Background Frequent takeaway meal consumption has been associated with increased risks of coronary heart disease (CHD), type 2 diabetes (T2D) and obesity in adults. However, the associations between takeaway meal consumption and risk markers for CHD, T2D and obesity have been little studied in children. We set out to examine these associations in a study of 9–0 year-old children.

Methods A cross-sectional study of UK primary school children aged 9–10 years from a sample of 85 primary schools in London, Birmingham and Leicester provided balanced numbers of white European, South Asian and black African origin. Children reported their frequency of takeaway meal consumption (never/hardly ever, <1/ week, 1/week, >1/ week), completed a 24 h dietary recall, had physical measurements including bioelectrical impedance assessment of fat mass and provided a fasting blood sample for measurement of insulin, HbA1c and blood lipids. Standard multilevel linear regression models were used to examine associations between takeaway meal frequency and risk markers.

Results 2529 children (response 69%) participated in the study, of whom 1948 had complete data; participants with and without complete data were similar. Among participants, 499 (26%) never/rarely ate a takeaway meal, 894 (46%) did so less than weekly and 545 (28%) did so at least weekly. In models adjusted for age, sex, month, school (random effect), ethnic group and socioeconomic status, higher reported takeaway meal frequency had graded positive associations with fat mass index, serum total and LDL-cholesterol (p trend = 0.03, 0.04, 0.01 respectively). Compared with children who never/hardly ever ate a takeaway meal, children who ate one at least weekly had a higher fat mass index (% difference 10.6% [95% CI 1.00, 20.9%]), a higher total cholesterol (mean difference 0.09 mmol/L [95% CI 0.01, 0.17 mmol/L]) and a higher LDL-cholesterol (mean difference 0.10mmol/L [95% CI 0.02, 0.18 mmol/L]); insulin resistance, HbA1c and blood pressure did not differ. Children with higher takeaway meal frequency had higher total energy, energy density, fat% energy (particularly saturated fat% energy) intakes (all p < 0.001 for trend) and lower starch, protein and micronutrient intakes than children who never/hardly ever ate a takeaway meal (all p < 0.05 for trend).

Conclusion More frequent takeaway meal consumption was associated with higher body fatness, total and LDL-cholesterol levels and with higher energy and fat intakes (particularly saturated fat). Frequent takeaway meal consumption may have adverse cardiometabolic effects but the takeaway effects need to be distinguished from those of other dietary differences in takeaway meal consumers.