# Association of eating out of home and type 2 diabetes mellitus in Chinese urban workers: A nationwide study

## TL;DR

Frequent eating out is linked to a higher risk of type 2 diabetes in Chinese urban workers, especially among younger people.

## Contribution

This study identifies a dose-response relationship between eating out frequency and T2DM risk in Chinese urban workers.

## Key findings

- Eating out ≥10 times/week was associated with a 31% increased odds of T2DM.
- A threshold of 5 times/week was identified for a significant increase in T2DM risk.
- The association was strongest in individuals aged ≤45 years.

## Abstract

The prevalence of type 2 diabetes mellitus (T2DM) has been rapidly growing in Chinese populations in recent decades, and the shift in eating habits is a key contributing factor to this increase. Eating out of home (EOH) is one of the major shifts in eating habits during this period. However, the influence of EOH on the incidence of T2DM among Chinese urban workers is unknown.

The cross‐sectional study involved an analysis of 13,904 urban workers recruited from 11 health examination centers in the major cities of China to explore the relationship between EOH and T2DM between 2013 September and 2016 March.

Average weekly EOH frequency ≥10 times was positively associated with increased incidence of T2DM in the sampled population (OR: 1.31 [1.11–1.54], p < 0.01), most notably in participants ≤45 years old (OR: 1.41[1.11–1.80], p < 0.01]) and in males (OR:1.26 [1.06–1.51], p < 0.01). An EOH frequency of 5 times/week appears as a threshold for a significant increase in the odds of T2DM. Weekly EOH frequency ≥5 times was associated with increased odds of T2DM in a dose–response manner in the total population and almost all subgroups (p
overall association < 0.05 and p
nonlinearity ≤ 0.05).

This study showed that a frequency of EOH (≥5 times/week) was associated with a frequency‐dependent increase in the odds of T2DM urban workers in China. More nutrition promotion is needed to improve the eating behavior of Chinese urban workers to reduce T2DM risk.

Dose–response associations between weekly frequency of eating out of home (EOH) and type 2 diabetes mellitus (T2DM) in (A) the total population, (B) male population, (C) female population, (D) population > 45 years old, and (E) population ≤45 years old. The fully adjusted model included age, gender (except for male and female population), BMI, smoking status, drinking status, physical activity, hypertension, dyslipidemia, and family history of T2DM.

High frequency of eating out of home (EOH) was associated with increased odds of type 2 diabetes mellitus (T2DM) in Chinese urban workers.The positive association between EOH and T2DM was independent of sex, and the association was strongest in individuals ≤45 years of age.EOH frequency of about 5 times/week seemed to be a threshold for the increased odds of T2DM.

High frequency of eating out of home (EOH) was associated with increased odds of type 2 diabetes mellitus (T2DM) in Chinese urban workers.

The positive association between EOH and T2DM was independent of sex, and the association was strongest in individuals ≤45 years of age.

EOH frequency of about 5 times/week seemed to be a threshold for the increased odds of T2DM.