Research Original Research| Volume 121, ISSUE 9, P1741-1749.e1, September 2021

Association Between Frequency of Eating Away-From-Home Meals and Risk of All-Cause and Cause-Specific Mortality

Published:March 25, 2021DOI:



      Dining out is a popular activity worldwide. Evidence on the association between eating meals away from home and long-term health outcomes is still limited.


      The objective of this study was to examine the association of frequency of eating meals prepared away from home with all-cause and cause-specific mortality.


      This study included 35,084 adults aged 20 years or older from the National Health and Nutritional Examination Survey 1999-2014, who reported their dietary habits including frequency of eating meals prepared away from home in a questionnaire during face-to-face household interviews.

      Main outcome measures

      All-cause mortality, cardiovascular mortality, and cancer mortality were ascertained by linkage to death records through December 31, 2015.

      Statistical analyses performed

      Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios of mortality from all-cause, cardiovascular, and cancer mortality.


      During 291,475 person-years of follow-up, 2,781 deaths occurred, including 511 deaths from cardiovascular disease and 638 death 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 (2 meals or more per day) compared with those who seldom ate meals prepared away from home (fewer than 1 meal/wk) 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.


      Frequent consumption of meals prepared away from home is significantly associated with increased risk of all-cause mortality. The association of eating meals prepared away from home with cardiovascular mortality and cancer mortality warrants additional investigation.


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      Y. Du is a PhD candidate, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.


      S. Rong is an associate professor, Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China.


      Y. Sun is a postdoctoral research scholar, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.


      B. Liu is a postdoctoral research scholar, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.


      Y. Wu is a PhD candidate, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.


      L. G. Snetselaar is a professor and chair, Preventive Nutrition Education, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.


      R. B. Wallace is a professor and Irene Ensminger Stecher Professorship in Cancer Research, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City.


      W. Bao is an assistant professor, Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, and a member, Obesity Research and Education Initiative, and Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City.