title: Spending on vegetable and fruit consumption could reduce all-cause mortality among older adults.
abstract: BACKGROUND
  Few studies have evaluated the linkage between food cost and mortality among older adults. This study considers the hypothesis that greater food expenditure in general, and particularly on more nutritious plant and animal-derived foods, decreases mortality in older adults.
  
  
  METHODS
  This study uses the 1999-2000 Elderly Nutrition and Health Survey in Taiwan and follows the cohort until 2008, collecting 24-hr dietary recall data for 1781 participants (874 men and 907 women) aged 65 y or older. Using monthly mean national food prices and 24-hr recall, this study presents an estimate of daily expenditures for vegetable, fruit, animal-derived, and grain food categories. Participants were linked to the national death registry.
  
  
  RESULTS
  Of the 1781 original participants, 625 died during the 10-y follow-up period. Among the 4 food categories, the fourth and fifth expenditure quintiles for vegetables and for fruits had the highest survival rates. After adjusting for co-variates, higher (Q4) vegetable and higher fruit (Q4) food expenditures referent to Q1 were significantly predictive of reduced mortality (HR = 0.55, 95% CI: 0.39-0.78 and HR = 0.64, 95% CI: 0.42-0.99, respectively) and the risk decreased by 12% and 10% for every NT$15 (US$0.50) increase in their daily expenditures. Animal-derived and grain food spending was not predictive of mortality.
  
  
  CONCLUSIONS
  Greater and more achievable vegetable and fruit affordability may improve food security and longevity for older adults.
authors.affiliation: Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yuan-Ting
authors.initials: YT
authors.lastname: Lo
authors.forename: Yu-Hung
authors.initials: YH
authors.lastname: Chang
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wahlqvist
authors.forename: Han-Bin
authors.initials: HB
authors.lastname: Huang
authors.forename: Meei-Shyuan
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004032:Diet / Q000191:economics*; D002523:Edible Grain / Q000191:economics; D058620:Elder Nutritional Physiological Phenomena; D005260:Female; D005500:Follow-Up Studies; D005523:Food Supply; D005638:Fruit / Q000191:economics*; D005102:Health Expenditures; D006801:Humans; D008136:Longevity; D008297:Male; D009026:Mortality; D009749:Nutrition Surveys; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015996:Survival Rate; D013624:Taiwan; D014675:Vegetables / Q000191:economics*