Improving awareness and accessibility of healthy diets are key challenges for health professionals and policymakers alike. While the US government has been assessing and encouraging nutritious diets via the Dietary Guidelines for Americans (DGA) since 1980, the long-term sustainability, and thus availability, of those diets has received less attention. The 2015 Dietary Guidelines Advisory Committee (DGAC) examined the evidence on sustainable diets for the first time, but this topic was not included within the scope of work for the 2020 DGAC. The objective of this study was to systematically review the evidence on US dietary patterns and sustainability outcomes published from 2015 to 2019 replicating the 2015 DGAC methodology. The 22 studies meeting inclusion criteria reveal a rapid expansion of research on US dietary patterns and sustainability, including 8 studies comparing the sustainability of DGA-compliant dietary patterns with current US diets. Our results challenge prior findings that diets adhering to national dietary guidelines are more sustainable than current average diets and indicate that the Healthy US-style dietary pattern recommended by the DGA may lead to similar or increased greenhouse gas emissions, energy use, and water use compared with the current US diet. However, consistent with previous research, studies meeting inclusion criteria generally support the conclusion that, among healthy dietary patterns, those higher in plant-based foods and lower in animal-based foods would be beneficial for environmental sustainability. Additional research is needed to further evaluate ways to improve food system sustainability through both dietary shifts and agricultural practices in the United States.

Food insecurity increased during the COVID-19 pandemic, but the impact varied across different age groups during the prolonged public health emergency. This study sought to describe national food insecurity prevalence by adult age group at multiple stages of the pandemic and explore differences by demographic characteristics. Data were from the nationally representative US Census Bureau’s Household Pulse Survey from April 2020 to May 2023 (N = 4,153,462). Locally weighted scatterplot smoothing (LOESS) regression analysis identified change points in food insecurity trends, segmenting the timeline into three periods: (1) April 2020–March 2021, (2) April 2021–May 2022, and (3) June 2022–May 2023. Logistic regression models examined associations between age, time period, and self-reported household food insecurity; covariates included demographics, socioeconomic status, household structure, and food support program usage. Overall, 9.3% of respondents experienced food insecurity, ranging from 3.5% among those aged ≥75 to 12.2% for ages 35–44 years. Significant interaction between age group and time period indicated inconsistency in the age-food insecurity association during the pandemic (p < 0.001). From Period 1 to 3, the proportion of food-insecure adults aged ≥65 rose from 9.2% to 13.9%. Across all age groups, higher odds of food insecurity were found among Black, Hispanic/Latino, or Other/Multiracial respondents; those with less than a Bachelor’s degree; those with incomes below USD 35,000; those unemployed for reasons other than retirement; and non-homeowners (p < 0.001). The results show that trends and characteristics associated with food insecurity varied across age groups and time periods. Continuous monitoring of food insecurity during emergencies is critical to identify vulnerable populations and timely interventions.

Diet quality is a key determinant of healthy aging, yet fully assessing dietary intake remains a challenge partly because of data limitations and difficulty in integrating information from methodologically distinct datasets. Different nationally representative datasets can offer complementary perspectives: the National Health and Nutrition Examination Survey (NHANES) captures self-reported dietary intake using 1 to 2 d of 24-h recall, whereas the Circana Consumer Network (CN) is a national retail dataset that records year-long grocery purchases from ∼60,000 United States households. This study aimed to evaluate whether dietary intake reported in NHANES 2017-2018 aligns with food purchase trends in CN 2018 among United States adults aged ≥55 y. We examined self-reported dietary intake of grocery/store-bought foods from 24-h recalls in NHANES (n = 1950 individuals) and, separately, household grocery purchases from 1- and 2-person households in CN (n = 29,192 households), analyzed by sex and age group (55-64 y, 65-74 y, and 75+ y). For each dataset, healthfulness of food intakes or purchases was assessed using the 2015 Healthy Eating Index (HEI) and food group proportions were evaluated by percent mass (grams) and energy (kilocalorie). Mean total HEI scores were modest and comparable across datasets (NHANES: 55.7 ± 0.9; CN: 51.3 ± 0.1; P = 0.004). Both sources demonstrated moderate agreement among the 13 HEI component scores, revealing consistent shortfalls in total/whole fruit, greens and beans, whole grains, and saturated fat moderation. Food group proportions had <10% difference across most categories by both mass and energy, although there were higher discrepancies for mixed dishes, condiments, and snacks/sweets. In United States adults aged ≥55 y, grocery/store-sourced intake from NHANES and household grocery purchases from CN showed broadly similar but not interchangeable patterns of diet quality, indicating that purchase data can complement, but not replace, recall-based dietary surveillance. Integrating purchase records with recalls could provide deeper insights into older adults' dietary behaviors and strengthen precision nutrition research.