Breakfast-Skippers Beware

Coronary heart disease and heart attack risk rises in men who skip breakfast

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) There may be more good reasons to call breakfast the most important meal of the day. The morning meal may make a big difference when it comes to heart health.

Starting the day with a healthy breakfast kick-starts the metabolism. This meal has been shown to help weight control, improve concentration, boost strength and lower cholesterol levels.

Now, a new study reports that men who regularly skipped breakfast may have faced a higher risk of heart attack or death from coronary heart disease.

"Eat a healthy breakfast."

Leah Cahill, PhD, postdoctoral research fellow in the Department of Nutrition at Harvard School of Public Health in Boston, led this study, which reviewed data on 26,902 men over a 16-year period.

The men, who were all health professionals between the ages of 45 and 82, answered a questionnaire on their eating habits. About 97 percent of them were of white European descent.

From their responses, the researchers discovered that men who skipped breakfast had a 27 percent higher risk of heart attack or death from coronary heart disease than those who reported eating breakfast.

The breakfast skippers tended to be younger than the breakfast eaters. They were more likely to smoke, work full time, not be married, exercise less and drink more alcohol.

The researchers noted, however, that even after accounting for modest differences in diet, physical activity, smoking and other lifestyle factors, the link between skipping breakfast and coronary heart disease persisted.

"I am afraid this study leaves more questions unanswered than it proposes to resolve. It adds more confusion to a host of studies...that put breakfast skippers all over the map in terms of weight gain, and weight gain is associated with increased cardiovascular risk," Dr. Deborah Gordon, a nutrition and preventative medicine expert, told dailyRx News. "In this observational study, the male subjects were presumably eating a standard American diet, and in this situation, skipping breakfast seems to convey an added risk of heart disease." 

Midnight snackers may also be putting their hearts at risk, according the study authors. Men who said they ate late at night (eating after going to bed) had a 55 percent greater risk of coronary heart disease than those who didn’t.

The researchers were less concerned that this was a major public health problem because few men in the study revealed themselves as late-night munchers.

"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 Dr. Cahill.

"Eating breakfast is associated with a decreased risk of heart attacks. Incorporating many types of healthy foods into your breakfast 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 example, adding nuts and chopped fruit to a bowl of whole grain cereal or steel-cut oatmeal in the morning is a great way to start the day," she said.

The American Heart Association offers these tips for eating breakfast:

  • Start with a glass of fruit juice.
  • Order whole-grain instead of white toast. Replace butter on your toast with low-fat cottage cheese and a little jam.
  • Try low-fat cream cheese with your bagel.
  • Eat whole-grain cereals with fat-free milk (but watch out for high-fat granolas).
  • Enjoy fat-free or low-fat yogurt with fruit.
  • Prepare hot cereals such as oatmeal, grits, cream of wheat or cream of rice with a little honey.

"For both weight loss and cardiovascular risk reduction (normalization of blood lipids), I recommend something far different. Eat a satiating breakfast - only if you're hungry. Many times maligned and finally exonerated, we are better off eating what our grandparents ate: steak and eggs, and skipping the sugar-rich breakfasts described. Steamed greens rather than bagels, and fresh fruit rather than high sugar fruit juice," said Dr. Gordon.

This study was published on July 22 in the American Heart Association journal Circulation.

The authors had no relevant disclosures.

Reviewed by: 
Review Date: 
July 22, 2013
Last Updated:
July 26, 2013