Ancestral knowledge in agriculture and traditional medicine in the Mesoamerican Region: A review from a One Health perspective

Abstract Background : Ancestral knowledge systems are complex frameworks of understanding developed by Indigenous peoples through long-term interactions with their natural environments. In Mesoamerica, these systems have played a central role in traditional agriculture and medicine and remain relevant for addressing contemporary challenges related to sustainability, food security, and health. Methods : An exploratory narrative literature review was conducted to examine the relationship between ancestral agricultural knowledge and traditional medicine in Mesoamerica through a One Health perspective. Literature was searched in PubMed, Scopus, SciELO, Google Scholar, and regional academic repositories using English- and Spanish-language terms, complemented by gray literature and citation searching, with relevant sources screened by title, abstract, and full text. Results : The review identified traditional agricultural practices, diversified crop management systems, medicinal plant use, and ethnoveterinary practices with potential relevance to food security, environmental sustainability, and human and animal health. Across the literature, these practices illustrate context-specific pathways through which ancestral knowledge may interact with human, animal, and environmental dimensions of health and socioecological resilience. Increasing scientific interest has also focused on the phytochemical and pharmacological characterization of medicinal plants used in traditional healthcare systems. However, important limitations remain regarding the availability of clinical evidence supporting the efficacy and safety of many traditional remedies. Conclusions : The context-specific co-production of knowledge among Indigenous and local communities, researchers, and other relevant actors represents an important opportunity for strengthening One Health approaches in Mesoamerica. Such approaches may contribute to environmental sustainability, human and animal health, food sovereignty, and culturally appropriate development while supporting equitable dialogue among Indigenous, local, and scientific knowledge systems. The proposed framework emphasizes participatory knowledge co-production, ethical governance, and knowledge sovereignty, while recognizing the need for context-specific empirical and participatory evaluation before its effectiveness or transferability can be established. One Health impact statement This review highlights the relevance of ancestral and traditional knowledge systems to One Health in Mesoamerica by examining their relationships with human, animal, and environmental health within socioecological and biocultural contexts. It explores how traditional agricultural systems, medicinal plant knowledge, ethnoveterinary practices, and community-based environmental management may contribute to interconnected outcomes related to biodiversity conservation, food security, animal health, climate resilience, and human well-being. The review also proposes a conceptual framework for the ethical and participatory articulation of ancestral, traditional, and scientific knowledge systems, emphasizing knowledge co-production, intercultural dialogue, community authority, knowledge sovereignty, and context-specific evaluation. This perspective contributes to more equitable, participatory, and culturally responsive One Health research, practice, and governance in Mesoamerica.