The association between skipping breakfast and cardiovascular disease: a meta analysis

Background Cardiovascular disease (CVD) is a global health challenge significantly influenced by healthy behaviors. Nutritional research highlights the critical role of eating habits in the development of CVD. However, existing studies on the association between skipping breakfast and CVD have produced conflicting results. To address this controversy, we conducted a meta-analysis to clarify the relationship. Method We performed a systematic search of the PubMed, Embase, Cochrane and Web of Science databases for studies published before October 2024 to identify and assess prospective research on the relationship between skipping breakfast and CVD. In the study selection process, the PECOS framework and stringent inclusion/exclusion criteria were applied. The quality of the initially included studies was independently assessed using the Newcastle-Ottawa Scale (NOS). Data from the included studies, including odds ratio (OR) and 95% confidence intervals (CI), were extracted and analyzed using Stata 16.0. Sensitivity analyses were conducted to validate the results. Heterogeneity was assessed using the I 2 and Cochrane Q tests, and publication bias was evaluated using Egger's test and funnel plot analysis. Results This meta-analysis includes 2,383,813 participants. As a result, nine studies included 13 data points. Skipping breakfast, compared to regular breakfast consumption, was associated with an increased risk of CVD (OR: 1.17, 95% CI:1.09–1.26). Cardiovascular diseases were further categorized into coronary artery disease (CAD), stroke, and cardiovascular disease mortality (CDM). Skipping breakfast was associated with an increased risk of CAD (OR: 1.14, 95% CI: 1.05–1.24), stroke (RR: 1.15, 95% CI: 1.01–1.3), and CDM (OR: 1.49, 95% CI: 1.20–1.84). Conclusion Skipping breakfast is significantly associated with increased CVD risk. Our analysis elucidates multiple pathophysiological mechanisms underlying this association. These findings collectively suggest that regular breakfast consumption may confer cardiovascular protective benefits. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42025630303 , PROSPERO CRD 42025630303.