Background – Epidemiological studies suggest that adhering more closely to National Dietary Guidelines is
associated with improved diet-related health outcomes, with a reduction in morbidity and mortality. A number of methods have been used to generate dietary scores to measure diet quality and variety.
Objectives – To evaluate whether an association exists between diet quality and indices of quality of life, health service use and Medicare costs in the Australian Longitudinal Study of Women’s Health (ALSWH).
Design – Cross-sectional measurement of association between an Australian Recommended Food Score (ARFS), self-reported variables and Medicare costs in women (n = 11,194, 50-55 yr) participating in the 2001 survey of the mid-aged cohort of ALSWH. ARFS was derived from responses to the Dietary Questionnaire for Epidemiological Studies FFQ and increases as the number of foods consistent with Australian Dietary Guidelines consumed at least once a week, increases. ARFS was divided into quintiles with higher scores having more favourable macro and micronutrient profiles. Data linkage allowed examination of associations with Medicare costs.
Outcomes – More women in the lowest quintile of the Australian Recommended Food Score reported their general health as fair or poor compared to those in the highest quintile (18 vs 10%, P<0.0001). The mean SF36 general health perception domain score was higher for those in the top ARFS quintile compared to the bottom (mean (95%CI): 75.3 (74.3, 76.2) vs 67.1 (66.2, 68.0) P<0.0001). Fewer women in the highest ARFS quintile reported four or more GP consultations in the previous year compared to the lowest (13% vs 17%, P=0.0024) but there was no difference in Medicare costs across the quintiles, P>0.05.
Conclusion – Higher ARFS is associated with improved self-reported indices of quality of life, but not reduced Medicare costs. Longitudinal evaluation will determine whether a higher ARFS is protective in terms of predicting health outcomes or reducing long-term health costs.