DIETARY QUALITY AND FOOD PROCESSING LEVELS IN SUBSTANTIAL OUT-OF-HOME EATERS AND NON-SUBSTANTIAL OUT-OF- HOME EATERS

Background and objectives: Consumption of convenient ready-prepared foods and eating out-of-home has raised in low- and middle income countries. Eating out-of-home has been associated with unhealthy dietary patterns rich in processed and ultra-processed foods. The aim of this study is to compare the dietary quality and foods processing levels between Substantial out-of-home (SOH) and Non-substantial out-of-home (NSOH) eaters. Methods: A cross-sectional study was performed among 779 adolescents from an urban and a rural area in Ecuador (2008- 2009). Two non-consecutive 24-hour recalls were used to estimate dietary intake; eating out-of home was defined when food items were prepared in any place different than: the student home and relative's or friends home. Participants were classified as SOH eaters if they obtained more than 25% of their daily energy intake out-of-home; meanwhile, those who obtained ≤25% of daily energy intake out-of-home were identified as NSOH. Food processing levels were categorized using the NOVA Brazilian classification into non-processed, culinary ingredients, processed and ultra- processed foods. Two sample t-test was used to compare mean daily energy intake, energy density and macronutrient energy %, as well as energy % intake by food processing levels between SOH and NSOH eaters. Results: Overall, 71.89% of participants were classified as SOH eaters. Total energy intake (1927 kcal vs. 1825 kcal; p = 0.01), energy density (1.82 kcal/g vs. 1.62 kcal/g; p = 0.00) and total fat % 24.7% vs. 22.1%; p = 0.00) intakes were higher among SOH eaters compared with NSOH eaters. In addition, SOH eaters obtained less energy from non-processed food (48.4% vs. 60.7%; P