In an article published in PLoS ONE, researchers in the US examined whether more frequent intake of restaurant food is linked to a higher risk of death.
Eating restaurant food is popular in the United States for many reasons, such as convenience or socialization. The foods served in restaurants, however, are often energy-dense, high in fat and sodium content, and lower in nutrients thus making it plausible that more frequent consumption of restaurant foods may result in poorer health outcomes. To date, only a few studies have researched the association between eating restaurant food and body weight, HDL cholesterol, glucose levels, and insulin levels. However, there are currently no published studies investigating the frequency of restaurant food consumption and the risk of cardiometabolic and all-cause death.
Does Restaurant Food Increase Mortality?
In an article published in PLOS One, researchers from the United States conducted an observational prospective cohort study examining the association between eating restaurant food and the risk of cardiometabolic and all-cause death in the U.S. population.
For the study, they collected data regarding the frequency of eating restaurant food from the National Health and Nutrition Examination Surveys from 1999 to 2004 and was linked to the mortality data by the National Center for Health Statistics. The study population included respondents 40 years of age or greater at baseline and excluded pregnant and lactating women, and respondents who were missing information on their biomarkers, the frequency of restaurant food consumption, or mortality follow-up. In addition to analyzing mortality data, the researchers also examined several cardiometabolic and nutritional biomarkers, which included total and HDL cholesterol, triglycerides, glucose, insulin, c-reactive protein, folate, carotenoids, and vitamins C, D and E.
More than a third of the respondents included in the study reported eating restaurant food at least three times weekly and just over 10% reported never eating restaurant food. Eating restaurant food at least three times weekly was more common among men, non-Hispanic whites, those between 40 and 59 years of age, those with a higher BMI, higher education and income, current drinkers and those without chronic disease.
Restaurant Food is Not Linked to All-Cause Mortality
After adjusting for confounders, the study’s analysis didn’t observe any association between the frequency of eating restaurant food and death (cardiometabolic-related and all-cause). In addition, other metabolic biomarkers that were examined didn’t uncover any association with frequency of eating restaurant food. There was a decrease observed in some nutritional biomarkers, such as folate and carotenoid, with an increasing frequency of eating restaurant food, but no association was found with vitamins C, D, and E.
This study was the first to investigate the association between restaurant food consumption and death, as only a few past studies have investigated its association with specific conditions, such as type-2 diabetes and gestational diabetes. The study’s strengths include its nationally representative sample and the availability of baseline BMI, multiple confounders and assessment of restaurant food consumption frequency. Limitations, however, may include the observational nature of the study, lack of repeat assessment of restaurant exposure frequency during follow up and the latency of many metabolic diseases, which may not have been captured in the study’s short nine-year follow up.
Overall, the study did not find any association linking more frequent restaurant food consumption with cardiometabolic or all-cause death, despite the link between more frequent intake of restaurant food and poor quality diet.
Written by Maggie Leung, PharmD
Reference: Kant, A. K., & Graubard, B. I. (2018). A prospective study of frequency of eating restaurant prepared meals and subsequent 9-year risk of all-cause and cardiometabolic mortality in US adults. Plos One, 13(1). doi:10.1371/journal.pone.0191584
