Adherence to Dietary Guidelines Associated with Lower Medical Service Utilization in Preschoolers: a Longitudinal Study

Overview

Journal Nutr Diabetes

Specialties Endocrinology
Nutritional Sciences

Date 2024 Mar 23

PMID 38519466

Authors

Yi-Chieh Chen

Yuan-Ting C Lo

Hsin-Yun Wu

Yi-Chen Huang

Affiliations

Soon will be listed here.

Abstract

Objective: We aimed to evaluate the association between dietary guideline adherence and overall, outpatient, and emergency medical service utilization in Taiwanese preschoolers.

Methods: We selected 614 preschoolers (2-6 years) who had one day of 24-h dietary recall data from the 2013-2016 Nutrition and Health Survey in Taiwan. The Taiwanese Children Healthy Eating Index (TCHEI) was developed on the basis of Taiwanese Food-Based Dietary Guidelines; it assesses dietary adequacy and eating behavior. Data on the participants' outpatient and emergency medical service utilization were obtained for 2013-2018 from the National Health Insurance Research Database. A multivariable generalized linear model was used to evaluate the association between the TCHEI and medical service utilization for all disease and respiratory diseases.

Results: After adjustment for confounding factors, children aged 2-3 years in the Tertile (T) 2 and T3 groups of the TCHEI exhibited 25% (95% CI 0.69-0.83) and 16% (95% CI 0.77-0.92) lower overall medical visits, respectively. The same pattern was noted in the outpatient and emergency visits for all diseases and respiratory diseases. The children aged 4-6 years in the T2 group exhibited 15% (95% CI 0.80-0.91) and 11% (95% CI 0.82-0.97) lower overall visits and visits for respiratory diseases, respectively. Moreover, preschoolers in the T2 group exhibited lower overall medical expenditures than did those in the T1 group.

Conclusions: TCHEI score was positively correlated with better nutritional status. Optimal dietary intake associated with lower medical service utilization among Taiwan preschoolers.

References

Kirk S, Kuhle S, Ohinmaa A, Veugelers P . Health behaviours and health-care utilization in Canadian schoolchildren. Public Health Nutr. 2012; 16(2):358-64. PMC: 10271602. DOI: 10.1017/S1368980012002728. View

Gale C, Martyn C, Marriott L, Limond J, Crozier S, Inskip H . Dietary patterns in infancy and cognitive and neuropsychological function in childhood. J Child Psychol Psychiatry. 2009; 50(7):816-23. PMC: 2698009. DOI: 10.1111/j.1469-7610.2008.02029.x. View

Movassagh E, Baxter-Jones A, Kontulainen S, Whiting S, Vatanparast H . Tracking Dietary Patterns over 20 Years from Childhood through Adolescence into Young Adulthood: The Saskatchewan Pediatric Bone Mineral Accrual Study. Nutrients. 2017; 9(9). PMC: 5622750. DOI: 10.3390/nu9090990. View

Pinto da Costa M, Durao C, Lopes C, Vilela S . Adherence to a healthy eating index from pre-school to school age and its associations with sociodemographic and early life factors. Br J Nutr. 2019; 122(2):220-230. DOI: 10.1017/S0007114519001028. View

Kent S, Fusco F, Gray A, Jebb S, Cairns B, Mihaylova B . Body mass index and healthcare costs: a systematic literature review of individual participant data studies. Obes Rev. 2017; 18(8):869-879. DOI: 10.1111/obr.12560. View

Fram M, Ritchie L, Rosen N, Frongillo E . Child experience of food insecurity is associated with child diet and physical activity. J Nutr. 2015; 145(3):499-504. DOI: 10.3945/jn.114.194365. View

Guilleminault L, Williams E, Scott H, Berthon B, Jensen M, Wood L . Diet and Asthma: Is It Time to Adapt Our Message?. Nutrients. 2017; 9(11). PMC: 5707699. DOI: 10.3390/nu9111227. View

Yeh C, Lo Y, Chen Y, Chen W, Huang Y . Perceived Food Insecurity, Dietary Quality, and Unfavorable Food Intake among Children and Adolescents from Economically Disadvantaged Households. Nutrients. 2021; 13(10). PMC: 8540399. DOI: 10.3390/nu13103411. View

Kant A . Indexes of overall diet quality: a review. J Am Diet Assoc. 1996; 96(8):785-91. DOI: 10.1016/S0002-8223(96)00217-9. View

10.

Haq I, Asra M, Tian Q, Ahmed B, Khan N, Ahmad M . Association of Infant and Child Feeding Index with Undernutrition in Children Aged 6-59 Months: A Cross-Sectional Study in the Maldives. Am J Trop Med Hyg. 2020; 103(1):515-519. PMC: 7356416. DOI: 10.4269/ajtmh.19-0972. View

11.

Kyttala P, Erkkola M, Lehtinen-Jacks S, Ovaskainen M, Uusitalo L, Veijola R . Finnish Children Healthy Eating Index (FCHEI) and its associations with family and child characteristics in pre-school children. Public Health Nutr. 2013; 17(11):2519-27. PMC: 10284681. DOI: 10.1017/S1368980013002772. View

12.

Uauy R, Kain J, Mericq V, Rojas J, Corvalan C . Nutrition, child growth, and chronic disease prevention. Ann Med. 2008; 40(1):11-20. DOI: 10.1080/07853890701704683. View

13.

van Ansem W, Schrijvers C, Rodenburg G, van de Mheen D . Maternal educational level and children's healthy eating behaviour: role of the home food environment (cross-sectional results from the INPACT study). Int J Behav Nutr Phys Act. 2014; 11:113. PMC: 4177694. DOI: 10.1186/s12966-014-0113-0. View

14.

Rah J, Akhter N, Semba R, de Pee S, Bloem M, Campbell A . Low dietary diversity is a predictor of child stunting in rural Bangladesh. Eur J Clin Nutr. 2010; 64(12):1393-8. DOI: 10.1038/ejcn.2010.171. View

15.

Meng L, Wang Y, Li T, van Loo-Bouwman C, Zhang Y, Szeto I . Dietary Diversity and Food Variety in Chinese Children Aged 3⁻17 Years: Are They Negatively Associated with Dietary Micronutrient Inadequacy?. Nutrients. 2018; 10(11). PMC: 6267553. DOI: 10.3390/nu10111674. View

16.

Liu J, Raine A . Nutritional status and social behavior in preschool children: the mediating effects of neurocognitive functioning. Matern Child Nutr. 2016; 13(2). PMC: 5675074. DOI: 10.1111/mcn.12321. View

17.

Willers S, Wijga A, Brunekreef B, Scholtens S, Postma D, Kerkhof M . Childhood diet and asthma and atopy at 8 years of age: the PIAMA birth cohort study. Eur Respir J. 2010; 37(5):1060-7. DOI: 10.1183/09031936.00106109. View

18.

Jamaluddine Z, Sahyoun N, Choufani J, Sassine A, Ghattas H . Child-Reported Food Insecurity Is Negatively Associated with Household Food Security, Socioeconomic Status, Diet Diversity, and School Performance among Children Attending UN Relief and Works Agency for Palestine Refugees Schools in Lebanon. J Nutr. 2019; 149(12):2228-2235. DOI: 10.1093/jn/nxz189. View

19.

Lo Y, Wahlqvist M, Huang Y, Chuang S, Wang C, Lee M . Medical costs of a low skeletal muscle mass are modulated by dietary diversity and physical activity in community-dwelling older Taiwanese: a longitudinal study. Int J Behav Nutr Phys Act. 2017; 14(1):31. PMC: 5348879. DOI: 10.1186/s12966-017-0487-x. View

20.

Lee J, Kubik M, Fulkerson J . Diet Quality and Fruit, Vegetable, and Sugar-Sweetened Beverage Consumption by Household Food Insecurity among 8- to 12-Year-Old Children during Summer Months. J Acad Nutr Diet. 2019; 119(10):1695-1702. PMC: 6765424. DOI: 10.1016/j.jand.2019.03.004. View