Takeaway Food Consumption, Dietary Inflammatory Index, and Cardiometabolic Risk Factors in US Adults: Findings From NHANES (2009–2018)

ABSTRACT Takeaway food consumption (TFC) has risen and often reflects energy‐dense, nutrient‐poor patterns. The Dietary Inflammatory Index (DII) quantifies diet‐related inflammatory potential. We tested whether higher TFC aligns with higher DII and adverse cardiometabolic risk factors (CRFs) in US adults, and secondarily with all‐cause and heart disease mortality. Data from 8556 NHANES 2009–2018 participants were analyzed. Weighted logistic/linear regression assessed TFC‐DII and TFC‐CRF associations. Weighted Cox models and Kaplan–Meier curves evaluated mortality (via NHANES Linked Mortality File). Exploratory mediation analyses examined indirect effects via DII, cardiometabolic index (CMI), and visceral adiposity index (VAI). Compared with TFC 0–1/week, ≥ 6/week was associated with higher energy‐adjusted DII ( β = 0.226; 95% CI: 0.061, 0.392), lower HDL ( β = −1.597; 95% CI: −2.767, −0.426), and higher triglycerides ( β = 7.980; 95% CI: 1.202, 14.757). Incremental increases in TFC were associated with higher fasting glucose, serum insulin, and insulin resistance. TFC showed no significant mortality associations, whereas higher DII predicted all‐cause mortality (HR = 1.0717; 95% CI: 1.0126, 1.1343). Frequent TFC is linked to a more pro‐inflammatory diet and adverse CRFs. Although TFC alone was not associated with mortality, dietary inflammation predicted increased all‐cause mortality, suggesting a potential long‐term pathway. Reducing high‐frequency TFC and lowering dietary inflammatory potential may improve cardiometabolic health at a population level.