Relationship between breakfast skipping and hyperuricemia in Korean adults: results from KNHANES 2016-2023

Hyperuricemia is increasingly recognized not only due to its globally increasing prevalence trend but also its correlation with several metabolic disorders. Despite dietary and nutritional factors as contributors to hyperuricemia, the role of meal timing, particularly breakfast consumption, remains understudied. We aimed to investigate the association between breakfast skipping and hyperuricemia in Korean adults. This study included 36,274 Korean adults aged ≥ 19 years from nationally representative data. Participants were classified based on self-reported weekly breakfast consumption frequency into two groups: non-breakfast skippers (≥ 5 days/week) and breakfast skippers (< 5 days/week). Hyperuricemia was defined as serum uric acid levels > 7.0 mg/dL in men and > 6.0 mg/dL in women. Multivariate logistic regression models and Poisson regression analyses were employed to evaluate the association between breakfast skipping and hyperuricemia after adjusting for demographic, lifestyle, and clinical variables. Breakfast skippers demonstrated a significantly higher risk of hyperuricemia compared to non-breakfast skippers (adjusted odds ratio: 1.220; 95% confidence interval: 1.118-1.319; p < .001). A dose-response relationship was observed between breakfast frequency and hyperuricemia risk, with prevalence decreasing progressively with increasing breakfast consumption (from 17.5% in non-consumers to 10.5% in frequent consumers). Poisson regression analyses confirmed a significant inverse association between breakfast frequency and serum uric acid levels (estimate: -0.0088; 95% confidence interval: -0.0133--0.0047; p = .0002). This study identified an association between breakfast skipping and a higher prevalence of hyperuricemia. Thus, regular breakfast intake (≥ 3-4 times/week) showed an inverse association with hyperuricemia in this study, suggesting further longitudinal studies to clarify this correlation.