Abstract
Background
The relationship between diet quality and health care costs is unclear.
Objective
The aim of this study was to investigate the relationship between baseline diet quality
and change in diet quality over time, with 15-year cumulative health care claims/costs.
Design
Data from a longitudinal cohort study were analyzed.
Participants/setting
Data for survey 3 (2001) (n = 7,868) and survey 7 (2013) (n = 6,349 both time points)
from the 1946-1951 cohort of the Australian Longitudinal Study on Women’s Health were
analyzed.
Main outcome measures
Diet quality was assessed using the Australian Recommended Food Score (ARFS). Fifteen-year
cumulative Medicare Benefits Schedule (Australia’s universal health care coverage)
data were reported by baseline ARFS quintile and category of diet quality change (“diet
quality worsened” [ARFS change ≤ –4 points], “remained stable” [–3 ≤ change in ARFS
≤3 points], or “improved” [ARFS change ≥4 points]).
Statistical analyses
Linear regression analyses were conducted adjusting for area of residence, socioeconomic
status, lifestyle factors, and private health insurance status.
Results
Consuming a greater variety of vegetables at baseline but fewer fruit and dairy products
was associated with lower health care costs. For every 1-point increment in the ARFS
vegetable subscale, women made 3.3 (95% CI, 1.6-5.0) fewer claims and incurred AU$227
(95% CI, AU$104-350 [US$158; 95% CI, US$72-243]) less in costs. Women whose diet quality
worsened over time made more claims (median, 251 claims; quintile 1, quintile 3 [Q1;
Q3], 168; 368 claims) and incurred higher costs (AU$15,519; Q1; Q3, AU$9,226; AU$24,847
[US$10,793; Q1; Q3, US$6,417; US$17,281]) compared with those whose diet quality remained
stable (median, 236 claims [Q1; Q3, 158; 346 claims], AU$14,515; Q1; Q3, AU$8,539;
AU$23,378 [US$10,095; Q1; Q3, US$5,939; US$16,259]).
Conclusions
Greater vegetable variety was associated with fewer health care claims and costs;
however, this trend was not consistent across other subscales. Worsening diet quality
over 12 years was linked with higher health care claims and costs.
Keywords
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Biography
J. N. Baldwin is a casual academic, The University of Newcastle Faculty of Health and Medicine, Callaghan, NSW, Australia, and a senior statistician, The University of Newcastle Priority Research Centre for Physical Activity and Nutrition, Callaghan, NSW, Australia.
Biography
P. M. Forder is a senior statistician, The University of Newcastle Priority Research Centre for Generational Health and Ageing, New Lambton, New South Wales, Australia.
Biography
R. Haslam is a research associate, The University of Newcastle Faculty of Health and Medicine, Callaghan, NSW, Australia, and a senior statistician, The University of Newcastle Priority Research Centre for Physical Activity and Nutrition, Callaghan, NSW, Australia.
Biography
A. Hure is an associate professor, The University of Newcastle Priority Research Centre for Generational Health and Ageing, New Lambton, NSW, Australia, senior statistician, The University of Newcastle School of Medicine and Public Health, Callaghan, NSW, Australia, and senior statistician, The University of Newcastle Hunter Medical Research Institute, New Lambton, NSW, Australia.
Biography
D. Loxton is a professor and deputy director, The University of Newcastle Priority Research Centre for Generational Health and Ageing, New Lambton, NSW, Australia.
Biography
A. J. Patterson is a senior lecturer, The University of Newcastle Faculty of Health and Medicine, Callaghan, NSW, Australia, and a senior statistician, The University of Newcastle Priority Research Centre for Physical Activity and Nutrition, Callaghan, NSW, Australia.
Biography
C. E. Collins is a professor and senior research fellow, The University of Newcastle Faculty of Health and Medicine, Callaghan, NSW, Australia, and a senior statistician, The University of Newcastle Priority Research Centre for Physical Activity and Nutrition, Callaghan, NSW, Australia.
Article info
Publication history
Published online: January 22, 2021
Accepted:
December 15,
2020
Received:
March 4,
2020
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by a National Health and Medical Research Council of Australia Senior Research Fellowship, and a Gladys M. Brawn Senior Research Fellowship from the Faculty of Health and Medicine, the University of Newcastle, Australia (C. E. Collins).
Identification
Copyright
© 2021 by the Academy of Nutrition and Dietetics.
