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Trends in sustainable dietary patterns in United States adults, 2007-2018
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Sukyoung Jung, Heather Young, Barbara Braffett, Samuel Simmens, Eunice Hong Lim Lee, Cynthia Ogden
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Epidemiol Health. 2025;e2025045. Published online August 18, 2025
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DOI: https://doi.org/10.4178/epih.e2025045
[Accepted]
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Abstract
Summary
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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).
CONCLUSIONS 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.
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Summary
Korean summary
- 본 연구는 미국 국민건강영양조사에 참여한 20세 성인 25,543명을 대상으로 세계식량기구의 다차원적 지속가능한 식이 지수(SDI-US)를 활용하여 12년간의 추이를 분석하였다.
- 전체 SDI-US 점수는 전체적으로 큰 변화가 없었으나, 경제적 지표는 악화되고 환경 지표는 최근 개선을 보였고, 60세 이상 성인에서는 SDI-US 점수가 감소하였으며, 20-39세 성인에서는 낮은 수준이 유지되었다.
- 지속가능한 식이로의 전환을 위해 지속적 모니터링과 연령대별 맞춤형 정책이 필요하다.
Key Message
Among 25,543 US adults aged 20 years and older, overall sustainable diet index (SDI-US) scores showed no significant change between 2007 and 2018. While food expenditure share worsened and environmental indicators recently improved, declines were observed among older adults (≥60 years) and lower scores persisted among younger adults (20–39 years). These findings highlight the need for ongoing monitoring and tailored strategies to promote sustainable diets across age groups.
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