Appetite

How much pleasure we take in eating is more than just how much we enjoy the taste of food. Food involvement - the amount of time we spend on food beyond the immediate act of eating and tasting - is key to the human food experience. We took a biological approach to test whether food-related behaviors, together capturing food involvement, have genetic components and are partly due to inherited variation. We collected data via an internet survey from a genetically informative sample of 419 adult twins (114 monozygotic twin pairs, 31 dizygotic twin pairs, and 129 singletons). Because we conducted this research during the pandemic, we also ascertained how many participants had experienced COVID-19-associated loss of taste and smell. Since these respondents had previously participated in research in person, we measured their level of engagement to evaluate the quality of their online responses. Additive genetics explained 16-44% of the variation in some measures of food involvement, most prominently various aspects of cooking, suggesting some features of the human food experience may be inborn. Other features reflected shared (early) environment, captured by respondents twin status. About 6% of participants had a history of COVID-19 infection, many with transitory taste and smell loss, but all but one had recovered before the survey. Overall, these results suggest that people may have inborn as well as learned variations in their involvement with food. We also learned to adapt to research during a pandemic by considering COVID-19 status and measuring engagement in online studies of human eating behavior.

Food-related odors have been examined for their influence on different stages of eating behavior. However, the existing evidence is mixed across different study designs, making it difficult to obtain an integrated understanding. This systematic review aimed to synthesize experimental evidence on how exposure to food odors impacts different stages of eating behavior, including appetite and food craving, food choice and preference, and intake, and to explore factors that may contribute to variability in findings. PubMed, Web of Science, and Scopus were searched for studies on olfactory cues, appetite, food craving, food choice, food preference, and food intake. Of 15579 records identified, 43 met the inclusion criteria. Among these, 14 focused on appetite and craving, 18 on food choice and preference, and 16 investigated food intake. The included studies were evaluated using the Joanna Briggs Institute (JBI) tool to assess their quality. The results showed distinct patterns across outcomes: sensory-specific appetite and cravings were generally enhanced by food odor exposure, whereas effects on food choice and intake were less consistent and appeared to depend on factors such as individual characteristics and the mode of odor exposure. These findings provide a clearer direction for future research on how odors influence eating behavior, with the potential to inform strategies that promote healthier diets.

Genetic variation contributes to individual differences in food liking and dietary behaviour. Genome-wide association studies (GWAS) have identified genetic variants associated with these traits, but most evidence comes from middle-aged and older populations. Young adulthood is a key life stage during which long-term dietary habits develop, yet the genetic basis of food liking during this period remains largely unexplored. We conducted GWAS of 97 food liking traits and two derived principal components (PCs) in 2,784 young adults (age 25) from the Avon Longitudinal Study of Parents and Children. The PCs captured broader food preference patterns reflecting preferences for diverse plant-based and seafood foods (PC1) and meat-based foods (PC2). GWAS identified 32 genome-wide significant associations across 24 traits. Cross-trait analyses indicated that several variants influenced liking across groups of related foods. For example, the lentil-associated variant rs76659918 showed associations with multiple foods, including honey, plain yogurt, chilli peppers, aubergines, avocado, and black olives, as well as PC1, whereas variants associated with bacon, burgers, and steak were linked to multiple meat-based foods and PC2. Exploratory analyses showed that TAS2R38 bitter-sensitive alleles were associated with lower liking for Brussels sprouts, with limited evidence for associations with other traits. Comparison with GWAS of food liking in the UK Biobank cohort (age 37-73) showed limited replication, with robust evidence only for the grapefruit-associated locus. This study identifies genetic variants associated with food liking in young adulthood and suggests that genetic influences operate at both the level of individual foods and broader food preference patterns.

Withdrawal StatementThe authors have withdrawn this manuscript because it was posted without the approval of all co-authors. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding authors.

ObjectiveThe current study investigated whether dietary restraint moderates the relationship between Postprandial Distress Syndrome (PDS) symptoms (e.g., postprandial fullness, early satiety, and nausea) and Binge Eating (BE) in adolescents with overweight and obesity. BE is associated with PDS symptoms. Individuals often self-initiate restrictive diets that limit food variety in attempt to manage PDS symptoms. However, dietary restraint is thought to increase frequency of BE. Thus, individuals who attempt to manage PDS symptoms through dietary restraint may engage in more BE. Investigating the relationship between dietary restraint and PDS in relation to BE will increase our understanding of risk factors for BE during adolescence--a period associated with heightened onset of disordered eating and dieting attempts. MethodAdolescents (N=60) with higher weight (M Body Mass Index (BMI) percentile = 97.72 [SD = 2.61], M age = 15.37 years [SD = 1.34], 63.3% female) completed measures of PDS symptoms, dietary restraint, and BE. Generalized linear regression examined whether dietary restraint moderated the relationship between PDS symptoms and BE frequency. ResultsThe interaction effect was significant, such that greater PDS symptoms were associated with increased BE frequency when dietary restraint was average or higher than average. DiscussionResults suggest that the relationship between PDS and BE symptoms depends on level of dietary restraint. Future work should investigate if this relationship holds for other GI syndromes and investigate the differential impact of dietary restraint versus restriction on PDS and BE.

Greater consumption of food prepared outside of the home (OOH) is associated with higher energy intake. Strategies are needed to make eating OOH food less harmful to health. Identifying menu characteristics that contribute to higher energy consumption OOH could aid characterisation of OOH outlets by their relative healthiness and inform future policy intervention in the OOH food sector. Customers (N=3718) were asked to recall their food orders upon exiting a range of OOH outlets across four local authorities in England during 2021 and 2022. For each outlet, universal health rating scores were calculated based on select menu characteristics and deep learning healthiness scores were calculated based on outlet name. Random forest models and robust linear regression models clustered by outlet were used to identify whether outlet healthiness scores and individual menu characteristics were associated with kcal consumed. Universal health rating scores, but not deep learning scores, were predictive of energy consumed during OOH outlet visits (-28.27; 95% CI -44.76 to -11.77; p=.003). Menu characteristics with the greatest importance for predicting energy consumed were the percent of savoury main menu items over 600kcal and 1345kcal, the number of desserts, the number of unique vegetables, and the percent of drinks over 100kcal. Menu characteristics accounted for 29% of variance in energy consumed by customers. Universal health rating scores may be a useful tool to characterise the healthiness of OOH outlets in England. Investigating the potential impact of OOH outlet health ratings on consumer and business behaviour is now warranted.

It was suggested that the ingestion of extra calories towards the end of or shortly after a meal might be especially fattening. That hypothesis was based on the intuition that mixing of the sugared drink and accompaniments while the stomach was emptying rapidly would delay the release of hunger less than the same intake in the hour before the next meal. This paper presents an examination of that mechanism by calculating the time course of gastric emptying with extra intake at different times after the meal. The output from these simulations confirmed that early further energy would delay the end of emptying less than later. However, within the parameters tested, the effect is not large. Fattening effects of calories after meals could arise by a variety of mechanisms that remain to be tested without disrupting daily life. "Highlights"O_LIExtra intake may be more fattening shortly after meals than later. C_LIO_LIThat proposal was supported by theoretical calculations of gastric emptying. C_LIO_LIHence the timing of energy intake well before a meal seems critical to its effect on weight. C_LIO_LIThe eaters own concepts of meal, snacks and drinks are key to research on weight control. C_LI

Dietary patterns worldwide have shifted toward increased consumption of ultraprocessed foods (UPFs), which has been linked to higher disease burden. One mechanism proposed to impact both their consumption and contribution to metabolic disease is altered post-ingestive metabolic response in comparison to nutritionally similar foods. Here, we recruited 57 healthy-weight 18-45-year-old adults to examine the effects of food processing on postprandial metabolism and brain response. Despite nutritional matching, UPF meals evoked a greater insulinemic and energetic response with attenuated carbohydrate oxidation relative to non-UPF meals. Next, between-condition differences in peak carbohydrate oxidation were associated with mesolimbic and superior temporal gyrus activation in response to food cues. Finally, although food value did not differ between conditions, brain responses correlated with food valuation were positive for non-UPF but negative for UPF in visual cortex and striatum. These findings demonstrate that food processing influences post-ingestive metabolism in a way that could help explain long term health effects and differences in food reward through mechanisms beyond calories and macronutrient composition alone.

BackgroundEarly temperament may shape childrens eating behaviours and growth, yet longitudinal evidence supporting these associations remains limited. We aimed to identify latent temperament profiles from 6 months to 5 years and examine their associations with eating behaviours and longitudinal changes in BMI-SDS. MethodsData were drawn from the FinnBrain Birth Cohort Study, a population based longitudinal study in Southwest Finland (n=2,286). Child temperament was assessed at 6 and 12 months, and at 2, 4, and 5 years using validated questionnaires. Eating behaviour was reported at age 2, and BMI-SDS was measured at ages 2 and 5. Latent profile analysis was conducted on repeated temperament measures. Associations with outcomes were examined using the BCH method. ResultsThree temperament profiles emerged: Dysregulated group (38%; low self-regulation, low to average positive reactivity, low negative reactivity), High self-regulation group (37%: high self-regulation, low negative reactivity, high to average positive reactivity), High negative reactivity group (24%: high negative reactivity, moderate positive reactivity, average self-regulation). The high self-regulation group showed more favorable eating behaviours (less snacking and fussiness, more willingness to taste new foods) compared to the other groups. High negative reactivity group showed greater decrease in BMI than Dysregulated group. Other BMI change differences were non-significant. ConclusionsDistinct temperament profiles were linked to early eating behaviours and, to a lesser extent, BMI development. Understanding these early temperament-based patterns may help identify children at risk for less favourable eating patterns and inform tailored early interventions to promote healthy eating and growth.

BackgroundLarge out-of-home (OOH) food businesses in England have been required by law to display calorie information on menus since 6th April 2022. This study investigates whether the implementation of this policy was associated with changes in calories purchased OOH. MethodsControlled interrupted time series analysis was used to estimate changes in calories purchased from all OOH outlets in England (intervention group). Secondary outcomes included purchases from large chain outlets, non-chain outlets and five sub-types of purchases (meals, lower-calorie coffee, higher-calorie coffee, sandwiches, and fish and chip meals). The control series consisted of purchases from non-chain outlets in Scotland and Wales. Itemised OOH food and non-alcoholic drink purchase records, matched to calorie (kcal) content at one point in time, covered 13 weeks pre- and 34 weeks post-intervention (3rd January to 27th November 2022) and were aggregated to population level average weekly kcal purchase estimates. Linear regression, adjusted for season and inflation, was used to model level and trend changes compared to the counterfactual of no mandatory policy. The counterfactual was constructed from the intervention series pre-intervention level and the control series post-intervention level and trend. Subgroup analyses explored effects by age, sex, socioeconomic status (SES), weight status, and weekday/weekend purchases. ResultsCompared to the counterfactual, we found no evidence of a change in overall calories purchased OOH associated with mandatory calorie labelling. There was also no robust evidence of changes in calories purchased OOH for secondary outcomes and by subgroups compared to the counterfactual of no mandatory calorie labelling. Small changes observed in these analyses were sensitive to analytical choices. DiscussionOur findings suggest that mandatory calorie labelling in England did not reduce overall calories purchased from OOH venues. Findings should be interpreted taking into account that the data used did not capture possible changes to menus. Our findings support existing evidence that information provision alone is unlikely to secure significant changes in food purchasing behaviour at population level.

Obesity is associated with low-grade inflammation, which - our prior work shows - causally and reversibly increases effort aversion and related brain responses during food-related decision-making. However, how these laboratory findings translate to daily-life (food) motivation remains unclear. This study investigated low-grade inflammation in more ecologically valid measures of (food-related) motivation in obesity. We conducted a cross-sectional study (N=145 women, BMI>27 kg/m2, 18-59 yrs) and a 12-week randomized controlled trial (N=57 women, BMI>30 kg/m2, 18-59 years, C-reactive protein (CPR)>3 mg/l) testing the anti-inflammatory drug colchicine versus placebo. We measured effort-related food intake using a bogus taste test, daily-life motivation using ecological momentary assessment (EMA), and dietary intake using a food frequency questionnaire (FFQ). INFLA-score (CRP, white blood cell count, neutrophil-to-lymphocyte ratio, platelets) related to lower intake of high-effort food items on the taste test ({beta} -0.26 SD, p=0.011), lower engagement in high-effort activities (OR 0.72, p<0.001), and negatively moderated the association between anticipation and activity completion in EMA (OR 0.89, p=0.032). On the FFQ, INFLA-score related to lower intake of legumes and fruits and more intake of processed meat (all p<0.05). Colchicine decreased overall caloric intake ({beta} -341 kcal, p=0.018). A decrease in inflammation related to healthier dietary choices (Spearman {rho}=0.37, p=0.013). Colchicine did not affect effort-related food intake on the taste test or EMA. These findings indicate that that obesity-related inflammation is associated with increased effort-related food intake and motivation in daily life, and that reducing inflammation decreases (unhealthy) food intake. Such effects may partly underlie the challenges of achieving and maintaining weight loss.

BackgroundPrebiotic dietary fiber and related metabolites have been suggested to attenuate low-grade systemic and central inflammation through improving gut-brain axis signaling. We here aimed to test whether habitual or short-term high-dose fiber intake is linked to inflammatory markers in blood and to indicators of central hypothalamic inflammation. MethodsIn total, 59 adults (19 women, aged 28.3 years {+/-} 6.6 SD, mean body mass index, BMI, 27.3 {+/-} 1.5 SD) were included into analyses. Participants completed a food frequency questionnaire, underwent diffusion-weighted magnetic resonance imaging (MRI) at 3 Tesla for provision of mean diffusivity (MD) as a marker of brain tissue inflammation and donated fasting blood. Measurements took place at up to 4 timepoints, i.e. before and after 14 days of supplementary fiber and placebo intake, respectively. High-sensitive C-reactive protein (CRP), tumor-necrosis factor alpha (TNF-) and interleukin-6 (IL6) were assessed in serum. The study was preregistered at https://osf.io/uzbav. ResultsHabitual and interventional high-fiber diet was not significantly associated with neither inflammatory markers (|{beta}intervention|> 0.1, p > 0.32) nor with hypothalamic MD (|{beta}intervention| = 1.8, p = 0.07) according to linear mixed effects modeling. Male sex and higher body fat mass related to higher CRP. Further, higher BMI was borderline related to lower hypothalamic MD. ConclusionsIn this sample of overweight adults, dietary fiber intake was not related to inflammatory blood markers or hypothalamic microstructure. Instead, sex and body composition were of higher importance for prediction of interindividual differences in markers of (neuro)inflammation. Significance StatementPrebiotic dietary fiber has been discussed to lower systemic and central inflammation. While previous studies investigated the effects of fiber on inflammatory blood markers, the knowledge of the effect of fiber on neuroinflammation is limited. Thus, in this pre-registered randomized controlled trial analysis we examined the relationship between dietary fiber intake and inflammatory markers in blood and hypothalamus. 3T MRI and blood markers were assessed before and after high-fiber intake and placebo in 59 adults. In our overweight study sample of 19-42 years old adults, fiber intake had no significant impact on inflammatory markers. The current null findings can inform future nutrition neuroimaging trials and add to the discussion about how diet may affect brain structure and function.

Interoception, the perception of body signals, which is crucial for maintaining metabolic homeostasis, is asserted to play a vital role in obesity. Despite conceptual assumptions that impaired insular interoceptive processing contributes to overeating behaviors predominantly through modulating motor cortices, this link has not been extensively explored. Therefore, to further investigate neural mechanisms underlying insula-based interoceptive processing, this pre-registered (PMC9003175) study assessed blood oxygenation level-dependent (BOLD) responses via functional magnetic resonance tomography (fMRI) in 45 healthy participants (31 females/14 males, age 35.78 {+/-} 10 years, BMI 29.52 {+/-} 3.5 kg/m2) during a block-designed food cue reactivity task. Region of interest (insula) and whole brain voxel-wise correlation analyses explored neural correlates of visceral interoception. Furthermore, group factor analysis (GFA) unveiled coherence patterns between neural (fMRI) and psychological/behavioral measures. At the psychological level, self-reported hunger (P < 0.01, d = 0.82) and food craving (P < 0.01, d = 0.68) significantly increased, while craving control (P = 0.04, d = 0.37) decreased after cue exposure. Voxel-wise correlation analysis identified positive correlations (P < 0.01) between visceral interoception and activation of the precentral gyrus (PrG or motor cortex), insula, inferior frontal gyrus (IFG), posterior cingulate cortex (PCC), and superior parietal lobule (SPL). Moreover, altered functional connectivity dynamics were noted within the insula-PrG-IFG network during food cue exposure, with a significant reduction of IFG-PrG connections (P = 0.05). Interestingly, GFA identified a cross-unit latent factor across neural and psychological/behavioral measures. Overall, our findings indicate that altered interoceptive processing (insula activity), motor planning (motor cortex activity), and diminished inhibitory control (negative IFG-PrG connectivity) collectively contribute to food craving generation and potentially subsequent actions toward food consumption.

Background: Over half of UK adults eat food prepared out-of-home (OOH) weekly and the poor nutritional profile of OOH food contributes to ill health. Nutri-Score is a form of interpretative labelling which assigns food products a value of A (healthiest) to E (least healthy) based on nutritional quality, and inclusion on menus could be a public health policy option to reduce obesity. This is the first real-world Randomised Control Trial to test the effectiveness of Nutri-Score alongside calorie labelling on food menus in UK OOH settings. Methods: Adult participants (N=672), majority White (80%) female (63%), with a mean age of 47(SD18) years, were recruited from the local community to visit OOH food businesses to order, consume, and pay for meals. Data collection days were randomised to be control (calorie labelling) or Nutri-Score (calorie labelling with Nutri-Score). Linear mixed models assessed impacts of labelling condition on perceived effectiveness of menu labelling and nutritional quality of food orders. Findings: Scores for perceived effectiveness of labelling were significantly greater in the Nutri-Score condition compared to control (B = 0.21, p=0.010; 95% CI 0.05, 0.37) and food orders were significantly better nutritional quality, indicated by lower Nutrient Profiling Model scores in the Nutri-Score vs. control condition (B = -0.89, p=0.003; 95% CI -1.48, -0.31). Interpretation: Compared to providing calorie labelling alone, inclusion of Nutri-Score could be an effective policy approach to improve nutritional quality of diet and reduce diet-related disease.

Food cues that appear in the visual field capture our attention easily and can influence eating behavior. The current study investigated the influence of food-related stimuli on visual attention, considering the macronutrient composition of food items. Images representing sweet and savory foods were employed, the latter consisting primarily of high-protein foods. The participants were primed with these images prior to performing the attentional task. We found that both sets of food images elicited an emotional attentional blink (EAB), but a stronger EAB was observed for the high-protein foods, and this observation was further supported by a negative correlation between the attentional bias (ABias) and the proportion of protein consumed by the participants before the experiment, with participants who consumed less protein exhibiting a stronger ABias toward high-protein foods. These findings suggest that an ABias might also arise to facilitate the consumption of high-protein foods when prior consumption of this macronutrient is low.

Background and AimsSugar intake has been linked to obesity, however, the relationship between individual sugar perception and dietary choice remains unclear. The current study aims to measure individual bi-directional rejection thresholds and compare these measures to sugar intake and consumption patterns of sweet-taste beverages. MethodsA cross-section design will be used to analyse the relationship between sweetness perception, sucrose liking, and dietary intake. Participants will attend laboratory sessions to assess sucrose liking, ascending and descending rejection thresholds, and detection thresholds, and complete a 4-day weighed food-diary to assess dietary intake. ANCOVA will be used to test for differences in detection threshold and hedonic VAS ratings between the liking and disliking group, with age, gender, and BMI as covariates. A generalised linear mixed-models will be applied to test for differences in individual ascending versus descending rejection threshold across the two sweet liker status groups. Regression models will be used to test the role of ascending versus descending rejection thresholds on predicting sugar and sweet-taste beverage consumption. DiscussionMore research focusing on links between individual sweetness perception and sugar intake will be important for elucidating the mechanism underpinning sensory effects on dietary behaviour.

Mandatory calorie labelling was introduced in out-of-home (OOH) food sector outlets during 2022 in England. Previous research in North America has found labelled energy content can be underestimated for packaged and quick-serve foods, but no study has evaluated the accuracy of out-of-home food sector menu calorie labelling in response to the mandatory policy introduced in England. N=295 menu items from a range of outlet types (e.g. cafes, pubs, restaurants) and menu categories (e.g., starters and sides, main, dessert) were sampled. Bomb calorimetry was used to quantify energy content and the reported energy content on menus was recorded. Consistency of measured energy was assessed by sampling the same items across outlets of the same business (N=50 menu items). Differences between reported and measured energy content were tested through Wilcoxon Signed Rank tests, and a linear model examined correlates of the difference. Mean measured kilocalories (kcal) were significantly lower than reported kcal (-16.70kcal ({+/-}149.19), V=16920, p<.01, r=0.182). However, both over- and under-estimation of measured energy content was common and the averaged absolute percentage difference between reported and measured values was 21% ({+/-}29%). Discrepancy between measured and reported energy content was more common in some outlet types (pubs) and reported energy content was substantially different (>20%) to measured energy content for 35% of sampled menu items. There were significant inaccuracies in reported energy content of calorie labelled menu items in English food outlets subject to mandatory calorie labelling and this appears to be caused by both over- and under-estimation of reported energy content. HighlightsO_LI- Energy content measured by bomb calorimetry was significantly higher than on menus. C_LIO_LI- Both under and over estimation of food energy content were frequently observed. C_LIO_LI- Measured energy content was consistent across chain outlets in different locations. C_LI

BackgroundAttentional bias (AB) for palatable foods has been linked to overeating, yet data on its modulation with body-mass index (BMI) and hunger/satiety are inconsistent. We tested whether hunger, sensory-specific satiety and BMI interact to shape automatic capture of attention by real high-calorie snack foods. MethodsTwo emotional-attentional-blink (EAB) experiments presented food distractors either 300 msec (lag-3) or 900 msec (lag-9) before a neutral target. Experiment 1 (N = 183; whole BMI range) randomly assigned participants to taste (non-satiated), satiated or non-eating conditions; the snacks eaten (or not eaten) subsequently re-appeared as distractors in the EAB task. Experiment 2 (N = 61; 31 overweight/obese, 30 normal-weight) manipulated hunger/satiety states and snack type (consumed vs. novel) orthogonally, in a double session design. ResultsExperiment 1-- food images presented at lag-3 reduced target detection compared with lag-9 (OR = 0.61, CI 0.50-0.75, p <.01. Higher BMI predicted a larger AB when hungry, but a smaller AB when satiated (OR = 0.65, CI 0.48-0.88, p < 0.01). Experiment 2-- For novel snacks, an interaction revealed that participants with overweight/obesity retained robust AB after satiation, whereas AB declined for participants with normal-weight (OR = 2.45, CI 1.09-5.51, p = 0.03). For snacks just eaten, AB remained significant in both groups (lag-3 vs. lag-9: OR = 0.37, CI 0.25-0.55, p <.001). ConclusionsReal-food cues automatically biased attention regardless of metabolic state, with BMI modulating this effect: even when satiated, individuals with overweight/obesity continue to orient their attention toward both familiar and novel high-calorie foods. These findings suggest that satiety signals alone may be insufficient to curb attentional capture by food in obesity, highlighting the need for interventions that target attentional control and limit food availability.

Protein provides essential amino acids critical for survival. Recent research has identified that dietary protein restriction induces physiological and behavioral adaptations and that those adaptations are mediated by liver-produced fibroblast growth factor 21 (FGF21) that acts in the brain. Most of the research on adaptations to dietary protein restriction and the biological factors that mediate those adaptations carries an implicit assumption that the effects of dietary protein restriction are reversible. Rarely is the assumption of reversibility directly examined by varying dietary protein content within animals. Recently collected data on preference for protein versus carbohydrate solutions indicates that when mice are placed on a low (5%) protein diet, preference for protein is rapidly increased. However, when mice are switched from a low to normal (20%) protein diet, relative consumption of protein decreases but preference for protein persists. Re-analysis of published data suggests, similarly, that preference for protein-rich food sources remains elevated following exposure to dietary protein restriction and that calcium influx in the ventral tegmental area of the brain in response to protein consumption also remains persistently elevated following dietary protein restriction. Together, the data suggest that prior protein restriction can exert long-lasting effects on protein preference and on brain activity associated with protein consumption. The finding that the effects of protein restriction do not rapidly reverse implies that protein choice may be a function, not only of current nutritional state, but of historical nutritional conditions. Further, these results suggest that a full understanding of the environmental and biological determinants of protein choice requires studies in which dietary protein intake is varied within subjects.

BackgroundQuantifying the contribution of the out-of-home food and drink (OOHF) sector on the English national diet could inform effective nutrition policy development. However, rigorous data and analysis for estimating the relative contribution of the OOHF sector to total diet is lacking. ObjectivesTo quantify the nutritional contribution per day and per eating occasion of the OOHF sector on adults diets in England in terms of energy, total fat, saturated fat, sugar and salt, overall and across key demographics. DesignData collected from n=1232 participants (51% female) in a multi-stage online survey including demographics and mean 4.5 (SE 0.03) 24-hr dietary recalls over a 2-3 week period. Four waves of data collection (September 2023 -May 2024) captured seasonal differences. Hierarchical multilevel models explored differences in energy between 1) eating occasions or 2) days, containing OOHF versus not. Total nutritional differences by OOHF across demographics were described. ResultsMedian out-of-home (OOH) eating occasion energy intakes were 440kcal (vs 294kcal for non-OOH occasions). After adjustment, energy intakes during OOH eating occasions were 196kcal [95%CI: 171, 221] (p<0.001) larger than non-OOH occasions. OOH days contained 103kcal [29, 177] (p=0.006) more than non-OOH days, but evidence of association was not robust to multiple testing. OOHF contributed a median of 11.0% (IQR: 0, 23.4) energy to total weekly energy intake. Participants exceeded recommended daily nutritional intakes more often on OOH days versus non-OOH days (>70g fat (female): 43% vs 29%, >90g fat (male): 29% vs 16%; >20g saturated fat (female): 62% vs 53%, >30g saturated fat (male): 36% vs 28%; >90g total sugars: 33% vs 26%; >6g salt: 32% vs 18%). ConclusionsThe OOHF sector makes a substantial contribution to the national English diet, with food prepared OOH linked to higher energy and poorer nutritional intakes. Population-wide nutrition policies targeting the sector are needed.