Adherence to dietary guidelines associated with lower medical service utilization in preschoolers: a longitudinal study

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.