title: Elderly Taiwanese who spend more on fruits and vegetables and less on animal-derived foods use less medical services and incur lower medical costs.
abstract: A higher intake of fruits and vegetables (F&V) compared with animal-derived foods is associated with lower risks of all-cause-, cancer- and CVD-related mortalities. However, the association between consumption patterns and medical costs remains unclear. The effects of various food group costs on medical service utilisation and costs were investigated. The study cohort was recruited through the Elderly Nutrition and Health Survey in Taiwan between 1999 and 2000 and followed-up for 8 years until 2006. It comprised free-living elderly participants who provided a 24-h dietary recall. Daily energy-adjusted food group costs were estimated. Annual medical service utilisation and costs for 1445 participants aged 65-79 years were calculated from the National Health Insurance claim data. Generalised linear models were used to appraise the associations between the food group costs and medical service utilisation and costs. Older adults with the highest F&V cost tertile had significantly fewer hospital days (30%) and total medical costs (19%), whereas those in the highest animal-derived group had a higher number of hospital days (28%) and costs (83%) as well as total medical costs (38%). Participants in the high F&V and low animal-derived cost groups had the shortest annual hospitalisation stays (5·78 d) and lowest costs (NT$38,600) as well as the lowest total medical costs (NT$75,800), a mean annual saving of NT$45 200/person. Older adults who spend more on F&V and less on animal-derived foods have a reduced medical-care system burden. This provides opportunities for nutritionally related healthcare system investment strategies.
authors.affiliation: 1School of Public Health,National Defense Medical Center,Taipei 11490,Taiwan, ROC.
authors.forename: Yuan-Ting C
authors.initials: YT
authors.lastname: Lo
authors.affiliation: 1School of Public Health,National Defense Medical Center,Taipei 11490,Taiwan, ROC.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wahlqvist
authors.affiliation: 4National Defense Medical Center,Graduate Institute of Life Sciences,Taipei 11490,Taiwan, ROC.
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Huang
authors.affiliation: 1School of Public Health,National Defense Medical Center,Taipei 11490,Taiwan, ROC.
authors.forename: Meei-Shyuan
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000368:Aged; D044466:Asian People; D004032:Diet / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D005638:Fruit / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D016014:Linear Models; D008297:Male; D011939:Mental Recall; D009749:Nutrition Surveys; D011446:Prospective Studies; D013624:Taiwan; D014675:Vegetables / Q000191:economics*
keywords: Animal-derived foods; Food costs; Fruits and vegetables; Medical costs