New research published in The Journal of Nutrition reveals that pregnant individuals living in food deserts are more likely to have lower periconceptional Healthy Eating Index-2010 scores compared with those not living in food deserts.  Study results suggest the need to identify ways to improve access, affordability, and preparation of nutritious food to support healthy diets among pregnant individuals living in food deserts.

Living in a food desert, designated by an individual’s income and access to food stores within a geographic region, may contribute to persistent disparities and adverse pregnancy outcomes. Emerging data suggest that efforts to improve access to food in neighborhoods may positively influence an individual’s diet quality. Nevertheless, the association between living in a food desert, regardless of individual-level food insecurity, and diet quality has not been assessed. Researcher Dr. Venkatesh (The Ohio State University), a maternal-fetal medicine specialist and perinatal epidemiologist, and colleagues used data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be prospective cohort to assess whether women living in food deserts were more likely to experience poorer periconceptional diet quality compared with those who did not live in a food desert. 

Structured questionnaires were used to ascertain data on demographic characteristics, medical history, dietary history, and psychosocial factors. In addition, a food frequency questionnaire about periconceptional dietary intake was self-administered, and each participant’s residential address was collected and coded. The Healthy Eating Index-2010 assessed how well dietary intake aligned with key recommendations of the 2010 Dietary Guidelines for Americans, which included adequacy of intake of specific food groups and moderation of intake of less nutritious dietary components. Scores for each component increased as intake reached the recommended standard. Healthy Eating Index-2010 scores were analyzed by quartiles from the highest to the lowest dietary quality. Adherence to each of the dietary components of the Healthy Eating Index-2010 was also assessed.

Among the 7,956 assessed pregnant individuals, one in four (25%) lived in a food desert.  Poorer periconceptional dietary quality was more common among those who lived in food deserts compared with those who did not. Individuals living in food deserts were more likely to have diets in lower quartiles of the Healthy Eating Index-2010 and were more likely to be nonadherent to recommended standards for 5 adequacy components of the Healthy Eating Index-2010, including fruit, total vegetables, greens and beans, seafood and plant proteins, and fatty acids.   Individuals living in food deserts were also less likely to report excess intake of empty calories. 

The study results suggest that pregnant individuals living in food deserts are more likely to experience poorer diet quality when getting pregnant and in early pregnancy compared to those who do not live in food deserts. These findings emphasize the relationship between living in an environment with reduced access to food and individual dietary quality in pregnancy.  Further study is needed to identify  systems-level changes that promote healthy food availability and allow improved dietary quality in pregnancy within communities that experience food insecurity.


Venkatesh KK, Walker DM, Yee LM, Wu J, Garner J, McNeil B, Haas DM, Mercer B, Reddy UM, Sliver R, Wapner R, Saade G, Parry S, Simhan H, Lindsay K, Grobman WA. Association of Living in A Food Desert and Poor Periconceptional Diet Quality in a Cohort of Nulliparous Pregnant Individuals. The Journal of Nutrition, Volume 153, Issue 8, August 2023, Pages 2432-2441,

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