Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Nutrition. 2021 Oct;90:111245. doi: 10.1016/j.nut.2021.111245. Epub 2021 Mar 17.
There is an increasing trend of skipping meals, especially breakfast and dinner, in China. Previous studies on the association of meal skipping with lipid profiles and blood glucose have yielded inconsistent results.
A national representative survey of 47 841 adults (age ≥ 45 y) was conducted in China. Frequency of breakfast, lunch, and dinner consumption were assessed with a questionnaire. Blood triacylglycerols, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and fasting blood glucose were measured using standard methods. Generalized linear models were used to estimate relative concentrations and 95% confidence intervals (CIs).
Of 37 355 participants included in the analysis, the prevalence of skipping breakfast, lunch, and dinner was 9.06%, 0.67%, and 0.67%, respectively. Breakfast skippers are more likely to reside in rural areas, while lunch and dinner skippers tend to be urban residents. Compared with regular breakfast consumption, skipping breakfast was associated with 10.6% (95% CI, 8.3-12.9%) higher concentrations of triacylglycerols, 5.5% (95% CI, 4.7-6.3%) higher total cholesterol, 7.7% (95% CI, 6.5-8.9%) higher low-density lipoprotein cholesterol, 2.4% (95% CI, 1.5-3.4%) lower high-density lipoprotein cholesterol, and 1.6% (95% CI, 1.0-2.1%) lower fasting blood glucose. Significant linear trends were observed for days of skipping breakfast per week and biomarker concentrations. No association was found for lunch or dinner skipping. The higher triacylglycerols and lower high-density lipoprotein cholesterol associated with skipping breakfast were more evident in participants who were overweight or obese, and those who were physically inactive.
Our findings suggest a worse lipid profile of breakfast skippers. Not skipping breakfast might benefit cardiovascular disease prevention in Chinese adults.
在中国，不吃早餐和晚餐，尤其是晚餐，的趋势日益明显。既往关于不吃早餐与血脂和血糖关系的研究结果并不一致。
在中国进行了一项全国性的、针对 47841 名成年人（年龄≥45 岁）的代表性调查。采用问卷评估早餐、午餐和晚餐的食用频率。采用标准方法测量三酰甘油、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和空腹血糖。采用广义线性模型估计相对浓度和 95%置信区间（CI）。
在纳入分析的 37355 名参与者中，不吃早餐、午餐和晚餐的比例分别为 9.06%、0.67%和 0.67%。不吃早餐者更可能居住在农村地区，而不吃午餐和晚餐者则更可能居住在城市。与规律吃早餐者相比，不吃早餐者的三酰甘油浓度高 10.6%（95%CI：8.3-12.9%），总胆固醇高 5.5%（95%CI：4.7-6.3%），低密度脂蛋白胆固醇高 7.7%（95%CI：6.5-8.9%），高密度脂蛋白胆固醇低 2.4%（95%CI：1.5-3.4%），空腹血糖低 1.6%（95%CI：1.0-2.1%）。每周不吃早餐天数与生物标志物浓度之间呈显著线性趋势。不吃午餐或晚餐与任何生物标志物均无关联。在超重或肥胖以及身体活动不足的参与者中，与不吃早餐相关的更高三酰甘油和更低高密度脂蛋白胆固醇更为明显。
我们的研究结果表明，不吃早餐者的血脂状况更差。在中国成年人中，不不吃早餐可能有益于预防心血管疾病。
