title: Health behaviours and health-care utilization in Canadian schoolchildren.
abstract: OBJECTIVE
  Poor nutritional habits and physical inactivity are two health behaviours believed to be linked with increasing rates of overweight and obesity in children. The objective of the present study was to determine whether children who reported healthier behaviours, specifically in relation to nutrition and physical activity, also had lower health-care utilization.
  
  
  METHODS
  Population-based cross-sectional study, linking survey data from the 2003 Children's Lifestyle and School Performance Study (CLASS) with Nova Scotia administrative health data. Health-care utilization was defined as both (i) the total physician costs and (ii) the number of physician visits, for each child from 2001 to 2006. Exposures were two indices of healthy eating, the Diet Quality Index and the Healthy Eating Index, and self-reported physical activity and screen time behaviours.
  
  
  METHODS
  Elementary schools in the Canadian province of Nova Scotia.
  
  
  METHODS
  Grade 5 students and their parents; of the 5200 students who participated in CLASS and completed surveys, 4380 (84 %) could be linked with information in the administrative data sets.
  
  
  RESULTS
  The study found a relationship between both indices of healthy eating and a borderline significant trend towards lower health-care utilization in this population sample of children. No statistically significant relationships were seen for physical activity or screen time.
  
  
  CONCLUSIONS
  Both measures of diet quality produced similar results. The study suggests that healthy eating habits established in childhood may be associated with lower health-care utilization, although further research over a longer time frame is needed to demonstrate statistical significance.
authors.affiliation: School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada, B3H 3E2. Sara.Kirk@dal.ca
authors.forename: Sara F L
authors.initials: SF
authors.lastname: Kirk
authors.forename: Stefan
authors.initials: S
authors.lastname: Kuhle
authors.forename: Arto
authors.initials: A
authors.lastname: Ohinmaa
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Veugelers
mesh_terms: D002648:Child; D002652:Child Behavior; D003430:Cross-Sectional Studies; D004032:Diet / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D005102:Health Expenditures; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009674:Nova Scotia; D009765:Obesity / Q000209:etiology*; D009819:Office Visits