{
  "abstract": "Background Policies targeting the out-of-home (OOH) food and drink sector are potentially key to addressing the obesity epidemic. No data exist quantifying the contribution the OOH food sector makes to typical dietary intakes in England. To help inform future policy, we aimed to quantify the contribution of the OOH food/drink sector on typical adult energy and nutrient intakes in England and whether this differs across demographics.Methods We conducted an online survey of N=1232 English adults recruited via Prolific between September 2023 and May 2024. Demographic data were collected using a study-specific questionnaire. Dietary intakes were self-reported using five, non-consecutive 24-hour dietary recalls (modified Intake24), covering both weekdays and weekends. We matched 42% of reported OOH eating occasions with data from the MenuTracker database (version 2022) and updated energy, total fat, saturated fat, total sugars and salt content accordingly. A series of random-intercept multilevel models were used to explore differences in population-weighted energy intakes (outcome) between 1) OOH and non-OOH eating occasions and, 2) OOH and non-OOH-food containing days (nested within persons) in the sample overall and by demographic. Methods and analysis protocols were pre-registered on Open Science Framework (https://osf.io/5n84w).Results Participants reported a mean=4.5 eating occasions/day and median=2.2 OOH eating occasions/week (weighted by week/weekend day and contributing a median 11% energy to total weekly energy intakes). OOH versus non-OOH eating occasions were higher in absolute intakes of total fat (median: 17 g vs 9 g), saturated fat (5 g vs 3 g), total sugar (14 g vs 11 g) and salt (1.1 g vs 0.5 g), with similar patterns observed at day-level. Fast food outlets were the most common (25% of all OOH eating occasions) and highest contributor to OOH eating occasion energy (median: 828 kcal). Maximally adjusted energy intakes were higher overall for OOH versus non-OOH eating occasions by 196 [95% CI: 171, 221] kcal (p<0.001). Strong evidence of association remained after accounting for multiple testing. After covariate adjustment and accounting for multiple testing, there was no evidence for differences in energy intakes between OOH- and non-OOH-food containing days. Results did not differ by demographic or after further adjustment for potential energy misreporting.Conclusion In England, adult eating occasion energy intake is higher when eating OOH, irrespective of demographic. Fast food outlets are a potential target for OOH food sector public health policies to tackle obesity. Further research is needed to confirm if compensatory effects lead to reduced energy consumption during the rest of the day.",
  "authors": [
    {
      "affiliations": [
        "Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "James Garbutt"
    },
    {
      "affiliations": [
        "Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Nick Townsend"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Liverpool, Liverpool, UK"
      ],
      "name": "Eric Robinson"
    },
    {
      "affiliations": [
        "School of Psychology, Liverpool John Moores University, Liverpool, UK"
      ],
      "name": "Andrew Jones"
    },
    {
      "affiliations": [
        "Department of Public Health and Policy, University of Liverpool, Liverpool, UK"
      ],
      "name": "Zoé Colombet"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Liverpool, Liverpool, UK"
      ],
      "name": "Amy Finlay"
    },
    {
      "affiliations": [
        "Department of Public Health and Policy, University of Liverpool, Liverpool, UK"
      ],
      "name": "Martin O’Flaherty"
    },
    {
      "affiliations": [
        "Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK"
      ],
      "name": "Zoi Toumpakari"
    }
  ],
  "title": "P37 Determining the contribution of out-of-home foods and drinks to adult diets in England",
  "uid": "ee2ac631-53d5-5657-ad2e-249db45d884c"
}