Kim Soyoung, Park Minseon
Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Republic of Korea.
Department of Family Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea.
Nutrients. 2025 Jul 6;17(13):2237. doi: 10.3390/nu17132237.
BACKGROUND/OBJECTIVES: This cross-sectional study examined the association between diet quality, measured by the Korean Healthy Eating Index (KHEI), and medical expenditures among Korean adults.
We used data from the Korea National Health and Nutrition Examination Survey (2016-2021). Adults aged ≥20 years with complete data on diet, sociodemographics, and healthcare use were included. Medical costs were estimated from self-reported service use and converted to USD. KHEI scores were categorized into quartiles. Multivariable linear regression was used to assess the association between KHEI quartiles and log-transformed costs. Subgroup analyses were conducted by age (<57 vs. ≥57 years), and sensitivity analyses treated KHEI as a continuous variable. A two-part model addressed skewed, zero-inflated cost data.
Compared to Q1, participants in Q4 had significantly lower inpatient (β = -0.080; 95% CI: -0.139 to -0.020) and total costs (β = -0.086; 95% CI: -0.144 to -0.027). In the younger group, Q4 was associated with lower total costs (β = -0.115; 95% CI: -0.198 to -0.031). Higher continuous KHEI scores were also linked to lower costs. In the two-part model, Q4 participants had a higher probability of incurring any cost but lower conditional costs (Q3 vs. Q1: β = -0.173; Q4 vs. Q1: β = -0.160; both < 0.05).
Higher diet quality was associated with reduced healthcare costs in Korean adults, especially among younger individuals. Promoting healthy eating may help lower economic burdens in aging societies.
背景/目的：本横断面研究调查了以韩国健康饮食指数（KHEI）衡量的饮食质量与韩国成年人医疗支出之间的关联。
我们使用了韩国国家健康与营养检查调查（2016 - 2021年）的数据。纳入了年龄≥20岁且饮食、社会人口统计学和医疗保健使用数据完整的成年人。医疗费用根据自我报告的服务使用情况进行估算，并换算为美元。KHEI得分被分为四分位数。使用多变量线性回归来评估KHEI四分位数与对数转换后的费用之间的关联。按年龄（<57岁与≥57岁）进行亚组分析，敏感性分析将KHEI视为连续变量。采用两部分模型处理偏态、零膨胀的费用数据。
与第一四分位数相比，第四四分位数的参与者住院费用（β = -0.080；95%置信区间：-0.139至-0.020）和总费用显著更低（β = -0.086；95%置信区间：-0.144至-0.027）。在较年轻的组中，第四四分位数与较低的总费用相关（β = -0.115；95%置信区间：-0.198至-0.031）。较高的连续KHEI得分也与较低的费用相关。在两部分模型中，第四四分位数的参与者产生任何费用的概率更高，但条件费用更低（第三四分位数与第一四分位数相比：β = -0.173；第四四分位数与第一四分位数相比：β = -0.160；两者均<0.05）。
较高的饮食质量与韩国成年人医疗保健费用降低相关，尤其是在较年轻个体中。促进健康饮食可能有助于减轻老龄化社会的经济负担。
