Dietary patterns and food security is considered in four ways: Healthy Eating Index (HEI), food category consumption patterns, energy/macronutrient contributions of food categories, and sub‐category caloric intake accounting for consumption patterns. 2005–2012 National Health and Nutrition Examination Survey data were grouped by What We Eat in America food sub‐categories. Of the 20,363 adults, 14,592 were high (71.7%), 2,125 marginal (10.4%), 2,317 low (11.4%), and 1,329 very low food secure (6.5%). High food secure adults have higher HEI in total and each sub‐measure (including refined grains and empty calories). Consumption frequency in most food categories declines with food insecurity. As food insecurity deepens so more energy and carbohydrates are attributable to nonalcoholic beverages. Evidence of the negative dietary impact of sweetened beverages in particular for food insecure adults is presented. Very few differences in dietary patterns emerge, suggesting broad societal level policy combined with targeted sub‐category and nutrition education initiatives.

Food insecurity negatively impacts dietary intakes; however, a broader view of the underlying dietary patterns is needed to understand the health impacts. Dietary recall and food security status data for 16,625 adults from 2005‐2010 NHANES were evaluated to assess the food sources of key nutrients. Dietary data obtained from 24‐hour dietary recalls were used to assess the food sources and quantities of nutrients consumed. Nutrient obtained from the USDA food categories were aggregated to evaluate the total and percent of the day's intakes of nutrients. Differences in volume (g), energy and macronutrients by food categories were compared across the four levels of household food security status. Energy and dietary fat intakes from mixed dishes was highest for the most food insecure adults, at 20% and 25%, respectively. Low and very low food secure adults consumed less fruit (P<0.001) and more grains (P=0.038). Fruit and vegetable contributions to all nutrients were significantly greater for fully food secure adults (P<0.05). Non‐alcoholic beverages were the greatest contributors to carbohydrate intakes in the low and very low food secure adults, nearly 25% of the day's intakes. Dairy products contributed more protein (P<0.001) for adults from fully food secure households. Snacks and sweets had a u‐shaped curve for the contribution of energy and macronutrient intakes (P<0.02). A greater understanding of how the food categories contribute to nutrient intakes is critical to developing intervention strategies to address nutritional status and health disparities experiences during food insecurity.