Food Insecurity, Malnutrition, and the Microbiome
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GASTROENTEROLOGY, CRITICAL CARE, AND LIFESTYLE MEDICINE (SA MCCLAVE, SECTION EDITOR)
Food Insecurity, Malnutrition, and the Microbiome Vikram J. Christian 1
&
Keith R. Miller 2 & Robert G. Martindale 3
Accepted: 23 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Food insecurity is defined as the disruption of food intake or eating patterns because of lack of money and other resources. Although a relationship between food insecurity and malnutrition would seem intuitive, this relationship remains unclear. This review was aimed at summarizing the emerging evidence of the relationship between food insecurity, malnutrition, and intestinal microbial changes. Recent Findings Evidence suggests that malnutrition is certainly associated with alteration in the intestinal microbiome. Alternative theories have been proposed as to the nature of the alteration, whether that be a result of microbial immaturity, dysbiosis, or contributions from both processes. Summary Although the evidence continues to evolve, targeted nutritional therapies in conjunction with specific microbial therapy of probiotics or prebiotics may hold great promise for the treatment of malnutrition in the clinical and community settings. Keywords Food insecurity . Food desert . Hunger . Malnutrition . Microbiome . Microbial immaturity . Dysbiosis . Probiotic
Introduction: Food Insecurity—Definition and Significance Food insecurity is defined as the disruption of food intake or eating patterns because of lack of money and other resources [1]. Accordingly, food-insecure households are defined by the United States Department of Agriculture (USDA) as households in which “access to adequate food is limited by a lack of money or other resources” [2]. In 2013, 17.5 million US households or 14.3% of all households met this definition [3]. An estimated 11.8% of US households were food-
This article is part of the Topical Collection on Gastroenterology Critical Care, and Lifestyle Medicine * Vikram J. Christian [email protected] 1
Department of Pediatrics, Division of Gastroenterology, University of Minnesota, 2450 Riverside Ave, East Building, 6th floor, MB657, Minneapolis, MN 55454, USA
2
Department of Surgery, Division of Trauma and Surgery Critical Care, University of Louisville, Louisville, KY, USA
3
Department of Surgery, Division of Gastrointestinal and General Surgery, Oregon Health Sciences University, Portland, OR, USA
insecure at least some time during the year in 2017. In 2018, 11.1% of US households were food-insecure [4]. In 2017, the USDA revised the definitions of food insecurity. The USDA defined the term “low food security” that was previously referred to as “food insecurity without hunger,” as a household that reports reduced quality, variety, or desirability of diet with little or no indication of reduced food intake. The USDA defined “very low food security” that was previously referred to as “food insecurity with hunger” as a household that reports of multiple indications of
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