People who skip breakfast may be more likely to develop atherosclerosis, or hardening of the arteries, than individuals who start each day with a hearty meal, a new study suggests.
Even after researchers accounted for diet and other risk factors for heart disease, people who routinely skipped breakfast were significantly more likely to develop atherosclerosis compared to individuals who normally had a morning meal, the study found.
"A greater percentage of energy consumed earlier in the day may favour cardiovascular health," lead study author Dr. Valentín Fuster of the CNIC in Madrid and Mount Sinai Heart in New York City said by email.
Previous research has linked skipping breakfast to a higher risk of problems that can lead to heart disease such as obesity, diabetes and high cholesterol, researchers note in the Journal of the American College of Cardiology.
For the current study, researchers examined data from dietary questionnaires completed by 4,052 adults who didn't have a history of heart problems.
Overall, just 3 per cent of the participants reported skipping breakfast, while 69 per cent typically consumed a light morning meal (accounting for 5 per cent to 20 per cent of total calories for the day) and 28 per cent had a hearty breakfast (accounting for more than 20 per cent of the day's caloric intake).
Those who skipped breakfast were more likely to be male, smokers and dieters who consumed the bulk of their daily calories around lunchtime.
When they ate, breakfast skippers tended to spend no more than 5 minutes on their morning meal and consume mostly coffee or orange juice.
Compared to people who had a hearty breakfast, individuals who had a light breakfast were still 21 per cent more likely to have damage in a major artery in the neck and 17 per cent more likely to have damage in a major blood vessel in the abdominal area.
In addition to having the greatest risk of atherosclerosis, people who skipped breakfast also had the greatest waist circumference, body mass index, blood pressure, cholesterol and blood sugar levels.
Participants who skipped breakfast were more likely to have an overall unhealthy lifestyle, including poor overall diet, frequent alcohol consumption and smoking. They were also more likely to be overweight or obese.
The study wasn't a controlled experiment designed to prove that skipping breakfast directly causes heart problems or hardening of the arteries.
Another limitation of the study is that some people may have been skipping breakfast because they were obese and were trying to lose weight or improve other risk factors for heart disease that could also contribute to atherosclerosis, the authors note.
"Many overweight people who might be skipping breakfast or other meals in the hope of losing weight should keep in mind that studies have repeatedly shown that contrary to the commonly held belief, such habits can be associated with (weight gain) and might lead to significant metabolic abnormalities including the increased risk of metabolic syndrome and diabetes," said Dr. Prakash Deedwania, author of an accompanying editorial and researcher at the University of California, San Francisco.
"Indeed, these studies have proved the age old concept that breakfast is the most important meal of the day," Deedwania said by email.
Individuals who regularly eat breakfast also tend to have a healthier lifestyle, exercising more, eating better and smoking less than people who skip their morning meal, said Marie-Pierre St-Onge, a nutrition researcher at Columbia University Medical Center in New York City who wasn't involved in the study.
"I think that, for everyone, consuming a healthy breakfast is a great way to meet guidelines for fruits, whole grains, lean protein," St-Onge said by email.
"It doesn't have to be large," St-Onge added. "Many people are not that hungry in the morning, and it doesn't have to be very elaborate.
The important thing is not to wait too long to eat, because people may then resort to unhealthy snacks or whatever they can grab on the go to give them a boost until it's time to eat lunch, she said.
"Having a healthy first meal just sets the tone right for the rest of the day," St-Onge added.