Eating out, weight and weight gain. A cross-sectional and prospective analysis in the context of the EPIC-PANACEA study

Objective: The aim of this study was to examine the association of body mass index (BMI) and weight gain with eating at restaurants and similar establishments or eating at work among 10 European countries of the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Subjects: This study included a representative sample of 24 310 randomly selected EPIC participants. Methods: Single 24-h dietary recalls with information on the place of consumption were collected using standardized procedures between 1995 and 2000. Eating at restaurants was defined to include all eating and drinking occasions at restaurants, cafeterias, bars and fast food outlets. Eating at work included all eating and drinking occasions at the workplace. Associations between eating at restaurants or eating at work and BMI or annual weight changes were assessed using sex-specific linear mixed-effects models, controlling for potential confounders. Results: In southern Europe energy intake at restaurants was higher than intake at work, whereas in northern Europe eating at work appeared to contribute more to the mean daily intake than eating at restaurants. Cross-sectionally, eating at restaurants was found to be positively associated with BMI only among men (beta = +0.24, P = 0.003). Essentially no association was found between BMI and eating at work among both genders. In a prospective analysis among men, eating at restaurants was found to be positively, albeit nonsignificantly, associated with weight gain (beta = +0.05, P = 0.368). No association was detected between energy intake at restaurants and weight changes, controlling for total energy intake. Conclusion: Among men, eating at restaurants and similar establishments was associated with higher BMI and possibly weight gain. International Journal of Obesity (2011) 35, 416-426; doi:10.1038/ijo.2010.142; published online 27 July 2010