Prevalence of hyperuricemia and gout in relation to night fasting duration and eating frequency: NHANES 2007-2018

The relationship between circadian-aligned dietary patterns, including daily eating frequency and nighttime fasting duration, and uric acid metabolism is not well established. This study examined their associations with hyperuricemia and gout to design preventive strategies.

Data were obtained from 22,735 adults in NHANES data (2007-2018). Daily eating frequency and nighttime fasting duration were derived from two non-consecutive 24-h dietary recalls. Hyperuricemia was defined as serum urate ≥ 7.0 mg/dL in men or ≥ 6.0 mg/dL in women, and gout by self-reported physician diagnosis. Multivariable logistic regression and restricted cubic spline models were used to assess associations.

Among 22,735 participants, the prevalence of hyperuricemia was 19.72% and gout 4.13%, respectively. Compared with more frequent eating (> 3 times/day), lower eating frequency (≤ 3 times/day) was associated with a higher prevalence of hyperuricemia (OR = 1.32; 95% CI 1.12-1.56, P = 0.001) and gout (OR = 1.33; 95% CI 1.01-1.75; P = 0.039). Nighttime fasting duration ≥ 14 h was also associated with hyperuricemia (OR = 1.48; 95% CI 1.21-1.82; P < 0.001). Subgroup and sensitivity analyses showed consistent results across gender and age groups.

Daily eating frequency and nighttime fasting duration were nonlinearly associated with hyperuricemia and gout. Lower eating frequency and prolonged fasting were linked to a higher risk of these conditions. These findings highlight the role of chrononutrition in metabolic health and suggest potential dietary strategies for prevention. Key Points • Identified nonlinear associations of meal frequency and nighttime fasting with hyperuricemia and gout. • Lower meal frequency and prolonged fasting were associated with a higher prevalence of hyperuricemia and gout. • Findings underscore the role of chrononutrition in metabolic health and inform preventive dietary strategies.