The dietary patterns of 680 noninstitutionalized, predominantly white, elderly volunteers from the Boston area (447 women and 233 men) were examined by cluster analysis of food contribution to energy intake. Data were derived from 3-day dietary records. The four major patterns identified corresponded to high consumption of (a) alcohol, (b) milk, cereals, and fruits, (c) bread and poultry, and (d) meat and potatoes. The resulting clusters of subjects differed significantly in gender, education, income, and frequency of smoking. Those with diets high in milk, cereals, and fruits had the highest intakes of micronutrients and the best hematologic profile. Those with high meat and potato intakes had the lowest intakes of micronutrients and lowest levels of plasma folate and vitamin B-6. High alcohol consumers had lowest blood levels of riboflavin and vitamin B-12 and highest levels of high-density-lipoprotein cholesterol. Those with high bread and poultry intakes had lowest reported energy intakes, but, paradoxically, they had the highest mean body mass index. Neither total serum cholesterol nor cholesterol intake varied significantly among groups. Our findings suggest that the nutritional status of the elderly may be improved by promoting food patterns rich in milk, fruit, and cereals and by counseling the elderly to limit consumption of alcohol and meats high in saturated fats.