Food insecurity or inconsistent or inadequate access to enough food for a healthy life is a well-documented social determinant of health. But it is not experienced equally across the population. Our new preliminary research using the Massachusetts Statewide Food Access Survey reveals a striking picture: in 2024, more than half of LGBTQ+ adults in the Commonwealth were food insecure, and many are not using the systems designed to help.

​A Persistent Disparity
Using data from 9,169 Massachusetts residents surveyed between 2022 and 2024, we measured food insecurity with the 10-item USDA Household Food Security Survey Module. Among LGBTQ+ adults, food insecurity rose from 45% in 2022 to 56% in 2024, significantly higher than non-LGBTQ+ adults each year. These numbers are staggering, though not entirely surprising. A 2017 Williams Institute analysis found that 26.7% of American LGBTQ+ adults experienced food insecurity in the prior year, roughly double the national average. Furthermore, LGBTQ+ adults are about twice as likely to experience poverty compared to non-LGBTQ+ adults, a direct consequence of the historical and ongoing discrimination and stigma that likely drives high rates of food insecurity.

Many Aren't Getting Help
Beyond measuring food insecurity, this study examines whether LGBTQ+ adults are using available assistance. In 2024, only one-third used food pantries, and fewer than half used SNAP (the Supplemental Nutrition Assistance Program). LGBTQ+ adults reported multiple barriers to pantry access more frequently than non-LGBTQ+ adults. For example, many pantries are housed in religious settings that haven't always been welcoming to LGBTQ+ people. Transgender and gender nonconforming individuals may face additional, concrete obstacles when applying for benefits if they are unable to receive accurate identification documents. More broadly, discrimination and stigma in housing, employment, and healthcare can make it harder to trust the systems meant to help. Even SNAP, which offers more privacy than visiting a pantry in person, poses barriers and proposed federal policy changes that would make access harder.

Why This Matters and What Can Be Done
Food insecurity isn't just about hunger; it has cascading effects across physical and mental health. The association of food insecurity with poor health outcomes, including mental illness and chronic diseases, has been well-documented, but research has increasingly called for closer examination of how food insecurity affects LGBTQ+ individuals specifically. Given that LGBTQ+ adults already face elevated rates of depression, anxiety, and other chronic conditions, the added burden of food insecurity is particularly dangerous for their health outcomes.
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Our forthcoming research findings show that addressing food insecurity among LGBTQ+ adults requires more than just making programs available. We need multi-level interventions that are designed with input from LGBTQ+ communities themselves to address the unique barriers they face and begin to minimize the burden of food insecurity in this population.

Author
Austin R. Waters is a postdoctoral fellow through the Dana-Farber Cancer Institute and the Harvard LGBTQ Health Center of Excellence. He received his PhD in Health Policy and Management from the University of North Carolina at Chapel Hill. His research focuses on prevention, access, and outcomes among LGBTQ+ and adolescent and young adult (AYA) patient populations. The common threads of his research revolve around health equity, health-related social needs, economic instability, cost-related barriers to care, the influence of policy, and technology use. 

Hilary Dolstad, MD

​Eating well is important at any stage of life, but during pregnancy, nutrition becomes key to supporting a developing baby. Plant-based (also known as vegan) diets have increased in popularity in recent years due to their associated health benefits, as well as environmental and ethical concerns. In fact, from 2019 to 2020, U.S. retail sales of plant-based foods rose by 27%, reflecting the growing popularity of plant-based diets. This raises a question for some expectant parents: what do we know about the impact of a plant-based diet during pregnancy?

​A 2024 systematic review examined the research on vegan diets and birth outcomes, identifying just six relevant studies. Since this is still an emerging area of research with limited evidence, there were no definitive conclusions—but here’s some of what researchers have found so far:

• Many outcomes were similar between people following vegan diets and those with omnivorous diets.
• Maternal weight gain was lower among those on a vegan diet in the two studies that looked at this outcome.
• Gestational diabetes and preterm birth rates did not differ significantly between the two groups in any of the studies.
• Infant birth weight was lower in some of the studies among those on a vegan diet, but this finding was not consistent between all the studies.
• Preeclampsia was higher in one small study, but this study included only 18 vegan participants, and other studies did not note this trend.

Overall, it appears that few studies have directly examined the relationship between a vegan diet during pregnancy and birth or pregnancy outcomes, and the studies so far are small. Five of the six studies had 60 or fewer vegan participants, and none were randomized controlled trials, which would be gold standard for determining causal relationships. These limitations may help explain the inconsistent results. It’s also possible that any observed differences could be due to indirect factors, such as protein intake or caloric intake, which could be optimized within a well-planned vegan diet.

Given the rise in popularity of plant-based diets, hopefully there will soon be more data in this area. For now, the best guidance remains the same, regardless of underlying dietary patterns: recommendations include consuming sufficient folic acid, as part of a balanced diet rich in vegetables, fruits, healthy grains and proteins. 

Author
Hilary Dolstad is a fellow in General Internal Medicine and Primary Care. She received her medical degree from Harvard Medical School and completed combined residency training in internal medicine and pediatrics at Brigham and Women’s Hospital and Boston Children’s Hospital. Prior to her medical training, she worked in public health on the local and national level. As part of the Harvard Fellowship in General Internal Medicine and Primary Care, her research focuses on maternal and child health, including environmental factors and policies that influence health in the perinatal period and throughout the life course. She is currently an MPH candidate at Harvard T.H. Chan School of Public Health. Clinically, she is interested in primary care for adults and children.

Kat Lynch, MPH

​Grocery shoppers can often get swept up in the bright colors and healthy promise of fresh produce, only to watch it wilt as the week gets busy. It’s an unpleasant experience opening the refrigerator to find spoiled fruits and vegetables you meant to eat, especially when improper storage can speed up the process. What many people don’t realize is that frozen produce is often just as nutritious, if not more, than fresh options that have spent days sitting on the shelf.
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​Fresh fruits and vegetables naturally lose nutrients over time as they are exposed to oxygen, light, and temperature changes. Freezing, however, acts like a pause button, locking in nutrients right after harvest. Most frozen fruits and vegetables are picked at peak ripeness and then blanched (or briefly boiled) before freezing, which helps preserve vitamins and minerals. Frozen options are also affordable, available year‑round, and often pre‑chopped, making healthy cooking easier for busy schedules. The key is checking ingredient labels, since some frozen produce contains added sauces or sugars. Choosing plain frozen fruits and vegetables ensures consumers get the most nutritional value.
 
Despite these advantages, many people still view frozen produce as less healthy and less appealing than fresh ones. Perhaps this is because food beliefs are often shaped by biases rather than facts. People may attach moral meaning to foods, viewing “natural” as good and “processed” as bad. Similarly, labels like organic, vegetarian, or gluten-free can create a “halo effect,” that makes foods seem automatically better based on one positive attribute. Fresh produce benefits from this same “halo effect,” even when the nutritional value is equal to – or in some cases, lower than – its frozen counterparts.
 
One study tested this bias by asking people to evaluate spinach labeled as fresh or frozen. When shown only in the packaging, participants rated the “fresh” spinach more positively than frozen. However, when they saw the final cooked dish, the difference disappeared. Why? The fresh spinach looked less appealing after cooking, while the frozen spinach did not change once cooked. The preference was psychological, not nutritional. There’s a false belief that freezing is a “transformation” that reduces naturalness, even though it effectively preserves nutrients.
 
Misconceptions about frozen foods can discourage people from eating enough fruits and vegetables, especially among groups who would benefit most, including those in low-income households. In fact, in one study of participants in Supplemental Nutrition Assistance Program Education (SNAP-Ed) and Expanded Food and Nutrition Education Program (EFNEP) classes, 94% bought frozen produce at least occasionally for its convenience and long shelf life, yet many still believed fresh produce had better flavor, texture, appearance, nutritional value, and fewer preservatives. Broader national data also reinforce these patterns – income, education, and having children under 18 strongly predict frozen produce purchasing, and SNAP participants are especially likely to buy frozen vegetables, suggesting frozen options may be particularly valuable for households seeking affordable, long‑lasting foods. Together, these findings highlight the need for targeted nutrition education that emphasizes the nutritional equivalence, cost savings, and practical benefits of frozen produce.
 
Ultimately, our focus should shift away from trying to debate whether fresh or frozen is better, and instead consider what helps us eat more fruits and vegetables overall. Frozen options are just as nutritious as fresh, last longer, reduce waste, and offer flexibility. That convenience makes healthy eating more realistic and affordable. In the end, the best produce is the kind you will actually eat – whether it comes from the fridge or the freezer.

​The nation’s updated five‑year 2025-2030 Dietary Guidelines for Americans introduce several notable updates, including a redesigned food pyramid and a renewed emphasis on whole foods and protein. The changes have sparked debate among researchers, clinicians, and public health professionals. Beyond the headlines, the more important question is how recent evidence informed these recommendations, and what they may mean for chronic disease prevention and federal nutrition programs moving forward.

Unprocess Your Plate
One of the most significant shifts is the clearer emphasis on limiting highly processed foods. For the first time, the guidelines explicitly discourage packaged, ready-to-eat products high in added sugars and refined ingredients. This change reflects a growing body of research linking diets high in ultra-processed foods to obesity, type 2 diabetes, cardiovascular disease, and overall mortality.
A recent meta-analysis reported consistent associations between higher ultra-processed food consumption and increased risk of cardiovascular disease and other adverse cardiometabolic outcomes. While earlier editions focused primarily on individual nutrients such as added sugars or sodium, the current guidance more directly acknowledges the role of food processing and overall dietary patterns in shaping health outcomes. This evolution reflects decades of research supporting dietary patterns centered on whole and minimally processed foods, such as vegetables, fruits, whole grains, legumes, nuts, and healthy fats that protect against chronic disease.
The guidelines also continue to reinforce limits on added sugars and encourage greater intake of fiber-rich whole foods. The updated guidance emphasizes nutrient-dense foods and overall dietary quality, rather than focusing narrowly on calorie counts. These recommendations remain consistent with long-standing evidence from the Mediterranean diet and the DASH diet, both linked to improved cardiometabolic health and reduced risk of chronic disease.
The Protein Pivot
Another prominent feature of the new pyramid is its prioritization of protein. The guidelines highlight protein consumption across the lifespan, with attention to muscle maintenance and metabolic health. National data from What We Eat in America (NHANES) indicate that most U.S. adults already consume an adequate or high amount of protein, though adequacy varies by age and sex. This context has prompted experts to debate how broadly to interpret higher protein targets, and whether that messaging could distract from other important components of a balanced diet. Because guidelines still advise limiting saturated fat to less than 10% of daily calories, careful communication is essential to ensure that increased attention on protein does not create confusion around high-saturated fat sources, such as certain red or processed meats. Messaging should also highlight protein-rich options like legumes, seafood, nuts, and low-fat dairy.
Nuanced Nutrition and Forming the Foundation for Federal Programs
These nuances do not diminish the broader strengths of the guidelines. Rather, they illustrate the complexity of translating evolving nutrition science into clear, population-level recommendations. Faculty experts at Harvard T.H. Chan School of Public Health have noted that while the guidelines maintain important advances, particularly in discouraging ultra-processed foods, certain aspects, including the prioritization of animal protein sources over plant-forward options, have generated discussion about alignment with elements of their Advisory Committee’s scientific report.
Importantly, the public health implications of the Dietary Guidelines extend beyond individual dietary choices. The guidelines serve as the foundation for federal nutrition programs, including SNAP, WIC, the National School Lunch Program, and the Child and Adult Care Food Program. The updated guidelines can influence food procurement standards, nutrition education, and meal planning across programs serving millions of Americans. Even modest, widespread improvements in diet can help reduce obesity, cardiovascular disease, diabetes, and other chronic conditions.
Ultimately, the impact of the 2025-2030 Dietary Guidelines depends less on the design of a pyramid, and more on how well the recommendations are translated into practice. Aligning federal policy, food environments, and clinical guidance with the strongest available evidence offers an opportunity to strengthen prevention efforts nationwide. Thoughtful implementation and clear communication will determine whether these updates translate into measurable improvements in population health.

Author 
​Nelly Miranda Mongalo, MPH, is a public health professional with a concentration in Health Services Management & Policy. She earned her Master of Public Health from Tufts University School of Medicine, where her work focused on nutrition policy analysis and early childhood health initiatives. Her interests include maternal and child health and chronic disease prevention. As a foreign-trained dentist who transitioned into U.S. public health, she brings a clinical perspective and a population-level approach to health policy. Nelly is passionate about advancing policies and programs that support healthier families and communities. Outside of her professional work, she enjoys traveling and spending time on family adventures with her husband and two daughters.

Eliza Stuart, B.S., B.A

​Many of us turn to coffee, tea, and energy drinks to perk us up, yet these caffeinated beverages fail to address a common underlying cause of low energy: iron deficiency. Caffeine might even worsen the issue by reducing the body’s ability to absorb iron, so for those of us with low iron levels, focusing on increasing iron consumption might be a more effective way to feel energized throughout the day than drinking another cup of coffee.

​Nearly 1 in 3 adults in the US are iron deficient, and iron deficiency is more common among women than men, with the highest prevalence among women under 50. The widespread consumption of caffeine in the US may be ineffective, and even counterproductive, for improving energy levels in nearly a third of the population because caffeine is associated with reducing the body’s ability to absorb iron.  

These numbers reflect real experiences. For example, when my grandmother was iron deficient, she described feeling like a “limp noodle,” and didn’t have much energy, regardless of how much coffee she drank. Beyond lethargy, low iron levels are associated with decreased physical capacity, impaired neurocognitive function, and heart failure, so maintaining an adequate iron level is important for many long-term health outcomes.

Taking iron supplements and eating iron-rich foods like meat, seafood, greens, beans, and breads and cereals with fortified grains can help increase iron levels. Cooking in a cast iron skillet can also help increase the iron in your food!

To optimize your body’s ability to absorb the iron you consume, it is beneficial to be thoughtful about what vitamins and compounds you are having (or not having) alongside an iron-rich meal or iron supplement. Vitamin C is known to improve iron absorption, so healthcare professionals commonly advise people taking iron supplements to drink a glass of orange juice when they take their iron pill.

Conversely, a recent study found that caffeine, especially in conjunction with the polyphenols in coffee and tea, is associated with reducing the bioavailability of iron by increasing inflammation. Timing matters: the beneficial effects of Vitamin C and the negative effects of caffeine on iron absorption are most profound when these are consumed around the same time as iron.
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In short, pairing iron-rich meals or supplements with Vitamin C and steering clear of caffeine for a few hours before and after can make a big difference. These small changes can help you get the most out of your iron and keep your energy levels strong.