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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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
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Authors and Affiliations
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
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
Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Yanjun Guo
Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Xiang Cheng
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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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
