Skipping breakfast or eating late at night increases risk of coronary heart disease
Prospective Study of Breakfast Eating and Incident Coronary Heart Disease in a Cohort of Male US Health Professionals.
Cahill LE, Chiuve SE, Mekary RA, et al.
Circulation. 2013 Jul 23;128(4):337-43. doi: 10.1161/CIRCULATIONAHA.113.001474
BackgroundAlthough breakfast is commonly considered to be the most important meal of the day, no evidence-based recommendation exist about eating habits for adults. The 2002 National Health and Nutrition Examination Survey (NHANES) suggests that American adults frequently skip breakfast (18%) and snack (86%). Habits such as skipping meals have been positively associated with cardiometabolic health outcomes such as overweight  and weigh gain , dyslipidemia [4,5], blood pressure , insulin sensitivity [4,5] and diabetes mellitus .
This study aimed to prospectively determine whether eating habits, including skipping breakfast, are related to the risk of coronary heart disease (CHD). 51529 male participants were followed in the Health Professionals Follow-up Study (HPFS) through mailed questionnaires.
- Men who did not eat breakfast had a 33% higher risk of CHD as compared to men who eat breakfast (RR: 1.33, 95%CI: 1.13-1.57). Adjusting for demographic, dietary and activity factors hardly changed the risk (RR: 1.27, 95CI%: 1.06-1.53), while further correction for potential mediators of BMI, hypercholesterolemia, hypertension and diabetes mellitus attenuated the risk (RR: 1.18, 95%CI: 0.98-1.43).
- Men who eat late at night had a 55% higher CHD risk than men who did not eat late at night (RR: 1.55, 95%CI: 1.05-2.29). Performing the same analysis, but removing men with BMI>30 gave similar results (RR: 1.58, 95%CI: 1.02-2.46).
- No association was found between eating frequency and risk of CHD.
- Exclusion of participants with diabetes mellitus, hypertension or hypercholesterolemia at baseline gave very similar results.
- When stratifying by age, men <60 years old who skipped breakfast had a higher CHD risk than men who ate breakfast (RR: 1.55, 95%CI: 1.09-2.22), while in older men skipping breakfast did not significantly increase risk of CHD (RR: 1.06, 95%CI: 0.84-1.33).
ConclusionThis large prospective study showed a higher risk of CHD in men who skip breakfast and among men who regularly eat late at night. Eating frequency was not associated with CHD risk. The found associations were consistent but modest, thus require confirmation in other studies and in women and other ethno-cultural group before a daily breakfast can be recommended to prevent CHD.
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