The Importance of Breakfast in Atherosclerosis Disease
Key result
Habitually skipping breakfast is linked to ~157% higher prevalence of generalized atherosclerosis versus high-energy breakfast.
- OR 2.57
- 95% CI 1.54-4.31
- n=4,052
Why the study?
Skipping breakfast is an unhealthy habit associated with increased cardiovascular risk, but its association with cardiovascular risk factors and the presence, distribution, and extension of subclinical atherosclerosis needed exploration.
Does skipping breakfast increase the prevalence of subclinical atherosclerosis in asymptomatic adults?
Key Points
- To investigate the association between breakfast consumption patterns and the presence, distribution, and extent of subclinical atherosclerosis.
- Analyzed N=4,052 asymptomatic adults aged 40 to 54 years with lifestyle, multivascular imaging, and clinical data.
- Classified breakfast intake into high-energy (>20% of daily energy), low-energy (5% to 20%), and skipping breakfast (<5%).
- Estimated associations with subclinical atherosclerosis using multivariate logistic regression adjusting for traditional and dietary cardiovascular risk factors.
- High-energy breakfast was consumed by 27% of participants, low-energy breakfast by 70%, and 3% skipped breakfast.
- Habitual breakfast skipping was associated with higher generalized atherosclerosis compared with high-energy breakfast consumption (OR: 2.57; 95% CI: 1.54 to 4.31).
- Breakfast skipping was associated with noncoronary atherosclerosis compared with high-energy breakfast intake (OR: 1.55; 95% CI: 0.97 to 2.46).
Study Design
Type
Cross-Sectional (n=4,052)
Structured PICO
Does skipping breakfast increase the prevalence of subclinical atherosclerosis in asymptomatic adults?
P
Population
4,052 asymptomatic adults aged 40 to 54 years, free of cardiovascular events at baseline, evaluated for subclinical atherosclerosis.
E
Exposure
Skipping breakfast (consuming <5% of total daily energy)
C
Comparator
High-energy breakfast (contributing to >20% of total daily energy intake)
O
Outcome
Presence, distribution, and extension of subclinical atherosclerosis (noncoronary and generalized) assessed via multivascular imagingsurrogate
Main Result
Odds Ratio: 2.57 (95% CI 1.54–4.31)
Skipping breakfast is associated with an increased prevalence of subclinical atherosclerosis independently of conventional cardiovascular risk factors.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
JLJosé Luis PeñalvoAssistant professor, Friedman School of Nutrition, Tufts University
“Our results indicate that there is an independent association between breakfast consumption and cardiovascular disease. A higher caloric intake in the morning could result in better glucose regulation throughout the day, as well as increased satiety and balanced appetite regulation that could prevent overeating during the day.”
“Many people have the false belief that skipping breakfast will help them lose weight, when in fact it can have the reverse consequence. The truth is that eating a nutritious breakfast will help you maintain a healthy metabolic balance, which reduces your risk of obesity, diabetes, and heart disease.”
JLJosé Luis PeñalvoAssistant professor, Friedman School of Nutrition, Tufts University
“It's not that you skip breakfast, you get plaques. For many people, skipping breakfast is part of a cluster of bad habits.”
Implication
Skipping breakfast was associated with subclinical atherosclerosis; hypothesis-generating for causality, prospective studies needed before practice implications.
Abstract
BACKGROUND: Daily habits, including the number and quality of eating occasions, are potential targets for primary prevention strategies with large health impacts. Skipping breakfast is considered a frequent and unhealthy habit associated with an increased cardiovascular (CV) risk. OBJECTIVES: The study sought to explore the association between different breakfast patterns and CV risk factors and the presence, distribution, and extension of subclinical atherosclerosis. METHODS: Cross-sectional analysis was performed within the PESA (Progression of Early Subclinical Atherosclerosis) study, a prospective cohort of asymptomatic (free of CV events at baseline) adults 40 to 54 years of age. Lifestyle and multivascular imaging data along with clinical covariates were collected from 4,052 participants. Multivariate logistic regression models were used in the analysis. RESULTS: Three patterns of breakfast consumption were studied: high-energy breakfast, when contributing to >20% of total daily energy intake (27% of the population); low-energy breakfast, when contributing between 5% and 20% of total daily energy intake (70% of the population); and skipping breakfast, when consuming <5% of total daily energy (3% of the population). Independent of the presence of traditional and dietary CV risk factors, and compared with high-energy breakfast, habitual skipping breakfast was associated with a higher prevalence of noncoronary (odds ratio: 1.55; 95% confidence interval: 0.97 to 2.46) and generalized (odds ratio: 2.57; 95% confidence interval: 1.54 to 4.31) atherosclerosis. CONCLUSION: Skipping breakfast is associated with an increased odds of prevalent noncoronary and generalized atherosclerosis independently of the presence of conventional CV risk factors. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).
Discussion
No takes yet. Share an insight, caveat, or question.
Cite This Study
Uzhova et al. (2017) conducted a cross-sectional in Subclinical atherosclerosis (n=4,052). Skipping breakfast vs. High-energy breakfast was evaluated on Generalized atherosclerosis (OR 2.57, 95% CI 1.54-4.31). Compared with a high-energy breakfast, habitually skipping breakfast was associated with a higher prevalence of generalized atherosclerosis (OR 2.57; 95% CI 1.54-4.31).