Author: *ASN Member Contributor

*Naïma Moustaïd-Moussa, Ph.D., DFASN, FTOS, FAHA, FNAI
President, American Society for Nutrition

Animal models for human diseases are critical for advancing disease prevention, treatment, and overall health. They help scientists understand how diseases develop and test possible treatments in ways that are not possible in people. At the same time, there is growing concern across the research community that these studies do not always produce consistent or reproducible results, even when they focus on the same disease.

A major contributor to these concerns includes the lack of standardization in animal diets and environments, which leads to a lack of reproducibility. When diets and environments are not standardized, it becomes difficult to compare findings across studies or repeat results. This lack of consistency slows scientific progress, increases costs, and delays the impact and translation of animal research into real-world health benefits.

The role of diet in research quality

To increase rigor and replicability of animal research, it is necessary to know precise diet composition, apply rigorous study design, and use relevant animal models. For diet composition, it is especially imperative to control dietary variables.

Given these serious issues, the American Society for Nutrition (ASN) supports the development and use of next-generation standardized research diets. These are designed to serve as rigorous reference diets in animal feeding studies.

ASN supports advancing the quality and integrity of nutrition research using animal models, supporting basic scientists, and strengthening the translational value of preclinical research. A timely white paper authored by the Laboratory Animal Nutrition Taskforce for an Education and Research Network (LANTERN) highlights persistent concerns related to the lack of standardization in diets used in animal research. The LANTERN team proposes the establishment of a resource center or consortium to provide guidance, recognition, and development of open, standardized reference diets for widely used animal models.

ASN’s leadership and next steps

ASN is poised to move this initiative forward and build on the LANTERN paper’s recommendations, while also taking into account two related editorials published in The Journal of Nutrition, From Chow to Conclusions: Why standardising laboratory animal diets is essential for rigor, reproducibility, and translational relevance in nutrition research and Standardising rodent and other animal diets: a call for action, both of which reinforce the urgency of improving rigor and reproducibility in this area. This is a high priority initiative to advance rigor, reproducibility, and replicability in animal research across diseases.

Consistent with ASN research priorities and my presidential aim to advance and support rigorous basic research, ASN recommends establishing a task force that brings together key experimental animal scientists, diet manufacturers, federal partners, and other stakeholders to provide clear guidance on standardized diets. This effort will also engage the international research community to support alignment and the broader adoption of globally relevant standards.

Join the Conversation at NUTRITION 2026

As a first step towards establishing such a task force, ASN will convene the LANTERN authors, diet manufacturers and other interested investigators at NUTRITION 2026 to discuss next steps, including membership and goals. This effort is intended to support the task force in developing rigorous guidelines for experimental animal research that will ultimately lead to establishing a national program focused on improving research rigor, as proposed by the LANTERN group, while also positioning these efforts to inform and support broader international efforts.

Importantly, it is critical that early career investigators and students are part of this conversation.

Only at NUTRITION 2026
Next-Generation Standard Reference Diets: Building Nutritional Rigor and Relevance using Replicable Diet Formulations in Animal Models of Human Disease
Monday, July 27, 2026 | 8:30 AM – 9:30 AM ET

Why this matters for science and health

Improving diet standardization in animal studies has real implications for how quickly and effectively research can improve human health. A coordinated effort in this area can lead to more effective and humane research practices, enhanced rigor and reproducibility, and stronger translation of findings to humans. It can also reduce cost and time associated with both conducting animal research and applying those findings in clinical settings, ultimately promoting health and reducing the burden of disease.

I hope to see you at NUTRITION 2026 to help us define what comes next.

About the author:

In addition to serving as President of the American Society for Nutrition, Dr. Moustaïd-Moussa is Executive Director of the Institute for One Health Innovation and Paul W. Horn Distinguished Professor at the Texas Tech University School of Veterinary Medicine. She is also Professor in the Department of Cell Biology and Biochemistry at Texas Tech University Health Sciences Center, Founding Director of the Obesity Research Institute, and a member of the National Academies’ Board on Agriculture and Natural Resources (BANR).

*By David S. Seres, MD, ScM, PNS, director of medical nutrition and professor of medicine in the Institute of Human Nutrition, Columbia University Medical Center, New York, NY

Recent ASN blogs explored the complex bidirectional links between the COVID-19 pandemic and food insecurity , and effective nutritional strategies to alleviate the global burden of COVID-19. Some of those nutritional strategies included vitamin D. A different take on vitamin D supplementation and COVID-19 outcomes is shared below.

In April of 2020, when widespread panic about COVID-19 was taking hold, I received a call from a journalist asking: “Did you see that article?”.  He was referring to a pre-review paper that had been posted to the website of a prestigious journal.  It was an analysis of historic vitamin D levels in several countries, to which the authors had correlated one COVID outcome or another.  It made for interesting hypotheses at best.  But the authors concluded that wholesale vitamin D supplementation could improve COVID outcomes.  The story that vitamin D might prevent COVID, based on this paper, appeared on national news two nights later.  It had not been peer reviewed nor accepted for publication, and the journal subsequently rejected the paper.

Since then, the number of hits when searching for “vitamin D and COVID” on PubMed has risen to over 1400.  The vast majority of these are observational studies, systematic review/meta-analysis of observational studies, or narrative reviews.  Because of a strong association between vitamin D levels and COVID outcomes, most promote a potential role for vitamin D supplementation to decrease COVID transmission, morbidity, or mortality, and refer to low levels of vitamin D as “deficiency”.  But the few randomized trials have failed to demonstrate any benefit.

There is little controversy that vitamin D is critical for a plethora of normal immunological functions, that true deficiency is likely to worsen infectious outcomes including those from COVID, and that there are strong associations between vitamin D levels and numerous COVID-related outcomes in observational studies (e.g. retrospective, cohort, etc.). Why then do all the randomized trials to date fail in the aggregate to live up to the great promise that vitamin D supplementation will prevent or ameliorate COVID, except perhaps in those with the very lowest levels? 

The answer lies partly in the inherent risk of drawing conclusions about cause from observational studies.  Equally important, vitamin D physiology easily explains the concordance between vitamin D levels and outcomes in COVID and other disease states such as that seen in critical illness.  That is, vitamin D is a fat-soluble vitamin transported in the bloodstream on a carrier protein.  The level of vitamin D binding protein (VDBP), like albumin, drops in the face of systemic inflammation.  The lower the carrier protein, the lower the measured level of that which is carried.  But is this truly a deficiency? 

To my understanding, a deficiency state occurs when the lack of a substance causes a pathological condition, which in turn is reversed or prevented when the substance is replaced or supplemented.  Disease activity often results in low blood levels of numerous nutrients, but these low levels do not represent true deficiencies.  Take calcium, for example.  Most circulating calcium is carried by albumin. Every clinician is taught to adjust the interpretation of calcium levels based on albumin levels.  A low calcium level, which is due to a low albumin level, which in turn is due to systemic inflammation, is not a deficiency state.  If supplementation given to patients with low vitamin D levels does not improve outcomes, then that low level should not be considered a deficiency.  Thus, a low vitamin D level is not a surrogate for deficiency in someone who is ill.  Rather, it is a surrogate for severity of illness.  Low vitamin D levels are strongly predictive of outcomes, but not predictive of a response to supplementation in sick patients. 

This type of relationship between nutrients and disease acuity is very common but often ignored in our zeal to demonstrate the importance of nutrition.  In my opinion, there are two critically important reasons this should be discussed.  First, continued expenditure for observational studies linking vitamin D to COVID outcomes are unwarranted.  Second, there is continuing damage being done to the credibility of science when scientists and other professionals do not monitor how research findings are discussed with the science consumer. When benefits are touted or even theorized, and then disproven, the public’s trust is betrayed and scientific credibility lost.    

Research published in ASN Journals is providing public health professionals and policy makers with the data and tools needed to mitigate the pandemic’s effect on human health and nutrition in general. We invite you to peruse all four ASN Journals for more information on the bidirectional relationship between COVID-19 and nutrition. A quick search using the term “COVID-19” will lead you to hundreds of articles. In addition, if you are researching any aspect of the relationship between nutrition and COVID-19 disease, we invite you to submit your findings for publication in an ASN Journal.

Webinar Summary Prepared by the Committee on Advocacy and Science Policy

*By Christine Taylor, PhD, Chair of ASN’s Committee on Advocacy and Science Policy

A recent **webinar sponsored by ASN’s Committee on Advocacy and Science Policy (CASP) served to underpin the ASN interest in supporting and strengthening the National Health and Nutrition Examination Survey (NHANES). NHANES — which provides an essential foundation for policy, research, clinical decisions, program planning and more – faces emerging challenges that cannot be ignored by its numerous and diverse stakeholders. The webinar’s goal was to inform the ASN membership about NHANES and to explore the nature of the advocacy required to ensure that this survey moves into the future as a reliable source of critical data.

Dr. Paul Coates, ASN Past-President, opened the webinar and provided an overview of the wide application and vital nature of the NHANES. He emphasized its many applications in public health policy, in the development of federal regulations and programs such as school lunch, in establishing science-based standards and clinical practices, and in basic research. Dr. Coates noted the high regard in which the NHANES staff are held as well as their competence, diligence, and hard work. He also noted that the contractual process for the 2023-2033 survey precluded staff from offering an NHANES update for the webinar, but an NHANES staff member was able to participate in the brief panel discussion at the close of the session. Dr. Coates introduced the remainder of the program by pointing out that the goal was not to dig down into the detailed specifics of data collection, but to consider the larger overarching challenges that NHANES faces.

The program continued with two speakers who set the stage for further discussion. Dr. Christine Taylor, CASP Chair, began by pointing to issues stemming from stagnant funding and which affect current survey operations as well as the ability to innovate. She then outlined concerns related to decreasing survey response rates as well as the likelihood that the sample size is too small to provide the level of granular data needed to address the increasing interest in health disparities. Dr. Jaime Gahche, National Institutes of Health, described the nutrition-related components of the survey.

The final two speakers discussed the nature of the challenges in more detail, while offering thoughts about possible solutions. Mr. Charles Rothwell, former Director of the National Center for Health Statistics, offered a general stakeholder perspective and outlined options to potentially meet the critical needs for modernization, innovation and the study of new methodologies. Dr. Cathie Woteki, Iowa State University, reflected on the nutrition perspective. She highlighted an interest in updating the dietary component of the survey, which was put in place more than 30 years ago and therefore may need updating to be consistent with current interests and needs within the nutrition community.

The webinar discussions offered several take-away points. Most health surveys are under increasing pressure to modernize and adapt, and NHANES is no exception. While funds are always a central topic and are limited in any case, advocating for funding alone is not sufficient. A broader approach is needed to address the methodological challenges involved in conducting a survey such as NHANES. Questions were raised about: the constraints the survey must operate under; how it can continue to meet the needs of its stakeholders in the future; and how it begins to prepare for the future, including exploration of newer technologies and potentially different data collection goals and methodologies while preserving the ability to maintain key time trends. Second, the complicated nature of these considerations coupled with the value gained when there is input from varied experts led to the suggestion that ASN support efforts to request that the National Academies of Sciences, Engineering and Medicine (NASEM) convene an expert committee to review the NHANES and make recommendations about ways to meet its future challenges. It was acknowledged that this task requires that ASN work to build alliances around a NASEM study. Third, it was suggested that CASP continue to explore the questions about NHANES and expand the webinar discussions by organizing a workshop focused on the future of NHANES. A broad community of participants beyond nutritionists should be included. Finally, it was pointed out that NHANES is critical to many programs within the U.S. Department of Agriculture. Therefore, given the upcoming activities surrounding the authorization of the Farm Bill, ASN could include a focus on NHANES and a NASEM study in its recommendations to Congress concerning the components of the bill. The importance of ASN advocacy around these issues was pointed out.

CASP found the webinar informative and will consider how best to incorporate the options offered during the discussions.

**Recording and slides on the NUTRITION 2022 meeting platform:
https://www.eventscribe.net/2022/ASN/index.asp?sessionTarget=1128057

• To view the recording, individuals can click ‘View Recording’ button on the lower right.
• To view slides, individuals can click on each individual presentation title at the bottom of the popup, and then click the ‘Handouts’ button for each individual presentation.

*Heather Schier is a PhD student at the Ohio State University and recently served as an ASN Science Policy Fellow. Her research employs community-engaged, mixed methods to elevate the voices of transgender and gender diverse youth.

As we celebrate sexual and gender diversity, sobering discriminatory legislation (240+) is being proposed (and passed) in states across the US. Policy impacts the social determinants of health and therefore has downstream nutrition implications. For example, insufficient anti-bullying policies in schools¹, school curriculum and topic censoring, and other bans and restrictions may further alienate LGBTQIA+ individuals and promote discrimination. Social rejection, discrimination, and stigma manifest as stress, compromised mental health, suicidality, food insecurity, disordered eating patterns, increased allostatic load, inflammation, overweight/obesity, and chronic disease².

This is concerning when we consider the known disparities experienced by the LGBTQIA+ community. For example elevated risk of overweight and obesity among lesbian and bisexual women^3,4, HIV among gay and bisexual men⁵, and mixed findings suggest elevated risk of some cancers^4,6 and cardiovascular disease^4,7 among LGB adults. Fewer studies have explored disparities among transgender individuals. Those that have been conducted indicate socioeconomic and health disparities persist among transgender individuals^8–11. This includes elevated rates of depression, anxiety, and psychological distress^10,12. Further, disproportionate rates of poor general health^10,13, food insecurity^14–16, and disordered eating patterns^1,14,16,17.

The disparities are stark and can’t be ignored. However, combatting health disparities does not stop at identifying prevalence. In alignment with the Health Equity Promotion Model¹⁸, identifying the strengths and pathways that promote health is equally important. The LGBTQIA+ communities have strength, resilience, persistence, adversity, and empathy. In working with LGBTQIA+ communities to leverage those strengths we begin to elevate solutions.

Research that applies this model of empowerment and celebration offers the community and advocates the tools to combat these disparities through interventions and policy change.

These articles summarize recently published research related to nutrition considerations for LGBTQIA+ communities:

Sexual orientation–based disparities in food security among adults in the United States: results from the 2003–2016 NHANES, The American Journal of Clinical Nutrition, December 2021

In the US, 10.5% of the general population experience food insecurity. These rates are disproportionately higher among sexual minority (e.g., lesbian, gay, bisexual, and otherwise non-heterosexual) individuals, likely a manifestation of discrimination and stigma. Data from NHANES revealed a statistically significant difference in household food security between sexual minority groups and their heterosexual counterparts. Rates and relative risk of moderate and severe food insecurity were 20-70% higher among all sexual minority groups compared to heterosexuals after adjusting for sex, race, ethnicity, and age. The highest rates were among bisexuals¹⁹.

An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients, Journal of the Academy of Nutrition and Dietetics, February 2022

The Nutrition Care Process (NCP) directs registered dietitians (RD) when conducting nutrition assessments. Many domains of the nutrition assessment are sex-specific, posing a unique question for those serving a transgender or gender diverse (TGGD) population. Applying clinical logic, Linsenmeyer et. al., offer suggested approaches for clinicians working with TGGD patients to deliver gender affirming care. Those suggestions include: use references consistent with sex assigned at birth if the patient has not medically transitioned (e.g., hormone therapy); individualize approach based on the patient’s medical transition status using the World Professional Association for Transgender Health Standards of Care; and report data as a range between male and female references. Additionally, clinicians can affirm patients by using correct names and preferred pronouns, updating medical records to reflect the patient’s gender identity, and using gender neutral terms (e.g., when describing the body). The article details hypothetical case studies for application²⁰.

Opportunities for Action

Regardless of your area of research, ASN members can take steps to celebrate and affirm sexual and gender diversity. A few opportunities for action are listed below:

• Gender affirming language improves mental health, sense of belonging, and reduces suicidality. This includes using preferred pronouns, gender neutral terms (e.g., when discussing the body), and refraining from deadnaming.
• Reference the National Academies of Science, Engineering, and Medicine’s report on measuring sex, gender identity, and sexual orientation. Ubiquitous adoption of these recommendations improves visibility of diverse sexual orientations and gender identities across data and is a critical step toward elucidating pathways to health disparities and promotion among LGBTQIA+ communities. 
• Support pathways to increase LGBTQIA+ representation across nutrition science professions.
• Empower LGBTQIA+ communities, elevating community-specific assets (e.g., size and strength of community, adversity, resilience) to identify effective solutions to address health inequities.
• Prioritize community-based participatory research methods if and when possible.
• Fund and evaluate interventions that prevent overweight/obesity, food insecurity, disordered eating behaviors, among other disparities.
• To learn more about ways to advocate for LGBTQIA+ communities, visit: The Trevor Project, UCLA Williams Institute, ACLU, or The National Center for Transgender Equality. 

Reference

1. Lessard LM, Wang EY, Watson RJ. School Safety Among Sexual and Gender Minority Adolescents: Implications for Eating and Weight Control Behaviors. J Sch Health. 2021;91(10):788-795. doi:10.1111/JOSH.13069
2. Tan KKH, Treharne GJ, Ellis SJ, Schmidt JM, Veale JF. Gender Minority Stress: A Critical Review. J Homosex. 2020;67(10):1471-1489. doi:10.1080/00918369.2019.1591789
3. Boehmer U, Bowen DJ, Bauer GR. Overweight and obesity in sexual-minority women: Evidence from population-based data. Am J Public Health. 2007;97(6):1134-1140. doi:10.2105/AJPH.2006.088419
4. Case P, Austin B, Hunter DJ, et al. Sexual Orientation, Health Risk Factors, and Physical Functioning in the Nurses’ Health Study II. https://home.liebertpub.com/jwh. 2004;13(9):1033-1047. doi:10.1089/JWH.2004.13.1033
5. CDC. HIV and Gay and Bisexual Men. Published online 2021. Accessed May 22, 2022. www.cdc.gov/hiv/group/msm.
6. Dibble SL, Roberts SA, Nussey B. Comparing breast cancer risk between lesbians and their heterosexual sisters. Women’s Heal Issues. 2004;14(2):60-68. doi:10.1016/J.WHI.2004.03.004
7. Fredriksen-Goldsen KI, Emlet CA, Kim HJ, et al. The Physical and Mental Health of Lesbian, Gay Male, and Bisexual (LGB) Older Adults: The Role of Key Health Indicators and Risk and Protective Factors. Gerontologist. 2013;53(4):664-675. doi:10.1093/GERONT/GNS123
8. Kenagy GP. Transgender Health: Findings from Two Needs Assessment Studies in Philadelphia. Health Soc Work. 2005;30(1):19-26. doi:10.1093/HSW/30.1.19
9. Xavier J, Jessica Xavier M, Julie Honnold MA, et al. Members of the Study Team. Published online 2007.
10. Fredriksen-Goldsen KI, Cook-Daniels L, Kim HJ, et al. Physical and Mental Health of Transgender Older Adults: An At-Risk and Underserved Population. Gerontologist. 2014;54(3):488-500. doi:10.1093/GERONT/GNT021
11. Grant, J.M., Mottet, L.A., Tanis J. Injustice at Every Turn : A Report of the National Transgender Discrimination Survey. Sociology. 2013;(May):120-198. Accessed May 22, 2022. https://www.semanticscholar.org/paper/Injustice-at-Every-Turn%3A-A-Report-of-the-National-Grant-Motter/0d2215528d2687e79db63a5381580de92d383090
12. Bockting WO, Miner MH, Swinburne Romine RE, Hamilton A, Coleman E. Stigma, mental health, and resilience in an online sample of the US transgender population. Am J Public Health. 2013;103(5):943-951. doi:10.2105/AJPH.2013.301241
13. Fredriksen-Goldsen KI, Kim H-J, Emlet CA, et al. The Aging and Health Report The Aging and Health Report Disparities and Resilience among Lesbian, Gay, Bisexual, and Transgender Older Adults.
14. Arikawa AY, Ross J, Wright L, Elmore M, Gonzalez AM, Wallace TC. Results of an Online Survey about Food Insecurity and Eating Disorder Behaviors Administered to a Volunteer Sample of Self-Described LGBTQ+ Young Adults Aged 18 to 35 Years. J Acad Nutr Diet. 2021;121(7):1231-1241. doi:10.1016/J.JAND.2020.09.032
15. Russomanno J, Patterson JG, Jabson JM. Food Insecurity Among Transgender and Gender Nonconforming Individuals in the Southeast United States: A Qualitative Study. Transgender Heal. 2019;4(1):89. doi:10.1089/TRGH.2018.0024
16. Linsenmeyer WR, Katz IM, Reed JL, Giedinghagen AM, Lewis CB, Garwood SK. Disordered Eating, Food Insecurity, and Weight Status among Transgender and Gender Nonbinary Youth and Young Adults: A Cross-Sectional Study Using a Nutrition Screening Protocol. LGBT Heal. 2021;8(5):359-366. doi:10.1089/LGBT.2020.0308/ASSET/IMAGES/LARGE/LGBT.2020.0308_FIGURE2.JPEG
17. Guss CE, Williams DN, Reisner SL, Austin SB, Katz-Wise SL. Disordered Weight Management Behaviors, Nonprescription Steroid Use, and Weight Perception in Transgender Youth. J Adolesc Heal. 2017;60(1):17-22. doi:10.1016/J.JADOHEALTH.2016.08.027
18. Fredriksen-Goldsen KI, Simoni JM, Kim HJ, et al. The health equity promotion model: Reconceptualization of lesbian, gay, bisexual, and transgender (LGBT) health disparities. Am J Orthopsychiatry. 2014;84(6):653. doi:10.1037/ORT0000030
19. Gibb JK, Shokoohi M, Salway T, Ross LE. Sexual orientation–based disparities in food security among adults in the United States: results from the 2003–2016 NHANES. Am J Clin Nutr. 2021;114(6):2006-2016. doi:10.1093/AJCN/NQAB290
20. Linsenmeyer W, Garwood S, Waters J. An Examination of the Sex-Specific Nature of Nutrition Assessment within the Nutrition Care Process: Considerations for Nutrition and Dietetics Practitioners Working with Transgender and Gender Diverse Clients. J Acad Nutr Diet. 2022;122(6):1081-1086. doi:10.1016/j.jand.2022.02.014

*Heather Schier (she/her/hers) is a cisgender Graduate Research Associate in Dr. Carolyn Gunther’s Community Nutrition Research Lab and a doctoral student in the Ohio State Interdisciplinary Ph.D. Program in Nutrition. Her research interests include nutrition-related issues among transgender youth and nutrition policy. She is currently an American Society for Nutrition Science Policy Fellow.

During the month of June, we celebrate the LGBTQIA+ community, recognize the contributions of individuals and honor the ongoing liberation movement since (and before) the Stonewall riots of 1969. Discrimination and health inequities continue to negatively impact sexual and gender minority groups. A recent survey indicated LGBTQIA+ young adults were at higher risk for experiencing nutrition insecurity, disordered eating patterns, and depression. These disparities were highest among transgender males (1).

A few years ago, as a graduate student, I attended a research talk on Transgender Care targeting an allied healthcare professional audience. I returned home and began furiously searching the scholarly databases for literature to understand the nutrition related considerations for transgender individuals. This search didn’t take long. The literature is rather limited for transgender adults and bare for transgender youth. We, as a scholarly community, ought to ask ourselves, why?

Nearly 1.4 million (0.6%) adults and 150,000 (0.7%) youth (ages 13 to 17) identify as transgender or gender non-binary (TGGNB) in the United States (2). These figures are comparable to the prevalence of Americans with Type 1 Diabetes (which we have strong nutrition guidelines for, right?). To date, there are no nutrition guidelines for TGGNB individuals published by the Academy of Nutrition and Dietetics, in large part due to the paucity of research required to develop nutrition recommendations. This deficiency of evidence hinders healthcare professionals’, including registered dietitians’ (RD), ability to best care for their TGGNB patients. Encouragingly, efforts to promote health equity and celebrate TGGNB health are emerging. Recent work published through the American Society for Nutrition journals have highlighted the benefits of brief educational modules to improve RDs knowledge in interacting with TGGNB individuals (3), protocols for screening disordered eating and food insecurity for TGGNB youth and adolescents (4), and a scoping review describing the extent, range and nature of current literature related to nutrition considerations for hormone therapy and health outcomes in transgender individuals (5). Research initiatives to elucidate the clinical nutrition and psychosocial implications for TGGNB youth and adults associated with medically transitioning (e.g., hormone therapy, gender affirming surgery, administration of puberty blockers and other supplementation) and approaches which celebrate TGGNB health are long overdue.

Are we asking the necessary questions to rigorously study dietary behaviors and nutritional status of LGBTQIA+ individuals? Sex and gender differences are often overlooked in research design, study implementation, and general scientific inquiry and reporting (6). TGGNB identification is grossly overlooked due to the conflation of sex and gender (male or female) in nutrition surveillance programs. This has partly contributed to a dearth of and limited ability to harmonize data (7). For example, the United States Census, the National Health and Nutrition Examination Survey (NHANES) and the National Health Interview Survey (NHIS) do not ask participants about their gender identity. The Sex and Gender Equity in Research (SAGER) guidelines offer recommendations for gender-sensitive approaches. This includes adopting the two-question method for distinctly assessing sex and gender (8). This change could yield multiple benefits. Importantly, it gives space for individuals to be seen and celebrated as they identify. Secondly, it is the first critical step to facilitate the pooling and harmonization of data. Dr. Whitney Linsenmeyer, assistant professor of nutrition and dietetics at Saint Louis University and spokesperson for the Academy of Nutrition and Dietetics, explains, “The development of clinical practice guidelines for nutrition professionals working with the transgender community is dependent on a robust body of research.  We champion evidence-based practice, but until there is sufficient evidence, we are mostly using our clinical judgments or opinions.  More research is truly the first step towards optimal gender-affirming nutrition care.”

Looking beyond how we collect data, who is involved in the research process?  Diversity is more than race and ethnicity – but also sexual orientation, gender identity, class, ability-level, and the intersectionality of these identities. Representation of sexual and gender minority individuals across the nutrition sciences field (practitioners, academics, scientists, and students) will elevate the rigor and quality of research outcomes, moving the needle forward. One way to do this is by prioritizing community-based or engaged research which foster partnerships with LGBTQIA+ community members and stakeholders as equitable partners in solving complex health issues. Another is to foster sexual and gender inclusive cultures in spaces where research is conducted.

Bolstering the body of nutrition-related evidence specific to sexual and gender identities strengthens communities and the nutrition science field. Let’s do it with PRIDE.

Key takeaways:

• Language matters: Researchers, healthcare providers, and students can start by learning to practice gender-affirming communication
• As a research community, efforts to ubiquitously collect and report sexual and gender identities as a standard using SAGER guidelines are critically needed to pool and harmonize data and better represent individuals
• While the LGBTQIA+ term represents a greater community, it is critical to see each group separately as each presents with unique lived experiences and nutrition-related considerations
• Enabling scientists/scholars from the LGBTQIA+ community: representation across the nutrition sciences field is critical to move the needle forward
• Community based or engaged research approaches that foster equitable partnerships between LGBTQIA+ groups/individuals and researchers elevates voices, critical to solving complex issues
• Bolstering the body of nutrition-related evidence specific to sexual and gender identities strengthens communities and the nutrition science field

Diversity, Equity and Inclusion is a critical component of ASN’s Mission. For those who are interested in supporting Diversity, Equity and Inclusion (DEI) efforts, through volunteering, please contact us at mem@nutrition.org. As we continue our work, we will be enlisting the support of member volunteers for targeted projects.

For those interested in supporting DEI efforts through giving, you can donate towards Minority Investigators and Students Donations, which help support the development and execution of programs for minority investigators and students including the annual “Young Minority Oral Investigator Competition” held at ASN’s annual conference.

For information and updates on ongoing DEI initiatives and activities, please visit https://nutrition.org/our-members/inclusion-diversity-equity-and-accessibility/.

For those with ideas, recommendations, feedback or questions, please contact us at sec@nutrition.org. We welcome them all!

References

1. Arikawa, A. Y., Ross, J., Wright, L., Elmore, M., Gonzalez, A. M., & Wallace, T. C. (2020). Results of an Online Survey about Food Insecurity and Eating Disorder Behaviors Administered to a Volunteer Sample of Self-Described LGBTQ+ Young Adults Aged 18 to 35 Years. Journal of the Academy of Nutrition and Dietetics, S2212-2672(20)31341-1. Advance online publication. https://doi.org/10.1016/j.jand.2020.09.032
2. Flores AR, Herman JL, Gates GJ, Brown TN. The Williams Institute. How many adults identify as transgender in the United States? https://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf. Published June 2016. Accessed June 1 2021.
3. Douglass, P., Kazaks, A., & Boutin, D. (2020). Three Populations Knowledge Regarding Nutrition and Health Care for Transgender and Gender Non-Binary (TGGNB) Individuals. Current Developments in Nutrition, 4(Suppl 2), 1363. https://doi.org/10.1093/cdn/nzaa060_001
4. Linsenmeyer, W., Reed, J., Giedinghagen, A., Lewis, C., & Garwood, S. (2020). Nutrition Considerations for Transgender Adolescents and Young Adults: Screening for Disordered Eating and Food Insecurity at a Midwestern Transgender Center. Current Developments in Nutrition, 4(Suppl 2), 1130. https://doi.org/10.1093/cdn/nzaa055_015
5. Rozga, M., Linsenmeyer, W., Cantwell Wood, J., Darst, V., & Gradwell, E. K. (2020). Hormone therapy, health outcomes and the role of nutrition in transgender individuals: A scoping review. Clinical nutrition ESPEN, 40, 42–56. https://doi.org/10.1016/j.clnesp.2020.08.011
6. Heidari, S., Babor, T. F., De Castro, P., Tort, S., & Curno, M. (2016). Sex and Gender Equity in Research: rationale for the SAGER guidelines and recommended use. Research integrity and peer review, 1, 2. https://doi.org/10.1186/s41073-016-0007-6
7. Linsenmeyer, W., Waters, J. Sex and gender differences in nutrition research: considerations with the transgender and gender nonconforming population. Nutr J 20, 6 (2021). https://doi.org/10.1186/s12937-021-00662-z
8. Tate, C. C., Ledbetter, J. N., & Youssef, C. P. (2013). A two-question method for assessing gender categories in the social and medical sciences. Journal of sex research, 50(8), 767–776. https://doi.org/10.1080/00224499.2012.690110