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    Meal timing and eating window with all-cause and cardiovascular mortality and life expectancy: population-based cohort study

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    Meal timing and eating window with all-cause and cardiovascular mortality and life expectancy: population-based cohort study

    Abstract

    Background

    The impact of meal timing and eating window on mortality and life expectancy remains unclear

    Methods

    This cohort study included 31,044 adults aged 40 years and older from the National Health and Nutrition Examination Survey 1999–2018. The meal timing and the eating window were estimated from a 24-h dietary recall

    Results

    During a median (IQR) follow-up of 8.6 (4.5–13.0) years, 7129 deaths were documented. Compared with a first meal within 7:00–8:00, the hazard ratios (HRs) and 95% CIs of all-cause mortality were 1.10 (1.02–1.18), 1.19 (1.05–1.34), and 1.29 (1.10–1.51) for a first meal within 8:00–10:00, 10:00–12:00, and after 12:00, respectively. Compared with a last meal within 19:00–20:00, the HR of all-cause mortality was 1.13 (1.03–1.25) for a last meal before 19:00, and 1.27 (1.06–1.54) for eating after midnight. The associations were also observed for cardiovascular mortality. The association between eating window and cardiovascular mortality risk varied by first meal timing. At the age of 50 years, the estimated life expectancy was on average 2.46 (0.61–4.28) years shorter among participants having a first meal after 12:00 and 2.35 (0.82–5.14) years shorter among those having a last meal after midnight compared with reference groups.

    Conclusions

    Later first meals and earlier or later last meals were associated with higher mortality risks and shorter life expectancy. These findings suggest that meal timing may be a modifiable behavioral factor associated with mortality risk and life expectancy

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    Fig. 1: Dose-response associations between the times of the first and last meal and all-cause and CVD mortality.
    Fig. 2: Dose-response associations between eating window and all-cause and CVD mortality stratified by the time of first meal.
    Fig. 3: Estimates of life expectancy from age 50 years onward among adults with different time of first or last meal.

    Subjects

    • Epidemiology
    • Risk factors

    Data availability

    The datasets used in the current study are publicly available through the National Health and Nutrition Examination Survey (NHANES) website at https://wwwn.cdc.gov/nchs/nhanes/Default.aspx. The data underlying this article will be shared on reasonable request to the corresponding author

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    Acknowledgements

    The authors are grateful to the members of the National Center for Health Statistics, Centers for Disease Control and Prevention, for gathering the data and making it available for public use. We also thank the participants involved in the survey

    Funding

    ZS is supported by the National Natural Science Foundation of China (No. 82373567 and No. 82222061), the Noncommunicable Chronic Diseases-National Science and Technology Major Project (2024ZD0531703), and the National Key Research and Development Program of China (2023YFC2506504). The funders had no role in designing or conducting the study; in collecting, managing, analyzing, or interpreting the data; or in deciding to submit the manuscript for publication

    Author information

    Authors and Affiliations

    1. Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, NHC Specialty Laboratory of Food Safety Risk Assessment and Standard Development, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

      Wen Hu, Mengyao Wang, Sibo Liu, Qi Wu, Hongkun Di, Tianzhu Qin, Shili Zhou, Liegang Liu & Zhilei Shan

    2. Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

      Wen Hu, Mengyao Wang, Sibo Liu, Qi Wu, Hongkun Di, Tianzhu Qin, Shili Zhou, Yanjun Guo, Liegang Liu & Zhilei Shan

    3. Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

      Yanjun Guo

    4. Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

      Xiang Cheng

    5. Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

      Chaolong Wang

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    Contributions

    WH and ZS contributed to the conception and design of the work. WH contributed to the acquisition, analysis, or interpretation of data for the work. WH drafted the manuscript. MW, SL, QW, HD, TQ, SZ, YG, XC, CW, LL, and ZS critically revised the manuscript for important intellectual content. All authors gave final approval and agreed to be accountable for all aspects of the work, ensuring integrity and accuracy

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    Competing interests

    The authors declare no competing interests

    Ethics approval

    The NHANES protocols were reviewed and approved by the National Center for Health Statistics Ethics Review Board, including Protocol #98-12, Protocol #2005-06, Protocol #2011-17, and Protocol #2018-01. All participants provided written informed consent. The present study used publicly available de-identified NHANES data and was conducted in accordance with relevant guidelines and regulations

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    Hu, W., Wang, M., Liu, S. et al. Meal timing and eating window with all-cause and cardiovascular mortality and life expectancy: population-based cohort study.
    Eur J Clin Nutr (2026). https://doi.org/10.1038/s41430-026-01796-1

    • Received:28 November 2025

    • Revised:25 June 2026

    • Accepted:22 July 2026

    • Published:31 July 2026

    • Version of record:31 July 2026

    • DOI
      :https://doi.org/10.1038/s41430-026-01796-1

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