Relationship between skipping breakfast and metabolic syndrome among adults aged 35–74 years: a cross-sectional study in Northwest China, 2018–2020

Background Although skipping breakfast has been associated with an increased risk of metabolic syndrome (MetS), evidence remains limited. Herein, we examined the association between breakfast skipping and MetS, as well as its individual components, among adults aged 35–74 years in Northwest China. Methods Baseline data were obtained from the Northwest China Cohort–Ningxia Project (CNC-NX), which initially recruited 20,837 participants; 15,959 were included in the final analysis. Demographic characteristics, lifestyle factors, and laboratory results were collected. Logistic regression analyses were performed to evaluate the association between breakfast skipping frequency and MetS. Associations were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results The prevalence of MetS was 76.7%, with males accounting for 40.2% and females for 59.8%. Compared with participants who never skipped breakfast, those who skipped breakfast ≥4 times per week had a significantly higher likelihood of developing MetS (OR: 1.250, 95% CI: 1.098–1.419). Subgroup analyses revealed that this association was particularly pronounced among males (OR: 1.333, 95% CI: 1.074–1.645) and individuals with a BMI of 24.0–27.9 kg/m 2 (OR: 1.328, 95% CI: 1.071–1.637). Frequent breakfast skipping (≥4 times/week) was also significantly associated with an increased risk of several individual MetS components, including elevated fasting blood glucose (OR: 1.328, 95% CI: 1.176–1.502), hypertension (OR: 1.249, 95% CI: 1.075–1.467), and reduced HDL-C levels (OR: 1.377, 95% CI: 1.165–1.638), even after adjusting for confounders. Conclusion Breakfast skipping was significantly associated with MetS among adults aged 35–74 years in Northwest China. Promoting regular breakfast consumption may represent a feasible public health strategy for MetS prevention in this high-risk population.