Heat or eat? Exploring the link between fuel poverty and diet quality among older adults aged over 50

Rising fuel prices have increased the prevalence of fuel poverty, forcing households to make trade-offs between spending on energy and food, a dilemma often described as 'heat or eat'. While prior studies have mentioned reductions in food expenditure or intake under these circumstances, less is known about the impact on overall diet quality among older adults. We analysed the association between fuel poverty and diet quality among adults aged over 50 in England using cross-sectional data from Wave 9 of the English Longitudinal Study of Ageing (ELSA; n = 3919). Diet quality was assessed using the Healthy Diet Indicator (HDI) score and daily fruit and vegetable intake. Fuel poverty was defined using three measures: the 10% threshold, the Low-Income High Costs (LIHC) indicator, and a subjective self-reported measure. Ordinal logistic regression was used for HDI, and ordinary least squares regression for fruit and vegetable intake. Older adults identified as fuel poor under the LIHC indicator had lower HDI scores (OR = 0.83) and consumed 0.41 fewer portions of fruit and vegetables per day compared with those not in fuel poverty. No consistent associations were observed when fuel poverty was defined using the 10% threshold or the subjective measure. Fuel poverty, when defined by the LIHC indicator, is negatively associated with diet quality in later life. Addressing fuel poverty may therefore support improved nutrition and health among older adults.