Aligning Dietary Intake and Food Purchase Data in United States Older Adults: Insights from the National Health and Nutrition Examination Survey and Circana Consumer Network.

BACKGROUND: 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. OBJECTIVES: 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. METHODS: 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). RESULTS: 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. CONCLUSIONS: 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.