Frequent consumption of meals prepared away from home linked to increased risk of early death
Elsevier
Dining out is a popular activity worldwide, but there has been little research into its association with health outcomes.
Investigators looked at the association between eating out and risk of death and concluded that eating out very frequently is significantly associated with an increased risk of all-cause death, which warrants further investigation.
Their results appear in the Journal
of the Academy of Nutrition and Dietetics, published by Elsevier.
Eating
out is a popular activity. The US Department of Agriculture recently estimated
that Americans' daily energy intake from food away from home increased from 17
percent in 1977-1978 to 34 percent in 2011-2012. At the same time, the number
of restaurants has grown steadily, and restaurant-industry sales are forecasted
to increase significantly.
Although
some restaurants provide high-quality foods, the dietary quality for meals away
from home, especially from fast-food chains, is usually lower compared with
meals cooked at home. Evidence has shown that meals away from home tend to be
higher in energy density, fat, and sodium, but lower in fruits, vegetables,
whole grains, and protective nutrients such as dietary fiber and antioxidants.
"Emerging, although still limited, evidence suggests that eating out frequently is associated with increased risk of chronic diseases, such as obesity and diabetes and biomarkers of other chronic diseases," explained lead investigator Wei Bao, MD, PhD, assistant professor, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA. "However, little is known about the association between eating meals away from home and risk of mortality.
Investigators analyzed data from responses to questionnaires administered during face-to-face household interviews from 35,084 adults aged 20 years or older who participated in the National Health and Nutritional Examination Survey 1999-2014. Respondents reported their dietary habits including frequency of eating meals prepared away from home.
"We linked these records to death records through
December 31, 2015, looking especially at all-cause mortality, cardiovascular mortality,
and cancer mortality," noted first author Yang Du, MD, PhD candidate,
Department of Epidemiology, College of Public Health, University of Iowa, Iowa
City, IA, USA.
During 291,475 person-years of follow-up, 2,781 deaths occurred, including 511 deaths from cardiovascular disease and 638 deaths from cancer.
After adjustment for
age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors,
and body mass index, the hazard ratio of mortality among participants who ate
meals prepared away from home very frequently (two meals or more per day)
compared with those who seldom ate meals prepared away from home (fewer than
one meal per week) was 1.49 (95% CI 1.05 to 2.13) for all-cause mortality, 1.18
(95% CI 0.55 to 2.55) for cardiovascular mortality, and 1.67 (95% CI 0.87 to
3.21) for cancer mortality.
"Our
findings from this large nationally representative sample of US adults show
that frequent consumption of meals prepared away from home is significantly
associated with increased risk of all-cause mortality," commented Dr. Du.
"This
is one of the first studies to quantify the association between eating out and
mortality," concluded Dr. Bao. "Our findings, in line with previous
studies, support that eating out frequently is associated with adverse health
consequences and may inform future dietary guidelines to recommend reducing
consumption of meals prepared away from home."
"The
take-home message is that frequent consumption of meals prepared away from home
may not be a healthy habit. Instead, people should be encouraged to consider
preparing more meals at home," concluded the investigators.
Future
studies are still needed to look more closely at the association of eating out
with death from cardiovascular disease, cancer, dementia, and other chronic diseases.
"It
is important to note that the study design for this research examines
associations between frequency of eating meals prepared away from home and
mortality. While encouraging clients to consider preparing healthy meals at
home, registered dietitian nutritionists might also focus on how selections
from restaurant menus can be healthy. Tailoring strategies to each client by
reviewing menus from restaurants they frequent can help them make healthy food
choices," added co-investigator Linda G. Snetselaar, PhD, RDN, LD, FAND,
professor and chair, Preventive Nutrition Education, Department of
Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA,
and Editor-in-Chief of the Journal of the Academy of Nutrition and Dietetics.