A study published in the Journal of the American College of Cardiology indicates that people who do not eat breakfast have an increased risk of developing atherosclerosis. While previous studies have linked skipping breakfast to coronary heart disease risk, a press release reports, this is the first study to evaluate the association between breakfast and the presence of subclinical atherosclerosis.
Jose L Peñalvo (Friedman School of Nutrition Science and Policy, Tufts University, Medford, USA) and others examined male and female volunteers who were free from cardiovascular or chronic kidney disease. A computerised questionnaire was used to estimate the usual diet of the participants, and breakfast patterns were based on the percentage of total daily energy intake consumed at breakfast.
Three groups were identified—those consuming less than 5% of their total energy intake in the morning (skipped breakfast and only had coffee, juice or other non-alcoholic beverages); those consuming more than 20% of their total energy intake in the morning (breakfast consumers); and those consuming between 5% and 20% (low-energy breakfast consumers). Of the 4,052 participants, 2.9 p% skipped breakfast, 69.4% were low-energy breakfast consumers and 27.7% were breakfast consumers.
Atherosclerosis was observed more frequency among participants who skipped breakfast and was also higher in participants who consumed low-energy breakfasts compared to breakfast consumers. Additionally, cardiometabolic risk markers were more prevalent in those who skipped breakfast and low-energy breakfast consumers compared to breakfast consumers. Participants who skipped breakfast had the greatest waist circumference, body mass index, blood pressure, blood lipids and fasting glucose levels.
Participants who skipped breakfast were more likely to have an overall unhealthy lifestyle, including poor overall diet, frequent alcohol consumption and smoking. They were also more likely to be hypertensive and overweight or obese. In the case of obesity, the study authors said reverse causation cannot be ruled out, and the observed results may be explained by obese patients skipping breakfast to lose weight.
Peñalvo comments: “Aside from the direct association with cardiovascular risk factors, skipping breakfast might serve as a marker for a general unhealthy diet or lifestyle which in turn is associated with the development and progression of atherosclerosis. Our findings are important for health professionals and might be used as a simple message for lifestyle-based interventions and public health strategies, as well as informing dietary recommendations and guidelines.”