(P24-095-23) Association of Frequency, Location, and Mealtime of Foods Consumed Away-From-Home and Cardiometabolic Factors Among Adults in Puerto Rico

Objectives: Consuming foods away-from-home (FAFH) is linked to low diet quality with limited information on its role in cardiometabolic health. We examined the associations between frequency, location, and mealtime of FAFH and cardiometabolic factors in adults living in Puerto Rico.

Methods: We analyzed data from 1,162 adults (30-75 y) in the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic disease Trends (PROSPECT). Participants self-reported the frequency of consuming commercial (C-FAFH) at various establishments and non-commercial (NC-FAFH) (i.e., others' homes) for any meal (i.e., breakfast, lunch, dinner, snack) as rarely/never ( < 2 times/wk) vs frequently (≥2 times/wk) and NC-FAFH. A food frequency questionnaire evaluated usual diet and the Alternate Healthy Eating Index (AHEI) was calculated to depict diet quality. Clinical and laboratory markers from fasting blood samples were measured using standardized protocols. Adjusted logistic models estimated the odds ratio (OR; 95% CI) of having each dysregulated factor by FAFH.

Results: Frequent NC-FAFH consumption for any meal was reported by 22.6% of adults and by 46.3% for C-FAFH, which was mostly at lunch (36.1%) and from fast-food (30.0%). Compared with rarely/never, frequently consuming C-FAFH was associated with higher odds of hyperglycemia for any meal (1.34; 1.01, 1.78) and for lunch (1.50; 1.12, 2.02); and with higher odds of low HDL-C for breakfast (1.61; 1.15, 2.25) and lunch (1.32; 1.01, 1.72). Frequently consuming C-FAFH from fast-food was associated with higher odds of elevated waist circumference (2.05; 1.28, 3.29) and low HDL-C (1.45; 1.09, 1.92); while at cafeterias and food trucks it was associated with higher odds of having low HDL-C (1.37; 1.03, 1.82) and hyperglycemia (1.72; 1.11, 2.67). Consuming NC-FAFH frequently for any meal (vs. rarely/never) was associated with low HDL-C (1.41; 1.05, 1.90). Adjusting for AHEI did not change the associations.

Conclusions: Consuming FAFH more than twice a week, especially at fast-food establishments, cafeterias, and food trucks, for breakfast or lunch, was associated with an adverse cardiometabolic profile, even within a high-quality diet. Policies improving the quality of foods at these settings may curb cardiometabolic disease.

Funding Sources: Funding sources include NHLBI, NIMHHD, and the Robert Wood Johnson Foundation.