New Guidelines Push 'Real Food,' Challenging for Low-Income Pregnant Women

Dietary recommendations to eat whole, minimally processed foods may be harder for rural and low-income pregnant women to follow.

Published on Feb. 20, 2026

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The federal government's new Dietary Guidelines for Americans emphasize eating 'real food,' but a recent study found that pregnant women in rural areas consumed more added sugars and less fiber and vegetables compared to urban pregnant women. The researchers found that socioeconomic status, not just location, was a stronger predictor of diet quality, with low-income pregnant women across both rural and urban areas consuming less healthy diets. The authors suggest that subsidies, nutrition assistance, and practical budgeting strategies could help make 'real food' more accessible for low-income and rural pregnant women.

Why it matters

Pregnant women in rural and low-income communities often have less access to healthy whole foods, which can lead to pregnancy complications like preterm birth, gestational diabetes, and hypertension. Improving nutrition during pregnancy is crucial to supporting maternal and fetal health and breaking cycles of poor health across generations.

The details

The researchers studied dietary habits of 500 pregnant women recruited from clinics in Pennsylvania, West Virginia, and Iowa. About 1 in 5 participants lived in rural areas. They found that rural pregnant women consumed more added sugars from sugary drinks and less fiber and vegetables compared to urban pregnant women. However, socioeconomic status emerged as a stronger predictor of diet quality, with low-income women across both rural and urban areas consuming less healthy diets high in added sugars and low in nutrients like calcium, iron, folate, and choline.

  • The new Dietary Guidelines for Americans were released in January 2026.
  • The Pregnancy 24/7 Cohort Study was a 5-year observational study that investigated how 24-hour behavioral patterns throughout pregnancy affected maternal and fetal health.

The players

Bethany Barone Gibbs

A public health professor who worked on the Pregnancy 24/7 Cohort Study at West Virginia University.

Alex Crisp

A postdoctoral researcher who worked on the Pregnancy 24/7 Cohort Study at the University of Iowa.

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What they’re saying

“Telling Americans to "eat real food" may seem like straightforward advice based on decades of research. But our study highlights that following this advice might be harder for some women during pregnancy.”

— Bethany Barone Gibbs, Professor, Epidemiology and Biostatistics, West Virginia University (Mirage News)

“Pregnant women in rural and low-income communities could benefit from subsidies for fresh produce, or supplemental nutrition assistance.”

— Alex Crisp, Postdoctoral Research Scholar, Nutritional Assessment, University of Iowa (Mirage News)

What’s next

The researchers plan to further investigate how socioeconomic factors and geographic location influence pregnant women's access to healthy foods and dietary habits, with the goal of informing policies and programs to improve maternal and fetal nutrition.

The takeaway

While the new federal dietary guidelines encourage all Americans to 'eat real food,' this advice may be particularly challenging for low-income and rural pregnant women who face barriers to accessing affordable, nutritious whole foods. Targeted interventions like food subsidies and nutrition assistance could help make healthy eating more accessible and improve outcomes for mothers and babies in these underserved communities.