Trends in sustainable dietary patterns in United States adults, 2007-2018

Authors

Sukyoung Jung, Department of Healthcare Policy Research, Korea Institute for Health and Social Affairs, Sejong, Korea, Sejong, Korea.
Heather Young, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States, Washington, United States.
Barbara Braffett, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States, Washington, United States.
Samuel Simmens, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States, Washington, United States.
Eunice Hong Lee, Department of Healthcare Policy Research, Korea Institute for Health and Social Affairs, Sejong, Korea, Sejong, Korea.
Cynthia Ogden, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States, Washington, United States.

Document Type

Journal Article

Publication Date

8-18-2025

Journal

Epidemiology and health

DOI

10.4178/epih.e2025045

Keywords

NHANES; dietary patterns; dietary sustainability; sustainable diet; sustainable diet index; trend

Abstract

OBJECTIVES: Adopting sustainable diets is essential for improving both human and planetary health, and such diets should be evaluated from a multidimensional perspective. We characterized trends in sustainable dietary patterns, quantified by the Sustainable Diet Index for US adults (SDI-US), along with trends in diet quality, diet-related environmental impacts, food affordability, and food practices. METHODS: This study analyzed data from the National Health and Nutrition Examination Survey (2007-2018) for adults aged ≥20 years (n = 25,543). The SDI-US (range: 4-20 points), with higher scores indicating more sustainable diets, was calculated using 24-hour dietary recall data and responses to consumer and dietary behavior questionnaires. Mean total SDI-US scores, sub-indices, and 12 individual indicators were estimated for each survey cycle. Trends were assessed using orthogonal polynomial contrasts in regression models. RESULTS: From 2007 to 2018, total SDI-US scores showed no significant overall trend (overall mean = 13.1). Nutritional and sociocultural indicators remained relatively stable, whereas the economic indicator (food expenditures) worsened from 21.4% to 26.4% (p<0.05, linear trend) between 2007-2008 and 2017-2018. Environmental impacts initially worsened between 2007-2008 and 2013-2014 but improved through 2017-2018 (all p<0.05, quadratic trend). When stratified by age (p for interaction <0.0001), a slight decline in SDI-US was observed among adults aged ≥60 years (14.1 to 13.9, p<0.0001). CONCLUSION: From 2007 to 2018, total SDI-US scores largely remained unchanged, although declines occurred among adults ≥60 years and scores remained lower among adults aged 20-39 years. Ongoing monitoring and coordinated improvements across all dimensions are needed to advance sustainable diets in all age groups.

APA Citation

Jung, Sukyoung; Young, Heather; Braffett, Barbara; Simmens, Samuel; Lee, Eunice Hong; and Ogden, Cynthia, "Trends in sustainable dietary patterns in United States adults, 2007-2018" (2025). GW Authored Works. Paper 7745.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7745

Department

Epidemiology