Habitual breakfast skipping and night eating associated with unfavorable changes in lipid profiles in Chinese adults: a longitudinal analysis

Background: Breakfast skipping and night eating have been shown to be associated with a high risk of cardiovascular disease. However, the longitudinal associations between eating behaviors and lipid profiles, which are key risk factors for cardiovascular disease, remain underexplored. Objectives: This study aimed to longitudinally investigate the individual and combined associations of breakfast skipping and night eating with changes in lipid profiles in Chinese adults. Methods: Included were 30,475 Chinese adults from the Kailuan study free of cardiovascular diseases, cancer, and dyslipidemia at baseline. Information on the status of breakfast consumption and night eating was collected using self-reported questionnaires at baseline. Lipid profiles were assessed in 2014, 2016, and 2018. The primary outcome was the annual change in LDL cholesterol, whereas secondary outcomes included annual changes in HDL cholesterol, triglycerides, and non–HDL cholesterol. Generalized estimating equations were employed to explore the associations between eating behaviors and changes in lipid profiles, adjusting for diet quality, sleep patterns, physical activity, and other potential confounders. Subgroup analyses and interaction tests were conducted to assess effect modification by demographic, lifestyle, and dietary factors. Results: Among individuals who skipped breakfast and engaged in night eating, the annual increase in LDL cholesterol was 0.023 (95% confidence interval: 0.011, 0.035) mmol/L/y higher, compared with those who did not. These associations were particularly pronounced in females, individuals with overweight or obesity, or those with an inactive lifestyle, compared with their counterparts (P-interactions for all < 0.05). Compared with optimal eating behaviors, these nonoptimal eating behaviors were associated with a more rapid increase in triglyceride concentrations and a faster decrease in HDL cholesterol (P-trend < 0.05 for both). Conclusions: Frequent breakfast skipping and night eating are associated with unfavorable longitudinal changes in lipid profiles.