Climate change, including rising temperatures and changes in weather extremes, is expected to increase the exposure of food to certain pathogens and toxins [Likely, High Confidence]. This will increase the risk of negative health impacts [Likely, Medium Confidence], but actual incidence of foodborne illness will depend on the efficacy of practices that safeguard food in the United States [High Confidence]. Chemical Contaminants in the Food Chain Key Finding 2: Climate change will increase human exposure to chemical contaminants in food through several pathways [Likely, Medium Confidence]. Elevated sea surface temperatures will lead to greater accumulation of mercury in seafood [Likely, Medium Confidence], while increases in extreme weather events will introduce contaminants into the food chain [Likely, Medium Confidence]. Rising carbon dioxide concentrations and climate change will alter incidence and distribution of pests, parasites, and microbes [Very Likely, High Confidence], leading to increases in the use of pesticides and veterinary drugs [Likely, Medium Confidence]. Rising Carbon Dioxide Lowers Nutritional Value of Food Key Finding 3: The nutritional value of agriculturally important food crops, such as wheat and rice, will decrease as rising levels of atmospheric carbon dioxide continue to reduce the concentrations of protein and essential minerals in most plant species [Very Likely, High Confidence]. Extreme Weather Limits Access to Safe Foods Key Finding 4: Increases in the frequency or intensity of some extreme weather events associated with climate change will increase disruptions of food distribution by damaging existing infrastructure or slowing food shipments [Likely, High Confidence]. These impediments lead to increased risk for food damage, spoilage, or contamination, which will limit availability of and access to safe and nutritious food depending on the extent of disruption and the resilience of food distribution infrastructure [Medium Confidence]. This chapter focuses on some of the less reported aspects of food security, specifically, the impacts of climate change on food safety, nutrition, and distribution in the context of human health in the United States. While ingestion of contaminated seafood is discussed in this chapter, details on the exposure pathways of water related pathogens (for example, through recreational or drinking water) are discussed in Chapter 6: Water-Related Illness. Systems and processes related to food safety, nutrition, and production are inextricably linked to their physical and biological environment. 5, 8 Although production is important, for most developed countries such as the United States, food shortages are uncommon; rather, nutritional quality and food safety are the primary health concerns. 5, 9 Certain populations, such as the poor, children, and Indigenous populations, may be more vulnerable to climate impacts on food safety, nutrition, and distribution (see also Ch. 9: Populations of Concern).