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Skipping breakfast raises risk of heart attack

Teresa Tanoos's picture
Eating breakfast lowers risk of heart attack according to new study

When it comes to eating for your health, what and how much you eat isn’t all you should be concerned with. What “time” you eat is important too, according to a new study published July 23 in the American Heart Association journal Circulation that found those who skipped breakfast had a higher risk of heart attack or fatal coronary heart disease.

In a statement, the study’s lead author explained what may be behind the findings.

"Skipping breakfast may lead to one or more risk factors, including obesity, high blood pressure, high cholesterol and diabetes, which may in turn lead to a heart attack over time,” said Leah Cahill, a postdoctoral research fellow in the department of nutrition at the Harvard School of Public Health.

For the U.S. study, researchers asked 26,902 male health professionals between the ages of 45 and 82 years to complete questionnaires about what they ate and when they ate it. They then tracked the health of the men over a period of 16 years from 1992 until 2008. All of the men in the study were free of heart disease and cancer at the start of the study.

However, 1,572 men experienced non-fatal heart attacks or died of coronary heart disease during follow-up – and, after analyzing the men’s responses to the questionnaires, the researchers found that those who reported skipping breakfast had a 27% higher risk of heart attack or death from coronary heart disease than those who reported eating breakfast.

The men who reported not having breakfast also tended to be younger, single, full-time workers who smoked more, drank more alcohol and did not exercise much.

When the results were then adjusted to remove factors like body mass index, high blood pressure, high cholesterol and diabetes, the researchers also found that the association between skipping breakfast and higher heart attack risk (or death from coronary heart disease) became much weaker.

In other words, the results were no longer statistically significant after adjusting them to account for other factors, which suggests "eating habits may affect risk of coronary heart disease through pathways associated with these traditional risk factors," according to the researchers who also found no link between how many times the men ate per day and the risk of coronary heart disease.

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What the researchers did find was a link between late night eating and coronary heart disease. The men who reported eating late at night had a 55% higher risk of coronary heart disease compared with those who said they did not eat late at night, but the researchers said this was unlikely to become a major public health concern because very few men in the study reported eating late at night.

According to Cahill, the message from this study is simple and reinforces previous research.

"Don't skip breakfast," she said. Based on the study’s findings, that’s good advice since eating at the start of the day is linked to lower risk of heart attacks.

But just don’t eat anything for breakfast. Make sure what you put in your mouth in the morning is healthy, nutritious and includes a variety of foods, which Cahill says is "an easy way to ensure your meal provides adequate energy and a healthy balance of nutrients, such as protein, carbohydrates, vitamins and minerals."

For variety and a “great way to start the day”, Cahill suggests adding nuts and chopped fruit or steel-cut oatmeal to a bowl of cereal.

Victoria Taylor, the British Heart Foundation's senior dietitian, has responded to this latest study confirming the importance of breakfast.

"In the morning rush it can be all too easy to skip breakfast, but this study suggests this could have a bigger impact on our health than we might think,” Taylor said.

“However, these researchers only looked at men aged over 45, so we would need to see further research to confirm that breakfast has the same impact on the heart health of other groups of people," she pointed out.

"What we do know is that a healthy and filling breakfast can make that mid-morning biscuit less tempting, as well as giving you another opportunity to widen the variety of foods in your diet,” she added. "Wholegrain toast, or cereals like porridge with low-fat milk are a good way to start the day. Try a sliced banana or dried fruit on top and you'll be on your way to five-a-day before you've even left the house."

SOURCE: American Heart Association journal Circulation, "Prospective Study of Breakfast Eating and Incident Coronary Heart Disease in a Cohort of Male US Health Professionals"; Leah E. Cahill, Stephanie E. Chiuve, Rania A. Mekary, Majken K. Jensen, Alan J. Flint, Frank B. Hu, and Eric B. Rimm; Circulation 23 July 2013, Volume 128, Issue 4, 337-343; DOI:10.1161/CIRCULATIONAHA.113.001474; Link to Abstract.