Breakfast Skipping and Elevated Neck Circumference Are Independently Associated with Newly Diagnosed Dyslipidemia in Adults Without Diabetes

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Abstract
Background/Objectives: Dyslipidemia is a major cardiometabolic disorder frequently accompanied by adverse fat distribution and unhealthy eating behaviors. This study aimed to compare meal pattern characteristics and anthropometric indicators between adults with newly diagnosed dyslipidemia and normolipidemic controls and to identify factors independently associated with dyslipidemia. We hypothesized that breakfast skipping would be more prevalent among individuals with dyslipidemia and that distribution-based anthropometric markers—particularly neck circumference (NC) and waist circumference (WC)—would be more strongly associated with dyslipidemia than body mass index (BMI). Methods: This cross-sectional comparative study included 257 adults without diabetes aged 18–65 years. Anthropometric assessment included BMI, WC, waist-to-height ratio (WHtR), and NC. Meal patterns were assessed using a structured questionnaire. Hierarchical binary logistic regression was used to identify independent associations. The linearity assumption was verified, and a sensitivity analysis was performed with HbA1c dichotomized at ≥5.7%. Results: Elevated NC was more frequent in participants with dyslipidemia (95.6% vs. 78.3%, p < 0.001). Breakfast skipping was more common among participants with dyslipidemia (30.7% vs. 15.0%, p = 0.003), whereas lunch skipping was less common (52.6% vs. 65.8%, p = 0.031). In the fully adjusted model, elevated NC (OR: 4.72), breakfast skipping (OR: 3.39), and HbA1c (OR: 3.61) were independently associated with dyslipidemia. These findings were confirmed in sensitivity analysis. Conclusions: Breakfast skipping and elevated NC were independently associated with newly diagnosed dyslipidemia, partially supporting the study hypothesis. Breakfast skipping and NC may aid in early risk identification in outpatient settings. Prospective studies are needed to confirm these associations.

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