The association of energy and macronutrient intake at dinner versus breakfast with the incidence of hyperuricemia in US and Chinese adults.
Level 3 - non-randomized controlled study
Prospective cohort study combined with cross-sectional survey data
PubMed 40436700 · doi:10.1016/j.numecd.2025.104105
What was done
This study analyzed the association between the difference in energy and macronutrient intake between dinner and breakfast (categorized into quintiles) and the risk of hyperuricemia. Data were derived from a cross-sectional survey (NHANES, n = 26,080 US adults) and a prospective cohort study (CHNS, n = 6,704 Chinese adults, average follow-up 9.34 years). Logistic and Cox regression models were used to assess associations, and isocaloric substitution models evaluated replacing 5% of energy at dinner with breakfast.
What was found
Participants in the highest quintile of dinner-versus-breakfast intake had higher hyperuricemia risk compared with the lowest quintile: - NHANES: OR for energy difference = 1.12 (95% CI: 1.01 to 1.24); protein = 1.32 (95% CI: 1.18 to 1.47); carbohydrate = 1.16 (95% CI: 1.04 to 1.28); polyunsaturated fatty acids = 1.14 (95% CI: 1.03 to 1.27). - CHNS: HR for energy difference = 1.30 (95% CI: 1.08 to 1.57); protein = 1.24 (95% CI: 1.01 to 1.52); carbohydrate = 1.31 (95% CI: 1.09 to 1.59). - Isocalorically replacing 5% of energy at dinner with breakfast was associated with 20% lower risk in NHANES and 13% lower risk in CHNS.
Why it matters
Shifting caloric and macronutrient intake from dinner to breakfast may be an actionable dietary timing strategy to lower hyperuricemia risk.
Limits
The NHANES component is cross-sectional and cannot establish temporality. Self-reported dietary recalls are subject to measurement error, and residual confounding from unmeasured dietary factors (e.g., purine-rich foods, alcohol) cannot be excluded from the abstract details.
Cited by
- supports NHANES dietary survey data indicates that in the United States, protein intake is skewed towards the evening meal, with Americans consuming about three times as much protein at dinner compared to breakfast or lunch.