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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #307083
Title: Diet quality and body mass index are associated with healthcare resource use in older adults

Author
item FORD, DARA - Pennsylvania State University
item HARTMAN, TERRYL - Emory University
item STILL, CHRISTOPHER - Geisinger Medical Center
item WOOD, CRAIG - Geisinger Medical Center
item MITCHELL, DIANE - Pennsylvania State University
item BAILEY, REGAN - National Institute Of Health (INSA)
item SMICIKLAS-WRIGHT, HELEN - Pennsylvania State University
item COFFMAN, DONNA - Pennsylvania State University
item JENSEN, GORDON - Pennsylvania State University

Submitted to: Journal of the Academy of Nutrition and Dietetics
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/18/2014
Publication Date: 6/1/2014
Citation: Ford, D.W., Hartman, T.J., Still, C., Wood, C., Mitchell, D.C., Bailey, R., Smiciklas-Wright, H., Coffman, D.L., Jensen, G.L. 2014. Diet quality and body mass index are associated with healthcare resource use in older adults. Journal of the Academy of Nutrition and Dietetics. DOI:10.1016/J.Jand.2014.02.011.

Interpretive Summary: With the number of older adults increasing, there is an associated increase in disease burden and potential for substantial increase in health care resource utilization. We examined the associations between diet quality and body mass index with health care resource use in a cohort of advanced age. Diets of greater quality, particularly with greater fruit and vegetable intake, are associated with favorable effects on healthcare resource utilization outcomes among older adults. Overweight and obesity are associated with increased outpatient healthcare resource utilization and, among obese individuals, with decreased emergency room visits. These findings suggest that body mass index and diet quality beyond age 74 years continue to affect healthcare resource measures. Increasing fruit and vegetable intakes, in particular, provide a practical approach to improving diet quality and weight status to achieve more favorable health care resource utilization outcomes.

Technical 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 risk¼0.84; 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.