Meal timing and eating window with all-cause and cardiovascular mortality and life expectancy: population-based cohort study

Abstract

The impact of meal timing and eating window on mortality and life expectancy remains unclear. This cohort study included 31,044 adults aged 40 years and older from the National Health and Nutrition Examination Survey 1999–2018. The meal timing and the eating window were estimated from a 24-h dietary recall. During a median (IQR) follow-up of 8.6 (4.5–13.0) years, 7129 deaths were documented. Compared with a first meal within 7:00–8:00, the hazard ratios (HRs) and 95% CIs of all-cause mortality were 1.10 (1.02–1.18), 1.19 (1.05–1.34), and 1.29 (1.10–1.51) for a first meal within 8:00–10:00, 10:00–12:00, and after 12:00, respectively. Compared with a last meal within 19:00–20:00, the HR of all-cause mortality was 1.13 (1.03–1.25) for a last meal before 19:00, and 1.27 (1.06–1.54) for eating after midnight. The associations were also observed for cardiovascular mortality. The association between eating window and cardiovascular mortality risk varied by first meal timing. At the age of 50 years, the estimated life expectancy was on average 2.46 (0.61–4.28) years shorter among participants having a first meal after 12:00 and 2.35 (0.82–5.14) years shorter among those having a last meal after midnight compared with reference groups. Later first meals and earlier or later last meals were associated with higher mortality risks and shorter life expectancy. These findings suggest that meal timing may be a modifiable behavioral factor associated with mortality risk and life expectancy.