# One Health Approach to Nutritional Status and Well-Being in Food Supply Chain Workers: A Study Protocol

## TL;DR

This study protocol explores how a One Health approach can improve the health and well-being of food supply chain workers in Italy.

## Contribution

It introduces a multidimensional One Health framework integrating nutritional, psychological, and biochemical indicators in occupational health.

## Key findings

- The protocol integrates bioelectrical impedance vector analysis with nutritional and psychological measures.
- It aims to identify high-risk worker subgroups for targeted interventions.
- The study will compare active workers with sedentary individuals to assess health differences.

## Abstract

Public health relevance—How does this work relate to a public health issue?
This protocol is motivated by the high burden of workplace accidents and musculoskeletal disorders among food-supply chain workers, a sector of major importance for public health and economic stability in Italy.It targets conditions that are among the leading global causes of disability, long-term functional impairment, and healthcare utilization.

This protocol is motivated by the high burden of workplace accidents and musculoskeletal disorders among food-supply chain workers, a sector of major importance for public health and economic stability in Italy.

It targets conditions that are among the leading global causes of disability, long-term functional impairment, and healthcare utilization.

Public health significance—Why is this work of significance to public health?
It applies a multidimensional “One Health” approach that integrates nutritional, psychological, biochemical, and body-composition indicators domains that are rarely assessed together in real-world occupational settings.The generation of harmonized and reproducible data will support system-level prevention strategies aimed at reducing avoidable disability, sick leave, and downstream healthcare costs in the food supply chain sector.

It applies a multidimensional “One Health” approach that integrates nutritional, psychological, biochemical, and body-composition indicators domains that are rarely assessed together in real-world occupational settings.

The generation of harmonized and reproducible data will support system-level prevention strategies aimed at reducing avoidable disability, sick leave, and downstream healthcare costs in the food supply chain sector.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
The protocol provides an operational framework for the early identification of high-risk worker subgroups, informing targeted nutritional and psychosocial preventive interventions.Its multidisciplinary design can assist policymakers and occupational health services in developing integrated surveillance and prevention systems tailored to the food-supply chain, strengthening workforce resilience and public health preparedness.

The protocol provides an operational framework for the early identification of high-risk worker subgroups, informing targeted nutritional and psychosocial preventive interventions.

Its multidisciplinary design can assist policymakers and occupational health services in developing integrated surveillance and prevention systems tailored to the food-supply chain, strengthening workforce resilience and public health preparedness.

The agri-food supply chain is a relevant contributor to the Italian economy but shows a high incidence of occupational injuries and musculoskeletal disorders, such as lower back pain. Repetitive manual handling and biomechanical overload highlight the need for a prevention-oriented, system-level assessment. This protocol aims to implement a harmonized One Health approach procedure for the multidimensional evaluation of food supply chain workers in real-world settings. The protocol integrates bioelectrical impedance vector analysis (BIVA), nutritional parameters, quality-of-life and psychological measures, and assessments of systemic oxidative stress and systemic serotonin levels. Data from active workers will be compared with those from sedentary individuals. The study will evaluate whether BIVA profiles differ between these groups and examine how the additional indicators contribute to a multidimensional well-being framework. By operationalizing an integrated One Health approach that bridges nutritional, psychological, and biomarker domains, this protocol is designed to guide targeted preventive and educational strategies and inform evidence-based occupational and public health policies across the food supply chain. Trial registration: NCT06896877 (ClinicalTrials.gov), 26 March 2025.