Joint associations of diet quality and physical activity with healthcare utilization among adults in South Korea: a cross-sectional study, 2014–2021
TL;DR
Combined high diet quality and sufficient physical activity was associated with a lower probability of inpatient healthcare utilization, particularly among women, older adults, and those with chronic diseases.
Abstract
Objective Little is known about the joint associations of diet quality and physical activity with healthcare utilization. We examined these associations in a nationally representative sample of Korean adults. Methods This cross-sectional study analyzed 37,059 adults aged 20 years or older in the Korea National Health and Nutrition Examination Survey, South Korea, 2014–2021. Participants were cross-classified into four groups by the sample median of the Korean Healthy Eating Index (KHEI) and physical activity level (≥150 moderate-equivalent minutes/week). Inpatient visits (past 12 months) and outpatient visits (past two weeks) were self-reported. Survey-weighted two-part models adjusted for sociodemographic and clinical covariates. Results The High KHEI & Active group showed a lower probability of inpatient visits (OR, 0.89; 95% CI, 0.79, 0.99) than the Low KHEI & Inactive reference. The High KHEI & Inactive group showed a higher probability of outpatient visits (1.19; 1.09, 1.30). Inpatient associations were strongest among women, older adults, and adults with chronic diseases. Conclusions Combined high diet quality and sufficient physical activity was associated with a lower probability of inpatient healthcare utilization, particularly among women, older adults, and those with chronic diseases. These findings support integrated health promotion strategies targeting both diet quality and physical activity.