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

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 (<i>β</i> = 0.226; 95% CI: 0.061, 0.392), lower HDL (<i>β</i> = -1.597; 95% CI: -2.767, -0.426), and higher triglycerides (<i>β</i> = 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.