stanley G, Shayo EH, Mboera LE. Knowledge, perception and practices about malaria, climate change, livelihoods and food security among rural communities of central Tanzania. Infect Dis Poverty 2015; 4(1):21.^,3838 Wesche SD, Chan HM. Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic. Eco Health 2010; 7(3):361-373.^,3939 Su YY, Weng YH, Chiu YW. Climate change and food security in East Asia. Asia Pac J Clin Nutr 2009; 18(4):674-678., which vary from one region to the other, taking into account the vulnerability of the territory and population. The direct effects are due to alterations on the agroecological conditions (increases in temperature, frequency and severity of extreme events, river levels, CO₂ concentrations in the atmosphere, soil erosions, changes to the water cycle, alterations in the cycles of vectors and pests)³⁴34 Rhodes CJ. Soil erosion, climate change and global food security: challenges and strategies. Sci Prog 2014; 97(2):97-153.^,4040 Gregory PJ, Johnson SN, Newton AC, Ingram JS. Integrating pests and pathogens into the climate change/food security debate. J Exp Bot 2009; 60(10):2827-2838.^,4343 Lal R. Soil carbon sequestration impacts on global climate change and food security. Science 2004; 304(5677):1623-1627. that reduce the productivity of plantations¹¹11 Myers SS, Smith MR, Guth S, Golden CD, Vaitla B, Mueller ND, Dangour AD, Huybers P. Climate change and global food systems: potential impacts on food security and undernutrition. Annu Rev Public Health 2017; 38:259-277.^,2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,3737 Molyneux N, Da Cruz GR, Williams RL, Andersen R, Turner NC. Climate change and population growth in Timor Leste: implications for food security. Ambio 2012; 41(8):823-840. and loss of animals¹¹11 Myers SS, Smith MR, Guth S, Golden CD, Vaitla B, Mueller ND, Dangour AD, Huybers P. Climate change and global food systems: potential impacts on food security and undernutrition. Annu Rev Public Health 2017; 38:259-277.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1919 Lauria V, Das I, Hazra S, Cazcarro I, Arto I, Kay S, Ofori-Danson, P, Ahmed M, Hossain MAR, Barange M, Fernandes JA. Importance of fisheries for food security across three climate change vulnerable deltas. Sci Total Environ 2018; 640:1566-1577.^,3232 Beerling DJ. Enhanced rock weathering: biological climate change mitigation with co-benefits for food security? Biol Lett 2017; 13(4):20170149.. Indirect effects affect the income distribution of producers. The relationship between the effects of climate changes and the populational growth (higher demand) and less availability of food²⁰20 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.^,3535 Godber OF, Wall R. Livestock and food security: vulnerability to population growth and climate change. Glob Chang Biol 2014; 20(10):3092-3102. is also discussed.

The availability dimension corresponds to the existence of sufficient quantities of food with an adequate quality, provided by means of the country’s production or through imports, including food aid²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017..

Populational growth and changes in food habits, with emphasis on a higher consumption of meat, dairy, and ultra-processed products, increased the demand for food. However, the increase of non-food related factors, such as the use of biofuels, urbanization, soil erosion, and climate changes have a potential influence on the FNS, especially food availability²²22 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465..

The direct and indirect effects of climate changes on agricultural productivity are also discussed: direct - climate variabilities (droughts and floods); and indirect - through pests and diseases, average increase of the sea levels, and change in water availability⁴⁴44 Gornall J, Betts R, Burke E, Clark R, Camp J, Willett K, Wiltshire A. Implications of climate change for agricultural productivity in the early twenty-first century. Philos Trans R Soc Lond B Biol Sci 2010; 365(1554):2973-2989..

There is strong evidence that climate changes are driven by El Niño and play a fundamental role in reducing the yields of plantations, especially rice, wheat, and corn¹1 Butler CD. Food security in the Asia-Pacific: climate change, phosphorus, ozone and other environmental challenges. Asia Pac J Clin Nutr 2009; 18(4):590-597.^,33 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,4545 McMichael AJ, Campbell-Lendrum DH, Corvalan CF, Ebi KL, Githeko AK, Scheraga JD, Woodward A, editores. Climate change and human health: risks and responses. Geneva: WHO; 2003.^,4646 Intergovernmental Panel on Climate Change (IPCC). Climate Change 2007: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge: Cambridge University Press; 2007.. In addition, they might reduce both the area and quality of farmlands, mainly in Africa⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708., and affect the production of fish products as well as cattle raising¹²12 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028..

Discussion around the vulnerabilities is relevant when approaching the interface between climate changes and FNS. Countries such as South Africa, which present overlapping vulnerabilities (a tendency to droughts, poverty, social inequalities, lack of access to education, absence of public policies, etc.), will suffer the effects of climate variabilities on the FNS in a more frequent and intense way²⁰20 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.. Studies affirm that the entire Africa and South Asia might undergo a reduction of 8% in food production by 2050²⁵25 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513..

A recent publication in Lancet⁴⁷47 Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika S, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed P, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. Lancet 2019; 393(10173):791-846. pointed out to two types of poor nutrition, malnutrition and obesity, and the climate changes as three simultaneous pandemics resulting in effects on human health. These three pandemics represent the Global Syndemic, which affects most of the people in every country and region of the world. For example, the food systems not only drive the obesity and malnutrition pandemics, but also generate between 25% and 30% of greenhouse gas emissions, deforestation, biodiversity loss, and soil degradation, factors that influence climate changes. On their turn, climate changes affect the food systems, resulting in alterations in consumption and food habits, and consequently in poor nutrition and FNS.

Considering this context, the increase of malnutrition is higher in countries of low and medium income due to the reduction in food production caused by extreme weather events. Richer countries, because of the urbanization processes, accelerated industrialization, and consequently higher emissions of greenhouse gases, show a higher prevalence of obesity when compared to countries of low and medium income. Changes in food habits should also be considered, such as an increase in the consumption of dairy products, meats, and ultra-processed foods, which, on their turn, also favor the emission of greenhouse gases.

Although the direct effects of climate changes in the productivity of crops are broadly studied, there are still important limitations when studying the impacts on food availability. First of all, these studies that map the negative effects of climate changes on plantations focus on the main cereals plus some roots and tubers. Second, the studies do not assess the effects of climate changes on cattle raising (changes on the pasture productivity, the quality of pasture, and cattle feeding). Lastly, the studies on plantations are less precise for extreme weather, which might have even more important consequences for the crops’ yields²⁵25 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513..

Utilization

Utilization was covered by 9 papers¹²12 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,2020 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.^,2222 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465.^,2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,2727 Janes CR. Failed development and vulnerability to climate change in Central Asia: implications for food security and health. Asia Pac J Public Health 2010; 22(Supl. 3):236S-245S.^,2828 Brown ME, Funk CC. Food security under climate change. Science 2008; 319(5863):580-581.^,3838 Wesche SD, Chan HM. Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic. Eco Health 2010; 7(3):361-373.^,4848 Guyot M, Dickson C, Paci C, Furgal C, Chan HM. Local observations of climate change and impacts on traditional food security in two northern Aboriginal communities. Int J Circumpolar Health 2006; 65(5):403-415., focusing on the effect of climate changes on food consumption, nutritional quality, and their social value. Nutritional quality¹²12 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,2222 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465.^,3838 Wesche SD, Chan HM. Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic. Eco Health 2010; 7(3):361-373.^,4848 Guyot M, Dickson C, Paci C, Furgal C, Chan HM. Local observations of climate change and impacts on traditional food security in two northern Aboriginal communities. Int J Circumpolar Health 2006; 65(5):403-415. may be affected both by reduced concentrations of micronutrients (zinc, iron, phosphor, potassium, calcium, sulfur, magnesium, copper, and manganese) in different food cultures, as well as by reduced ingestion of fruits, vegetables, nuts, seeds, and fish, foods rich in essential nutrients for the organism⁷7 Springmann M, Daniel Mason-D'croz MA, Sherman R, Tara G, Godfray HCJ, Gollin D, Rayner M, Ballon P, Scarborough P. Global and regional health effects of future food production under climate change: a modelling study. Lancet 2016; 387(10031):1937-1946.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,3838 Wesche SD, Chan HM. Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic. Eco Health 2010; 7(3):361-373.^,4949 Sá JCM, Lal R, Cerri CC, Lorenz K, Hungria M, Carvalho PCF. Low-carbon agriculture in South America to mitigate global climate change and advance food security. Environ Int 2017; 98:102-112..

Although the impacts on the utilization of food are less studied, when compared to the other dimensions, studies suggest that climate changes have a negative effect on the nutritional quality of food³3 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018., which influences the life conditions, nutritional status, and health of the individuals²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017..

Myers et al.¹²12 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028. suggest that climate changes cause a reduction in the food production/harvest, including the fishing sector, which makes millions of people more vulnerable to nutritional deficits, mainly the poorer, directly affecting their health.

As occurs with the previous dimensions, utilization contributes for statuses of poor nutrition (malnutrition, micronutrients deficiency, and obesity) and, consequently, for alterations in growth, cognitive development, immune system, and a higher risk of non-transmissible diseases (arterial hypertension, diabetes mellitus, cancer), especially in vulnerable groups such as newborns, children under 5 years, breastfeeding women, and elders²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017.. Children in situation of poverty tend to be shorter in stature and present severe nutritional consequences as a result of climate changes on the access, production, and utilization of food²⁷27 Janes CR. Failed development and vulnerability to climate change in Central Asia: implications for food security and health. Asia Pac J Public Health 2010; 22(Supl. 3):236S-245S..

Studies carried out in Bangladesh and Indonesia have shown that climate changes affected the production and caused an increase in the price of rice, a situation associated with the increased prevalence of low weight on children, directly affecting their nutritional status²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017.^,33 Food and Agriculture Organization of the United Nations (FAO). International Fund for Agricultural Development (IFAD). The United Nations Children's Fund (UNICEF). World Food Programme (WFP). World Health Organization (WHO). The state of food security and nutrition in the world 2018. Building climate resilience for food security and nutrition. Roma: FAO; 2018..

Stability

Stability corresponds to the guarantee of availability, access, and adequate use of food by individuals and, therefore, encompasses the other 3 dimensions. This analysis opted for selecting the papers that focused on the volatility of food prices.

This was the category with the least number of publications: 6 papers⁴4 Gregory PJ, Ingram JS, Brklacich M. Climate change and food security. Philos Trans R Soc Lond B Biol Sci 2005; 360(1463):2139-2148.^,55 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,2828 Brown ME, Funk CC. Food security under climate change. Science 2008; 319(5863):580-581.^,5050 Brown ME, Hintermann B, Higgins N. Markets, climate change, and food security in West Africa. Environ Sci Technol 2009; 43(21):8016-8020., which discussed the relationship between climate changes and the reduction of agricultural production as well as the quantity of food available in the food systems, which alters the food prices (volatility)⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,1212 Whitmee S, Haines A, Beyrer C, Boltz F, Capon AG, Dias BFS, Ezeh A, Frumkin H, Gong P, Head P. Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation - Lancet Commission on Planetary Health. Lancet 2015; 386:1973-2028.^,2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513., especially in rural areas⁵⁰50 Brown ME, Hintermann B, Higgins N. Markets, climate change, and food security in West Africa. Environ Sci Technol 2009; 43(21):8016-8020..

In general, the urbanization processes, depletion of natural resources, soil occupation, deforestation, climate changes, and natural disasters are factors that affect the access, availability, and utilization of food, and, therefore, the stability of food systems²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017..

Climate changes affect the stability of food systems as the weather is an important determiner in the patterns of production, offer, and demand for food, resulting in short-term and long-term price variabilities, mainly in poorer and more vulnerable populations²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017.^,2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.. With the occurrence of natural disasters, such as droughts and floods, the food production is harmed and/or there is also a reduction of farmlands, creating relevant impacts on the food systems. About 25% of the negative economic impacts of disasters reflect on the agricultural sector, which becomes a threat to FNS.

The variability of food prices has a direct impact on the more vulnerable populations, considering that the expenses with food represent a higher proportion of their income and they tend to have a smaller capacity/possibility to change their consumption patterns, forcing them to consume food with lower nutritional quality. On the other hand, the drop in food prices causes small producers to suffer with significant fluctuations on their income and have lower access to technologies, infrastructure, and resources to deal with the volatility of prices, generating significant costs to the food systems²2 Organização da Nações Unidas para a Alimentação e a Agricultura (FAO). Organização Pan-Americana da Saúde (OPAS). América Latina e Caribe. Panorama da Segurança alimentar e nutricional. Sistemas Alimentares sustentáveis para acabar com a fome e a má nutrição. Santiago: FAO; 2017..

The elasticity of food prices associated with the lack of stability of food systems arising from climate changes results in a reduced consumption of all food groups and, consequently, in situations of food and nutrition insecurity, especially in more vulnerable populations.

This way, it is possible to affirm that climate changes also influence the stability of the food system, considering that this dimension is transverse to the other three (access, availability, utilization). This situation generates a higher consumption of food with low nutritional quality, such as processed and ultra-processed products, directly affecting the nutritional status of individuals (higher prevalence of overweight/obesity). Besides, alterations in stability cause lower access and production of food (quantity), causing nutritional deficiencies and malnutrition¹⁶16 Raiten DJ, Aimone AM. The intersection of climate/environment, food, nutrition and health: crisis and opportunity. Curr Opin Biotechnol 2017; 44:52-62.^,4747 Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika S, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed P, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. Lancet 2019; 393(10173):791-846.. Both situations alter the FNS, resulting in the different types of poor nutrition.

Recent data demonstrate that 672 million adult individuals are obese (13.3% of the total population in this age group) and suffer from the consequences of excess weight. At the same time, 821 million people around the world are famish, whereas 2 billion live in a situation of severe/moderate food insecurity⁴⁷47 Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika S, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed P, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. Lancet 2019; 393(10173):791-846.^,5151 Organização das Nações Unidas para Alimentação e Agricultura (FAO). The stage of food security and nutrition in the world: safeguarding against economics slowdowns and downturns. Roma: FAO; 2019..

It is worth emphasizing that climate changes may increase the number of people under risk of starvation by 20% until 2050⁵²52 Hallegatte S, Bangalore M, Bonzanigo L, Fay M, Kane T, Narloch U, Rozenberg J, Vogt-Schilb A. Climate change and poverty [Internet]. Climate Change Group 2014, World Bank Group [cited 2019 mar 13]. Available from: http://www.worldbank.org/content/dam/Worldbank/document/Climate/Climate%20and%20Poverty%20Conference/D1S1_Hallegatte_CCandPov_9Fev_v6.pdf.
http://www.worldbank.org/content/dam/Wor... , which will cause a non-compliance with the 2^nd SDG: “End hunger, achieve food security and improved nutrition, and promote sustainable agriculture”¹⁸18 Organização das Nações Unidas (ONU). Transformando nosso mundo: a agenda 2030 para o desenvolvimento sustentável. Brasília: ONU; 2015..

Figure 2 brings the main impacts of climate changes on the FNS.

Mitigation/adaptation strategies

The mitigation/adaptation strategies category had the second higher number of publications, comprising 24 papers⁴4 Gregory PJ, Ingram JS, Brklacich M. Climate change and food security. Philos Trans R Soc Lond B Biol Sci 2005; 360(1463):2139-2148.^,55 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,2020 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.

21 Mugambiwa SS, Tirivangasi HM. Climate change: A threat towards achieving 'Sustainable Development Goal number two' (end hunger, achieve food security and improved nutrition and promote sustainable agriculture) in South Africa. Jamba 2017; 9(1):350.

22 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465.

23 Mcelhinney J. Influencing the agricultural sector to embrace adaptation to climate change, for the sake of global food security. Environ Sci Pollut Res Int 2016; 23(9):9245-9246.

24 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.^-2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,2828 Brown ME, Funk CC. Food security under climate change. Science 2008; 319(5863):580-581.^,3131 Considine MJ, Siddique KH, Foyer CH. Nature's pulse power: legumes, food security and climate change. J Exp Bot 2017; 68(8):1815-1818.^,3434 Rhodes CJ. Soil erosion, climate change and global food security: challenges and strategies. Sci Prog 2014; 97(2):97-153.

35 Godber OF, Wall R. Livestock and food security: vulnerability to population growth and climate change. Glob Chang Biol 2014; 20(10):3092-3102.

36 Ziska LH, Bunce JA, Shimono H, Gealy DR, Baker JT, Newton PC, Newton PCD, Reynolds MP, Jagadish KSV, Zhu C, Howden M, Wilson LT. Food security and climate change: on the potential to adapt global crop production by active selection to rising atmospheric carbon dioxide. Proc Biol Sci 2012; 279(1745):4097-4105.

37 Molyneux N, Da Cruz GR, Williams RL, Andersen R, Turner NC. Climate change and population growth in Timor Leste: implications for food security. Ambio 2012; 41(8):823-840.

38 Wesche SD, Chan HM. Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic. Eco Health 2010; 7(3):361-373.^-3939 Su YY, Weng YH, Chiu YW. Climate change and food security in East Asia. Asia Pac J Clin Nutr 2009; 18(4):674-678.^,4141 Catford J. Food security, climate change and heath promotion: opening up the streams not just helping out down stream. Health Promot Int 2008; 23(2):105-108.^,4343 Lal R. Soil carbon sequestration impacts on global climate change and food security. Science 2004; 304(5677):1623-1627.^,4949 Sá JCM, Lal R, Cerri CC, Lorenz K, Hungria M, Carvalho PCF. Low-carbon agriculture in South America to mitigate global climate change and advance food security. Environ Int 2017; 98:102-112.^,5050 Brown ME, Hintermann B, Higgins N. Markets, climate change, and food security in West Africa. Environ Sci Technol 2009; 43(21):8016-8020.^,5353 O'Mara FP. The role of grasslands in food security and climate change. Ann Bot 2012; 110(6):1263-1270.

54 Hannah L, Ikegami M, Hole DG, Seo C, Butchart SH, Peterson AT, Roehrdanz, PR. Global climate change adaptation priorities for biodiversity and food security. PLoS One 2013; 8(8):72590.^-5555 Palm CA, Smukler SM, Sullivan CC, Mutuo PK, Nyadzi GI, Walsh MG. Identifying potential synergies and trade-offs for meeting food security and climate change objectives in sub-Saharan Africa. Proc Natl Acad Sci 2010; 107(46):19661-19666..

Mitigation/adaptation strategies aim at making the food systems more resilient to climate changes in the future, namely: the implementation of public policies³⁹39 Su YY, Weng YH, Chiu YW. Climate change and food security in East Asia. Asia Pac J Clin Nutr 2009; 18(4):674-678., agricultural development plans, market protection laws, opening of local markets and agricultural subsidies⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,4141 Catford J. Food security, climate change and heath promotion: opening up the streams not just helping out down stream. Health Promot Int 2008; 23(2):105-108., as well as maintenance and recovery of affected soils⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,2020 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.^,3535 Godber OF, Wall R. Livestock and food security: vulnerability to population growth and climate change. Glob Chang Biol 2014; 20(10):3092-3102.^,3939 Su YY, Weng YH, Chiu YW. Climate change and food security in East Asia. Asia Pac J Clin Nutr 2009; 18(4):674-678.; adaptation of planting to the periods of precipitation; increased use of irrigation²⁰20 Masipa TS. The impact of climate change on food security in South Africa: Current realities and challenges ahead. Jamba 2017; 9(1):411.; increase in crop rotation and variety³⁷37 Molyneux N, Da Cruz GR, Williams RL, Andersen R, Turner NC. Climate change and population growth in Timor Leste: implications for food security. Ambio 2012; 41(8):823-840.; use of inorganic fertilizers and low-carbon agriculture; fortification and biofortification; pest control; reforestation; technological innovations (genetics, biotechnology, and agronomy), and the use of biofuels⁵5 Schmidhuber J, Tubiello FN. Global food security under climate change. Proc Natl Acad Sci USA 2007; 104(50):19703-19708.^,1515 Lake IR, Hooper L, Abdelhamid A, Bentham G, Boxall AB, Draper A, Fairweather-Tait S, Hulme M, Hunter PR, Nichols G, Waldron KW. Climate change and food security: health impacts in developed countries. Environ Health Perspect 2012; 120(11):1520-1526.^,2222 Kumar M. Impact of climate change on crop yield and role of model for achieving food security. Environ Monit Assess 2016; 188(8):465.^,2424 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.^,2525 Wheeler T, Von Braun J. Climate change impacts on global food security. Science 2013; 341(6145):508-513.^,2828 Brown ME, Funk CC. Food security under climate change. Science 2008; 319(5863):580-581.^,3131 Considine MJ, Siddique KH, Foyer CH. Nature's pulse power: legumes, food security and climate change. J Exp Bot 2017; 68(8):1815-1818.^,3636 Ziska LH, Bunce JA, Shimono H, Gealy DR, Baker JT, Newton PC, Newton PCD, Reynolds MP, Jagadish KSV, Zhu C, Howden M, Wilson LT. Food security and climate change: on the potential to adapt global crop production by active selection to rising atmospheric carbon dioxide. Proc Biol Sci 2012; 279(1745):4097-4105.^,4343 Lal R. Soil carbon sequestration impacts on global climate change and food security. Science 2004; 304(5677):1623-1627.^,4949 Sá JCM, Lal R, Cerri CC, Lorenz K, Hungria M, Carvalho PCF. Low-carbon agriculture in South America to mitigate global climate change and advance food security. Environ Int 2017; 98:102-112.^,5050 Brown ME, Hintermann B, Higgins N. Markets, climate change, and food security in West Africa. Environ Sci Technol 2009; 43(21):8016-8020.^,5353 O'Mara FP. The role of grasslands in food security and climate change. Ann Bot 2012; 110(6):1263-1270.^,5555 Palm CA, Smukler SM, Sullivan CC, Mutuo PK, Nyadzi GI, Walsh MG. Identifying potential synergies and trade-offs for meeting food security and climate change objectives in sub-Saharan Africa. Proc Natl Acad Sci 2010; 107(46):19661-19666..

The discussion on the union between the adaptation needs related to maintaining agricultural productivity and the ecosystem integrity, aimed at reducing poverty, protecting the agricultural production, and the ecosystem services, is also present in the studies as an adaptation and mitigation strategy (agroforestry)⁵⁴54 Hannah L, Ikegami M, Hole DG, Seo C, Butchart SH, Peterson AT, Roehrdanz, PR. Global climate change adaptation priorities for biodiversity and food security. PLoS One 2013; 8(8):72590..

The papers also mention the need to implement effective alert and alarm systems and monitoring tools to assist with the decision-making process in order to protect the agricultural production²⁸28 Brown ME, Funk CC. Food security under climate change. Science 2008; 319(5863):580-581.. Added to that, they point out to the need to prepare integrated plans for the prevention, protection, response, and rehabilitation of the exposed areas with social participation³⁶36 Ziska LH, Bunce JA, Shimono H, Gealy DR, Baker JT, Newton PC, Newton PCD, Reynolds MP, Jagadish KSV, Zhu C, Howden M, Wilson LT. Food security and climate change: on the potential to adapt global crop production by active selection to rising atmospheric carbon dioxide. Proc Biol Sci 2012; 279(1745):4097-4105.^,3939 Su YY, Weng YH, Chiu YW. Climate change and food security in East Asia. Asia Pac J Clin Nutr 2009; 18(4):674-678.^,5050 Brown ME, Hintermann B, Higgins N. Markets, climate change, and food security in West Africa. Environ Sci Technol 2009; 43(21):8016-8020.. However, it requires the civil society to be aware and capable in what concerns the risks and actions for preparation, response, and communication of risks by means of educational and sustainable practices²¹21 Mugambiwa SS, Tirivangasi HM. Climate change: A threat towards achieving 'Sustainable Development Goal number two' (end hunger, achieve food security and improved nutrition and promote sustainable agriculture) in South Africa. Jamba 2017; 9(1):350.^,2323 Mcelhinney J. Influencing the agricultural sector to embrace adaptation to climate change, for the sake of global food security. Environ Sci Pollut Res Int 2016; 23(9):9245-9246.^,2424 Gross M. Food security in the times of climate change. Curr Biol 2013; 23(1):R1-R4.^,3838 Wesche SD, Chan HM. Adapting to the impacts of climate change on food security among Inuit in the Western Canadian Arctic. Eco Health 2010; 7(3):361-373..

Lipper et al.⁵⁶56 Lipper L, Thornton P, Campbell BM, Baedeker T, Braimoh A, Bwalya M, Bwalya M, Caron P, Cattaneo A, Garrity D, Henry K, Hottle R, Jackson L, Jarvis A, Kossam F, Mann W, McCarthy N, Meybeck A, Neufeldt H, Remington T, Thi Sen P, Sessa R, Shula R, Tibu A, Torquebiau EF Climate-smart agriculture for food security. Nat Clim Chang 2014; 4(12):1068. point out to the importance of coordinated actions involving multiple actors (farmers, civil society, researchers, private sector, and managers) to build the resilience against climate changes and propose the implementation of the climate-smart agriculture (CSA). CSA is a weather-resilient/resistant agriculture anchored on sustainable agricultural practices aimed at increasing productivity and income, resilience of the means of subsistence and the ecosystems, and reducing/removing greenhouse gases from the atmosphere⁵⁷57 Campbell BM, Thornton P, Zougmore R, Asten P, Lipper L. Sustainable intensification: what is its role in climate smart agriculture? Curr Opin Environ Sustain 2014; 8:39-43., thus transversely contributing towards the SDG. According to the FAO, CSA is the key for FNS against the challenges of climate changes⁵⁸58 Food and Agriculture Organization of the United Nations (FAO). Climate smart agriculture managing ecosystems for sustainable livelihoods [Internet]. [cited 2019 mar 13]. Available from: http://www.fao.org/3/a-an177e.pdf.
http://www.fao.org/3/a-an177e.pdf... .

The transformation of the agricultural sector is urgent and fundamental for responding to the climate changes. According to the FAO⁵⁹59 Food and Agriculture Organization of the United Nations (FAO). Evaluation of FAO's contribution to Climate Change Adaptation and Mitigation. Final Report. Annexes [Internet]. FAO; 2015 [cited 2019 mar 13]. Available from: http://www.fao.org/3/a-bd719e.pdf.
http://www.fao.org/3/a-bd719e.pdf... , such purpose requires increasing the investments on research about the effects of climate changes on agriculture; the monitoring of climate data/information and alert/alarm systems that allow anticipating actions and reducing damages (mapping, statistic models, etc.); besides agricultural credit, dissemination of knowledge on the subject, involvement of the private sector for the implementation of sustainable agricultural techniques, access to agricultural insurance, and the organization of cooperatives⁵⁸58 Food and Agriculture Organization of the United Nations (FAO). Climate smart agriculture managing ecosystems for sustainable livelihoods [Internet]. [cited 2019 mar 13]. Available from: http://www.fao.org/3/a-an177e.pdf.
http://www.fao.org/3/a-an177e.pdf... ^,5959 Food and Agriculture Organization of the United Nations (FAO). Evaluation of FAO's contribution to Climate Change Adaptation and Mitigation. Final Report. Annexes [Internet]. FAO; 2015 [cited 2019 mar 13]. Available from: http://www.fao.org/3/a-bd719e.pdf.
http://www.fao.org/3/a-bd719e.pdf... .

It is important to emphasize that “climate action” is one of the 17 SDG of the government agendas by 2030¹⁸18 Organização das Nações Unidas (ONU). Transformando nosso mundo: a agenda 2030 para o desenvolvimento sustentável. Brasília: ONU; 2015..

Considering the analytical categories discussed above, a chart was prepared comprising a summary of the main results found in this study (Chart 1).

Study locations

Aimed at contextualizing the theme within the international scenario, the places of publication of the 34 papers deemed eligible for the study were also analyzed (Figure 3).

Figure 3 shows that the studies found were predominantly carried out in countries from Africa and Asia, the two (2) most populous continents in the world, considering that some papers deemed eligible for the study (14 in total) did not have information about localization.

Africa

The African continent is the second most populous continent in the world, with over 60% of its population living in rural areas. It is poor, little industrialized, and has low rates of economic development. Its riches represent 1% of the world’s Gross National Product (GNP) and the GNP per capita is around US$ 915.00. The main issues are: hunger, epidemics (especially HIV), and ethnical conflicts. Social indicators are not good as well, with a population of around 40% illiterates and a child mortality rate that reaches 100-200 thousand deaths for every 1000 births (the highest in the world). Added to that, the continent is home to 1/3 of the world population in conditions of extreme poverty, and 7 out of the 10 countries with the highest inequality rates in the world are located in the African continent⁶⁰60 Beegle K, Christiaensen L, Dabalen A, Gaddis I. Poverty in a rising Africa [Internet]. The World Bank; 2016 [cited 2019 mar 13]. Available from: https://openknowledge.worldbank.org/handle/10986/22575.
https://openknowledge.worldbank.org/hand... .

As regards FNS, the Hunger Map published by the World Food Programme (WFP) in 2018⁶¹61 World Food Programme (WFP). Hunger Map 2018 [Internet]. [cited 2019 mar 13]. Available from: https://docs.wfp.org/api/documents/WFP-0000098743/download/?_ga=2.77837533.837718209.1559262758-733728121.1559262758
https://docs.wfp.org/api/documents/WFP-0... presents the climate variability as one of the key points of world hunger and brings data on the prevalence of malnourished among the total population (%) in the period between 2015 and 2017. The African countries that appear in the publications deemed eligible to this study (most of them located in East Africa) predominantly have prevalence classified by the study as moderately high (15-24.9%), high (25-34.9%), and very high (35% or more), except for West Africa and South Africa, which have a moderately low prevalence (5-14.9%)⁶¹61 World Food Programme (WFP). Hunger Map 2018 [Internet]. [cited 2019 mar 13]. Available from: https://docs.wfp.org/api/documents/WFP-0000098743/download/?_ga=2.77837533.837718209.1559262758-733728121.1559262758
https://docs.wfp.org/api/documents/WFP-0... . That is, around 20% of the African population starves due to several causes, among which the effects of climate changes on the continent’s agricultural production.

It can be concluded that the African continent has a wide range of vulnerabilities: social, economic, and nutritional, among others not emphasized by this study. It is known that risk varies from one place to the other and the impacts can also be disproportional from one place to the other. This is mainly due to the fact that the places have different capacities to prepare, respond, and recover in the face of adverse situations, besides diverse exposure patterns. That is to say that a high vulnerability is potentialized by a low capacity of confrontation/response. Considering this scenario, it is also important to mention the high number of natural disasters that affected the African continent over the last years. Data from 2017 indicate Africa as the 3^rd continent in number of natural disasters recorded around the world, and the second in number of fatal victims of natural disasters in that year: 1 out of 5 fatal victims of natural disasters in the world are from the African continent⁶²62 Centre for Research on the Epidemiology of Disasters (CRED). Annual Statistical Review - 2017 [Internet]. CRED; 2018 [cited 2019 mar 13]. Available from: https://www.cred.be/annual-disaster-statistical-review-2017.
https://www.cred.be/annual-disaster-stat... .

Asia

Asia is the largest continent in the planet and also the most populous, with around 60% of the entire world population. Most of the Asian countries are in a situation of extreme poverty, in contrast with small clans that own large riches, what makes social inequality a huge problem in the continent.

Among the social indicators, it is important to emphasize that 1 out of 5 Asians is illiterate and that the child mortality rate in the continent reaches 115 in Afghanistan (one of the highest in the world ranking). Added to that, the continent faces problems such as: maternal mortality, sexual violence, armed conflicts, public health emergencies.

The Asian countries that appear in the publications deemed eligible for this study appear in the Hunger Map⁶¹61 World Food Programme (WFP). Hunger Map 2018 [Internet]. [cited 2019 mar 13]. Available from: https://docs.wfp.org/api/documents/WFP-0000098743/download/?_ga=2.77837533.837718209.1559262758-733728121.1559262758
https://docs.wfp.org/api/documents/WFP-0... , with prevalence of malnourished among the total population between moderately high (15-24.9%) and high (25-34.9%), except for India that presented a prevalence classified as moderately low (5-14.9%). This shows us that FNS is an important issue in the continent⁶¹61 World Food Programme (WFP). Hunger Map 2018 [Internet]. [cited 2019 mar 13]. Available from: https://docs.wfp.org/api/documents/WFP-0000098743/download/?_ga=2.77837533.837718209.1559262758-733728121.1559262758
https://docs.wfp.org/api/documents/WFP-0... .

It can be concluded that, despite large world powers being located in Asia, the continent has an overlapping of vulnerabilities: social, economic, and nutritional, among others not emphasized by this study. This situation, associated with the increased frequency and intensity of natural disasters, one of the effects of climate changes, turns into a concern. In the year 2017, Asia was the continent with the highest number of natural disasters recorded in the world (40% of the total), and with the highest number of deaths (58%). Three of the 5 countries in the world ranking of fatal victims of natural disasters are Asian⁶²62 Centre for Research on the Epidemiology of Disasters (CRED). Annual Statistical Review - 2017 [Internet]. CRED; 2018 [cited 2019 mar 13]. Available from: https://www.cred.be/annual-disaster-statistical-review-2017.
https://www.cred.be/annual-disaster-stat... .

FNS x poverty x social inequality

The relationship between climate changes, poverty, and inequality is complex, multifaceted, and specific por each context analyzed. The first studies arose in 2017, when it was perceived that climate changes could increase poverty and deepen the preexisting inequalities through their adverse effects on agriculture and health. However, there is currently a consensus that this relationship is characterized by a vicious cycle that retro-feeds itself: the existing poverty causes, for instance, the unfavored or poorer populations to live in areas more prone or more exposed to different risks, including climate risks (geographic and environmental vulnerability), just as it causes these same individuals/groups in disadvantage to disproportionately suffer from the effects of the risks of climate changes or be more susceptible to them, considering that they have less resources to face them and recover from them. Once affected, the poorer populations become even more vulnerable, aggravating even more the pre-existing poverty and social inequality in the location/population and that will make them more exposed or more prone to new risk scenarios⁶³63 Islam SN, Winkel J. Climate Change and Social Inequality [Internet]. DESA Working Paper; 2017 [cited 2019 mar 13]. Available from: https://www.un.org/esa/desa/papers/2017/wp152_2017.pdf
https://www.un.org/esa/desa/papers/2017/... .

Added to that, there is also political vulnerability: less favored groups have less voice and representativity, being usually excluded from the decision arenas and, consequently, from public policies⁶³63 Islam SN, Winkel J. Climate Change and Social Inequality [Internet]. DESA Working Paper; 2017 [cited 2019 mar 13]. Available from: https://www.un.org/esa/desa/papers/2017/wp152_2017.pdf
https://www.un.org/esa/desa/papers/2017/... .

The effects on health are also important in this discussion, as people living in poverty conditions are more susceptible to diseases that the effects of climate changes help to propagate, including those related to vectors and contaminated water, besides having less access to health services⁶³63 Islam SN, Winkel J. Climate Change and Social Inequality [Internet]. DESA Working Paper; 2017 [cited 2019 mar 13]. Available from: https://www.un.org/esa/desa/papers/2017/wp152_2017.pdf
https://www.un.org/esa/desa/papers/2017/... .

Studies show that the poorer regions are more severely affected by climate threats than the rich ones. As well as people in social and demographic disadvantages, including those that face discrimination based on gender, age, race, social class, caste, are particularly more affected by the negative effects of these. Besides that, factors such as the type of occupation of the individual (a choice strongly influenced by their socioeconomic condition) might intensify the effects of climate changes. Example: a population that makes their living predominantly from agriculture and exercises field activities totally depending on the weather will suffer more from the effects of climate changes⁶³63 Islam SN, Winkel J. Climate Change and Social Inequality [Internet]. DESA Working Paper; 2017 [cited 2019 mar 13]. Available from: https://www.un.org/esa/desa/papers/2017/wp152_2017.pdf
https://www.un.org/esa/desa/papers/2017/... .

Considering this context, a point that draws attention is the inexistence of studies in Brazil about the effects of climate changes on FNS, once the country is considered 1 of the 10 hotspots for climate changes and where food insecurity, as well as poverty, is deemed a public health problem, especially by the unequal and inadequate conditions of access and distribution of food for the population⁵⁴54 Hannah L, Ikegami M, Hole DG, Seo C, Butchart SH, Peterson AT, Roehrdanz, PR. Global climate change adaptation priorities for biodiversity and food security. PLoS One 2013; 8(8):72590.^,6464 Marengo JA, Jones R, Alves LM, Valverde M. Future change of temperature and precipitation extremes in South America as derived from the PRECIS regional climate modeling system. Int J Climatol 2009; 29(15):2241-2255.^,6565 Ambrizzi T, Rocha RP, Marengo JA, Pisnitchenko I, Alves LM. Cenários regionalizados de clima no Brasil para o Século XXI: Projeções de clima usando três modelos regionais. Relatório 3. Brasília: MMA; 2007..

The current global food system drives the bad types of nutrition (malnutrition, nutritional deficiencies, overweight, and obesity) through larger emissions of greenhouse gases, deforestation, and soil degradation, biodiversity loss, massive use of pesticides, all these contributing for changes on the weather and the environment⁴⁷47 Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika S, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed P, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. Lancet 2019; 393(10173):791-846.. On their turn, climate changes cause alterations on the access, availability, utilization, and stability of the food systems, thus affecting the nutritional status of the populations and intensifying the several types of poor nutrition⁴⁷47 Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika S, Larijani B, Lobstein T, Long MW, Matsudo VKR, Mills SDH, Morgan G, Morshed P, Nece PM, Pan A, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: The Lancet Commission report. Lancet 2019; 393(10173):791-846.. This situation becomes even more serious and worrisome among those more vulnerable to FNS that have less capacity to adapt, not only to the variations in food production and prices, but also the effects of climate changes⁵¹51 Organização das Nações Unidas para Alimentação e Agricultura (FAO). The stage of food security and nutrition in the world: safeguarding against economics slowdowns and downturns. Roma: FAO; 2019..

It is worth emphasizing as a limitation of this study that the choice for one single database, in this case PubMed, might have resulted in losses for this research in terms of a reduced number of papers covered and revised. In view of that, it is necessary to broaden the studies and research about the relationship between climate changes, bad types of nutrition, and FNS.

Conclusion

The results of this study indicate that climate changes affect both directly as well as indirectly the four dimensions of FNS, especially in poorer populations⁴4 Gregory PJ, Ingram JS, Brklacich M. Climate change and food security. Philos Trans R Soc Lond B Biol Sci 2005; 360(1463):2139-2148.^,5050 Brown ME, Hintermann B, Higgins N. Markets, climate change, and food security in West Africa. Environ Sci Technol 2009; 43(21):8016-8020., and bring to discussion the mitigation/adaptation strategies to this new scenario.

Thirty four papers were deemed eligible for the study, which cover the interface between climate changes and FNS, in the period between 2004 and 2018, which generates an average of 2.2 papers per year and draws the attention to the gap that exists about the subject in the literature. However, the relevance of the theme for the FNS agenda raises concern on the urgency of public policies for social protection and incentives for research, especially in the poorest countries of the world, which will be the most affected ones. Such research should view the problem from a holistic perspective, focused on the construction of a food system that is more resilient/resistant to weather, and not only for issues related to agricultural production, in view that a sufficient and sustainable food production will not ensure that the population is free from hunger, and from the types of poor nutrition, such as malnutrition and obesity, despite it solves part of the problem⁵¹51 Organização das Nações Unidas para Alimentação e Agricultura (FAO). The stage of food security and nutrition in the world: safeguarding against economics slowdowns and downturns. Roma: FAO; 2019..

The absence of studies in Brazil draws the attention, as it is a country that suffered for decades with hunger and malnutrition, and which experienced progresses related to FNS in the period between 2004 and 2013 with the implementation of public policies of income transfer (“Bolsa Família (Family Grant)”, for instance) and public policies for FNS promotion, which resulted in the country leaving the Hunger Map in 2014⁶⁶66 Silva JG, Tavares L. Segurança alimentar e a alta dos preços dos alimentos: oportunidades e desafios. Segurança alimentar e nutricional. Campinas 2008; 15(1):62-75.

67 Vasconcelos FAG, Machado ML, Medeiros MAT, Neves JA, Recine E, Pasquim EM. Public policies of food and nutrition in Brazil: From Lula to Temer. Rev Nutr 2019; 32:e180161.^-6868 Organização das Nações Unidas para a Alimentação e a Agricultura (FAO Brasil). Estado da Segurança Alimentar e Nutricional no Brasil 2015. Agendas convergentes. Brasília: FAO Brasil; 2015.. Currently, Brazil experiences the dismantling of public policies by the federal government, besides strong budgetary restrictions for these agendas, regressions that could cause it to re-enter the Hunger Map⁶⁷67 Vasconcelos FAG, Machado ML, Medeiros MAT, Neves JA, Recine E, Pasquim EM. Public policies of food and nutrition in Brazil: From Lula to Temer. Rev Nutr 2019; 32:e180161..

It is concluded that the impacts of climate changes on FNS are real and consist of an obstacle to meet the 2030 agenda throughout the entire planet. In view of that, restructuring the food system is urgent, as well as the world agricultural profile, and a change in the food and consumption profile of the population, in order to face the negative effects of climate changes.

At last, it is necessary to prepare and implement public policies capable of articulating different government agendas, regardless of the political arena at the time, aimed at ensuring the human right to and adequate and healthy eating.

References

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History