Increasing Oral-Gut Axis Health Literacy in Underserved Communities with Community-Involved, Pantry-Accessible Nutrition Education: A Conceptual Framework and Program

In metropolitan U.S. areas, health inequities caused by socioeconomic disparity continue to influence oral health, nutritional status, and the risk of chronic diseases. Diets heavy in added sugars and poor in fiber and vital micronutrients are especially harmful to the oral–gut axis, which connects diet, microbial balance, inflammation, and systemic and neurological health. Due to institutional hurdles to health literacy, limited access to preventive health education, and food poverty, these eating habits are more common among low-income individuals. Only 36% of low-income parents in Chicago report being in good health, compared to 75% of parents with better incomes, underscoring the need for easily accessible, neighborhood-based health education programs. By converting nutrition science and the oral-gut axis into useful, low-barrier educational programs, Nourish Chicago, a community-engaged health literacy project, aims to close these gaps. Instead of measuring health outcomes, this article offers a conceptual framework and program design. Nourish Chicago places a strong emphasis on skill-based learning, immersive training, and delivery in familiar neighborhood settings. It is built on the principles of critical health literacy and community-engaged education. The program uses the oral–gut axis as a translation anchor to connect everyday food choices, such as sugar frequency, fiber intake, protein pairing, and snack timing, to oral and digestive health through simplified, biologically grounded explanations. Educational modules incorporate short demonstrations, hands-on activities, guided discussion, and bilingual take-home materials designed for pantry-accessible contexts. The framework outlines a structured science translation pipeline, core design principles, and adaptable module architecture intended for low-resource environments. By centering usability, prevention, and feasibility, this design-focused manuscript offers a replicable model for educators and community partners seeking to strengthen practical health literacy while acknowledging structural constraints faced by underserved populations.