Abstract
Health care resource consumption is a growing concern. The aim of this study was to
examine the associations between diet quality and body mass index with health care
resource use (HRU) in a cohort of advanced age. Participants in the Geisinger Rural
Aging Study (n=5,993) were mailed demographic and dietary questionnaires in 2009.
Of those eligible, 2,995 (50%; 1,267 male, 1,728 female; mean age 81.4±4.4 years)
provided completed surveys. Multivariate negative binomial models were used to estimate
relative risk and 95% CI of HRU outcomes with diet quality as assessed by the Dietary
Screening Tool score and body mass index determined from self-reported height and
weight. Poor diet quality was associated with a 20% increased risk for emergency room
(ER) visits. Fruit and vegetable consumption was grouped into quintiles of intake,
with the highest quintile serving as the reference group in analyses. The three lowest
fruit and vegetable quintiles were associated with increased risk for ER visits (23%
to 31%); the lowest quintile increased risk for inpatient visits (27%). Obesity increased
risk of outpatient visits; however, individuals with class I obesity were less likely
than normal-weight individuals to have ER visits (relative risk=0.84; 95% CI 0.70
to 0.99). Diets of greater quality, particularly with greater fruit and vegetable
intake, are associated with favorable effects on HRU outcomes among older adults.
Overweight and obesity are associated with increased outpatient HRU and, among obese
individuals, with decreased ER visits. These findings suggest that BMI and diet quality
beyond age 74 years continue to affect HRU measures.
Keywords
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Biography
D. W. Ford is a graduate research assistant, School of Public Health, Emory University, Atlanta, GA.
Biography
T. J. Hartman is a professor of epidemiology, School of Public Health, Emory University, Atlanta, GA.
Biography
C. Still is director, Geisinger’s Obesity Institute, Danville, PA, adjunct assistant professor of nutrition, The Pennsylvania State University, University Park, and associate physician for internal medicine and director, Center for Nutrition and Weight Management, Danville, PA.
Biography
C. Wood is a biostatistician, Geisinger’s Obesity Institute, Danville, PA.
Biography
D. C. Mitchell is a senior research scientist and director, Penn State Diet Assessment Center, University Park, PA.
Biography
R. Bailey is a nutritional epidemiologist, Office of Dietary Supplements, National Institutes of Health, Bethesda, MD.
Biography
H. Smiciklas-Wright is emeritus faculty, The Pennsylvania State University, University Park.
Biography
D. L. Coffman is a principal investigator, The Methodology Center Research, and an associate professor, College of Health and Human Development, The Pennsylvania State University, University Park.
Biography
G. L. Jensen is head, Department of Nutritional Sciences, and a professor of nutritional sciences and medicine, The Pennsylvania State University, University Park.
Article info
Publication history
Published online: April 18, 2014
Accepted:
February 18,
2014
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST T. J. Hartmann serves as a consultant for the International Life Sciences Institute of North America for the analysis of caffeine in beverages consumed in the US population. No potential conflicts of interest were reported by the remaining authors.
FUNDING/SUPPORT D. W. Ford, G. L. Jensen, D. C. Mitchell, and H. Smiciklas-Wright were supported by a US Department of Agriculture (USDA) grant (USDA no. 1950-51530-010-00) to The Pennsylvania State University. D. L. Coffman was supported in this research with money paid to her and to The Pennsylvania State University through a USDA grant. T. J. Hartman was supported in this research by money paid to Emory University through a USDA grant.
Identification
Copyright
© 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
