Potential Association between Breakfast Skipping and Concomitant Late-Night-Dinner Eating with Metabolic Syndrome and Proteinuria in the Japanese Population

Abstract

Skipping breakfast is considered to be an unhealthy eating habit linked to predispositions to obesity and type 2 diabetes. Because eating dinner late at night can elicit subsequent breakfast skipping, we investigated if skipping breakfast concomitant with late-night-dinner eating (LNDE) was associated with metabolic syndrome (MetS) and proteinuria in the general Japanese population. We examined self-reported habitual breakfast skipping and LNDE, MetS (modified ATP-III criteria), and proteinuria in a cross-sectional study of 60,800 Japanese adults aged 20-75 years. A total of 14,068 subjects (23.1%) skipped breakfast, of whom approximately half (52.8%) skipped breakfast alone (without LNDE). The percentages of subjects who skipped breakfast showed a J-shaped relationship with body mass index (BMI). Multivariate logistic regression analysis showed that skipping breakfast concomitant with LNDE (n = 6,645) was significantly associated with MetS and proteinuria, even after adjusting for relevant confounders (odds ratio (95% CI), 1.17 (1.08-1.28), P = 0.0003, and 1.37 (1.24-1.52), P < 0.0001, resp.). Skipping breakfast alone and LNDE alone were not associated with MetS and proteinuria, respectively. In conclusion, habitual breakfast skipping concomitant with LNDE may represent poorer eating behavior than skipping breakfast alone, associated with MetS, asymptomatic proteinuria, obesity, and low body weight in the general Japanese population.

Figure 1

Proportions of subjects who skipped breakfast (SB) and with LNDE (a), and who skipped breakfast concomitant with LNDE (SB + LNDE), according to six body mass index (BMI) categories. The symbols in the middle of each bar represent the mean percentage of subjects with breakfast skipping, LNDE, or breakfast skipping concomitant with LNDE and was calculated as the number of subjects with these behaviors/number of subjects in each BMI group ×100, for each BMI category. The vertical bar represents the standard error (SEM) when skipping breakfast, LNDE, or skipping breakfast concomitant with LNDE was numbered as 1, and the absence of these behaviors as 0. Triangles (▲), circles (●), and diamonds (♦) represent overall breakfast skipping (SB), overall LNDE, and breakfast skipping concomitant with LNDE (SB + LNDE), respectively. The numbers of subjects in each of the six BMI categories from ≤18.9 to ≥27.0 kg/m² were 5,522, 12,341, 15,708, 12,836, 7,484, and 6,909, respectively. The numbers of subjects in each category who skipped breakfast were 1,316 (9.4%), 2,765 (19.7%), 3,451 (24.5%), 2,862 (20.3%), 1,739 (12.4%), and 1,935 (13.8%); respectively, and the numbers of subjects with LNDE were 1,526 (8.3%), 3,426 (18.6%), 4,550 (24.7%), 3,925 (21.3%), 2,482 (13.5%), and 2,497 (13.6%), respectively. The numbers of subjects with SB + LNDE were 584 (8.8%), 1,256 (18.9%), 1,586 (23.9%), 1,354 (20.4%), 871 (13.1%), and 994 (15.0%), respectively (% of total SB + LNDE).