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Guo Y, Lv L, Gao H, Feng R, Guo M. Causal relationship between breakfast skipping and myocardial infarction: Two-sample Mendelian randomization. Medicine (Baltimore) 2024; 103:e38895. [PMID: 39058860 PMCID: PMC11272345 DOI: 10.1097/md.0000000000038895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
While observational studies suggest a connection between skipping breakfast and myocardial infarction (MI), the causal nature of this relationship is unclear. This study aims to investigate the genetic causal relationships between breakfast skipping and MI through Mendelian randomization (MR). Employing genetic data from a public genome-wide association study, this research focuses on genetic variations linked to breakfast skipping and MI. The primary analytical method was the inverse variance-weighted approach, complemented by additional methods like MR-Egger, weighted median, and mode analyses. It also includes heterogeneity and horizontal pleiotropy tests such as the Cochrane Q test, MR-Egger intercept, and MR-PRESSO tests, with a leave-one-out analysis for enhanced sensitivity assessment reliability. The study discovered a notable association between breakfast skipping and an increased risk of MI (odds ratios: 1.34, 95% confidence intervals: 1.03-1.76, P = .027). The test revealed no heterogeneity or multiplicity, and the sensitivity analysis confirmed the robustness of the results. Our MR analysis suggests that habitual breakfast skipping might elevate the likelihood of MI, underlining the importance of regular breakfast consumption in potentially mitigating heart attack risks.
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Affiliation(s)
- Yuli Guo
- Department of Cardiology, The First Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China
| | - Luo Lv
- Department of Cardiology, The Second Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China
| | - Hui Gao
- Department of Cardiology, The First Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China
| | - Ruiting Feng
- Department of Cardiology, The First Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China
| | - Min Guo
- Department of Cardiology, The First Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China
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Khan MSI, Paul T, Al Banna MH, Hamiduzzaman M, Tengan C, Kissi-Abrokwah B, Tetteh JK, Hossain F, Islam MS, Brazendale K. Skipping breakfast and its association with sociodemographic characteristics, night eating syndrome, and sleep quality among university students in Bangladesh. BMC Nutr 2024; 10:46. [PMID: 38439041 PMCID: PMC10913273 DOI: 10.1186/s40795-024-00860-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
INTRODUCTION Skipping breakfast has become more common, and it can significantly affect a person's health, performance, mood, and other physiological and psychological factors. In Bangladesh, university students often encounter unhealthy dietary habits, which raises questions about why many university students choose to skip breakfast. The purpose of this study was to investigate the prevalence of skipping breakfast among university students in Bangladesh and explore the contributing factors. METHODS Patuakhali Science and Technology University, Bangladesh was the location of this cross-sectional study. Breakfast consumption was measured with the single-question item, "How often do you eat breakfast?" (Almost every day, sometimes, rarely, or never). Skipping breakfast was classified as respondents selecting sometimes, rarely, or never having breakfast. Sociodemographic, behavioral, and sleep-related data were collected as key predictor variables. Multiple logistic regression models identified factors associated with skipping breakfast. RESULTS The prevalence of skipping breakfast among study participants (N = 502, 51.6% female and mean age 21.31 years) was 63.5%. Female students were more likely to skip breakfast compared to male students (adjusted odds ratio, AOR = 1.65, 95% CI: 1.06-2.55). Smoker participants had a higher likelihood of skipping breakfast compared to non-smokers (AOR = 3.92, 95% CI: 1.57-9.78). Students with night eating syndrome had a higher likelihood of skipping breakfast compared to their counterparts (AOR = 1.84, 95% CI: 1.06-3.22). Students with poor sleep quality were three times more likely to skip breakfast than their counterparts (AOR = 2.95, 95% CI: 1.93-4.51). Overweight/obese students were less likely to skip breakfast compared to their counterparts (AOR = 0.40, 95% CI: 0.20-0.82). CONCLUSION This study highlights a high prevalence of skipping breakfast among university students in Bangladesh. Specifically, students who are females, smokers, poor sleepers and who have night eating syndrome are more likely to skip breakfast compared to their counterparts. These findings underscore a need for targeted interventions and educational programs to promote healthy breakfast habits. Addressing these modifiable risk factors can have a positive impact on students' nutritional practices and their health and wellbeing.
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Affiliation(s)
- Md Shafiqul Islam Khan
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Trisha Paul
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Md Hasan Al Banna
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh.
- Nutrition Initiative, Kushtia, Bangladesh.
| | | | - Cornelius Tengan
- Department of Hospitality, Catering and Institutional Management, Bolgatanga Technical University, Sumbrugu, Ghana
| | | | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Faria Hossain
- Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Md Shajadul Islam
- Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, 8602, Patuakhali, Bangladesh
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
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Hatamoto Y, Tanoue Y, Yoshimura E, Matsumoto M, Hayashi T, Ogata H, Tanaka S, Tanaka H, Higaki Y. Delayed Eating Schedule Raises Mean Glucose Levels in Young Adult Males: a Randomized Controlled Cross-Over Trial. J Nutr 2023; 153:1029-1037. [PMID: 36858920 DOI: 10.1016/j.tjnut.2022.12.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Misalignment of meals to the biological clock may cause adverse effects on glucose metabolism. However, the effects of repeated different eating schedules (early compared with late) on glucose concentration throughout the day are poorly understood. OBJECTIVES We examined the effects of different eating schedules on the 24-h glucose response using a continuous glucose monitor (CGM). METHODS Eight young adult males (age, 20.9 ± 3.4 y; body mass index: 21.3 ± 1.8 kg/m2) each followed 2 different eating schedules (early [08:30, 13:30, and 19:30] and late [12:00, 17:00, and 23:00]) in random order. These diet interventions were conducted for 8 d, with an experimental period of 3 d and 2 nights (from dinner on day 7) after 7 d of free living. The 3 meals in each intervention were nutritionally equivalent (55% carbohydrate, 15% protein, and 30% fat). The 24-h mean interstitial glucose concentration on day 8 was obtained under controlled conditions using the CGM (primary outcome). These concentrations were compared among the following 3 schedules using Dunnett's test, with the early eating schedule as reference (1 compared with 2 and 1 compared with 3): 1) early eating schedule (control), 2) late eating schedule according to the clock time (08:00 on day 8 to 08:00 on day 9), and 3) late eating schedule according to the time elapsed since the first meal for 24 h. RESULTS The 24-h mean ± SD interstitial glucose concentrations when participants followed the late eating schedule were higher than those when they followed the early eating schedule in terms of clock time (91.2 ± 2.9 compared with 99.2 ± 4.6 mg/dL, P = 0.003) and time elapsed (91.2 ± 2.9 compared with 98.3 ± 3.8 mg/dL, P < 0.001). CONCLUSIONS A late eating schedule increases the mean 24-h interstitial glucose concentration in young adult males. This insight will have useful implications in determining meal timings, especially for those with conditions such as diabetes.
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Affiliation(s)
- Yoichi Hatamoto
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan; The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.
| | - Yukiya Tanoue
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan; Ritsumeikan-Global Innovation Research Organization, Ritsumeikan University, Shiga, Japan; Research Organization of Science and Technology, Institute of Advanced Research for Sport and Health Science, Ritsumeikan University, Shiga, Japan
| | - Eiichi Yoshimura
- Department of Nutrition and Metabolism, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Mai Matsumoto
- Department of Nutritional Epidemiology and Shokuiku, National Institute of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Takanori Hayashi
- Department of Clinical Nutrition, National Institute of Biomedical Innovation, Health, and Nutrition, Tokyo, Japan
| | - Hitomi Ogata
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Higashihiroshima, Japan
| | - Shigeho Tanaka
- Faculty of Nutrition, Kagawa Nutrition University, Sakado, Japan
| | - Hiroaki Tanaka
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
| | - Yasuki Higaki
- The Fukuoka University Institute for Physical Activity, Fukuoka, Japan
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Drinking instead of eating as breakfast in South Korea: In which context do people place food with a beverage? Int J Gastron Food Sci 2022. [DOI: 10.1016/j.ijgfs.2022.100477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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de Souza Ramos JTG, Ferrari FS, Andrade MF, de Melo CS, Boas PJFV, Costa NA, Pereira AG, Dorna MS, Azevedo PS, Banerjee J, Phillips BE, Atherton PJ, Polegato BF, Okoshi K, Zanati SG, Paiva SAR, Zornoff LAM, Minicucci MF. Association between frailty and C-terminal agrin fragment with 3-month mortality following ST-elevation myocardial infarction. Exp Gerontol 2021; 158:111658. [PMID: 34920013 DOI: 10.1016/j.exger.2021.111658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/04/2022]
Abstract
The objective of this study was to evaluate the association between frailty, evaluated by the Clinical Frailty Scale (CFS) and FRAIL scale, and C-terminal agrin fragment (CAF) levels with 3-month mortality following ST-segment elevation myocardial infarction (STEMI). This was a prospective observational study that included patients over the age of 18 years with STEMI admitted to the coronary intensive care unit. Within 48 h of admission, the CFS and FRAIL scale were applied and blood samples collected for serum CAF evaluation. Patients were followed for 3 months after hospital discharge, and mortality was recorded. One hundred and eleven patients were included; mean age was 62.3 ± 12.4 years, 61.3% were male and 11.7% died during the 3 months of follow-up. According to the CFS, 79.3% of the patients were classified as not frail, 12.6% as pre-frail and 8.1% as frail. According to the FRAIL scale, 31.5% of the patients were classified as not frail, 53.2% as pre-frail and 15.3% as frail. In univariate analysis, the CFS but not FRAIL scale was associated with mortality. In multiple logistic regression analysis, pre-frail/frail according to CFS (odds ratio [OR]: 6.118; CI 95%: 1.344-27.848; p = 0.019) and CAF levels (OR: 0.943; CI 95%: 0.896-0.992; p = 0.024) were associated with increased 3-month mortality. In a sub-analysis of 53 patients ≥65 years, CFS and CAF levels were associated with 3-month mortality. In conclusion, CAF levels and frailty determined by the CFS were associated with 3-month mortality after STEMI in the general and older population.
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Affiliation(s)
- Juan Thomaz Gabriel de Souza Ramos
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Felipe Sanches Ferrari
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Morganna Freitas Andrade
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Caroline Souto de Melo
- Department of Anesthesiology, Complexo Hospitalar Santa Genoveva de Uberlândia, Minas Gerais, Brazil
| | - Paulo José Fortes Villas Boas
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Nara Aline Costa
- Faculty of Nutrition, UFG- Univ Federal de Goiás, Goiânia, Brazil
| | - Amanda Gomes Pereira
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Mariana Souza Dorna
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil
| | - Paula Schmidt Azevedo
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Jay Banerjee
- Geriatric Emergency Medicine, University Hospitals of Leicester, School of Health Science, University of Leicester, Leicester, UK
| | - Bethan E Phillips
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Derby, UK
| | - Philip J Atherton
- Medical Research Council-Versus Arthritis Centre for Musculoskeletal Ageing Research and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Derby, UK
| | - Bertha Furlan Polegato
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Katashi Okoshi
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Silmeia Garcia Zanati
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Sergio Alberto Rupp Paiva
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Leonardo Antonio Mamede Zornoff
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil
| | - Marcos Ferreira Minicucci
- Internal Medicine Department, Botucatu Medical School, Univ Estadual Paulista, UNESP, Botucatu, Brazil; University Hospital, Botucatu Medical School, Sao Paulo State University, UNESP, Botucatu, Brazil.
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Li ZH, Xu L, Dai R, Li LJ, Wang HJ. Effects of regular breakfast habits on metabolic and cardiovascular diseases: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27629. [PMID: 34871228 PMCID: PMC8568444 DOI: 10.1097/md.0000000000027629] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 08/06/2021] [Accepted: 10/12/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Breakfast, which is considered as an important meal of the day, is being ignored by an increasing number of people as the pace of modern life accelerates. Although a large number of previous studies have reported the relationship between skipping breakfast and type 2 diabetes mellitus, most of them were cross-sectional studies. It remains unclear how skipping breakfast affects such specific cardio-metabolic diseases as hypertension, strokes and hypercholesterolemia. METHODS The protocols and reports of this meta-analysis are based on a meta-analysis of observational studies in epidemiological guidelines (MOOSE). Relevant studies were systematically retrieved from PubMed, Embase, Web of Science and the Cochrane Library, and were restricted to English from the inception to May 10, 2019. All the results were obtained by RRs, and outcomes of interests should include the occurrence of cardiovascular and metabolic diseases. RESULTS Fourteen cohort studies in total were eventually included. Compared with people having breakfast frequency≦3times/week, those with a frequency>3 times/week have reduced the risk of type 2 diabetes mellitus, obesity, Metabolic Syndrome, Low high-density lipoprotein cholesterolemia, Cardiovascular Diseases, cardiovascular Mortality, hypertension and strokes, with (RR = 0.8 [95% CI: 0.7-0.91], P = .142, I2 = 37.6%), (RR = 0.74 [95% CI: 0.59-0.94], P < .001, I2 = 89%), (RR = 0.86 [95% CI:0.75-0.99], P = .512, I2 = 0%), (RR = 0.75 [95% CI:0.61-0.93], P = .643, I2 = 0%), (RR = 0.87 [95% CI:0.81-0.93], P = .479, I2 = 0%), (RR = 0.63 [95% CI:0.51-0.78], P = .396, I2 = 0%), (RR = 0.92 [95% CI:0.86-0.98], P = .419, I2 = 0.7%), and (RR = 0.89 [95% CI:0.79-0.99], P = .238, I2 = 29%), respectively. CONCLUSIONS A regular daily breakfast habit benefits the cardio-metabolism to a great extent, reducing the risk of Cardiovascular Diseases, type 2 diabetes mellitus, obesity, hypertension, strokes, Metabolic Syndrome, cardiovascular Mortality, Low high-density lipoprotein cholesterolemia, and Abdominal obesity, while it is not significantly related to hypercholesterolemia and coronary heart disease regardless of gender. Nevertheless, skipping breakfast once a week may greatly reduce the benefits of cardio-metabolism. Therefore, public institutions should promote and encourage citizens to cultivate regular daily breakfast habits.
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Affiliation(s)
- Zhi-hui Li
- Department of Orthopedics, Huaihe Hospital of Henan University, Kaifeng,China
| | - Lei Xu
- Department of Gastroenterology, Affiliated Hospital of Qinghai University, Xining, China
| | - Rao Dai
- Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining, China
| | - Li-jie Li
- Department of Cardiology, Tong Xu County Hospital, Tongxu, China
| | - Hao-jie Wang
- Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining, China
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Helo D, Appiah L, Bhende KM, Byrd TL, Appiah D. The association of skipping breakfast with cancer-related and all-cause mortality in a national cohort of United States adults. Cancer Causes Control 2021; 32:505-513. [PMID: 33590466 DOI: 10.1007/s10552-021-01401-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/28/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Many lifestyle and dietary factors have been recognized as risk factors for cancer morbidity and mortality. However, investigations of the association of the frequency of breakfast consumption and cancer are limited. This study aimed to examine the association of skipping breakfast with all-cause and cancer-related mortality in a national cohort of United States men and women. METHODS Data were from 7,007 adults aged ≥ 40 years who participated in the third National Health and Nutrition Examination Survey (1988-1994) and had follow-up information on mortality up until 31 December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). RESULTS The mean age of participants was 55.4 years, with 54.4% and 79% being women and non-Hispanic whites, respectively. Approximately, 16% of participants rarely consumed breakfast, 23.0% consumed breakfast some days, and 61% consumed breakfast every day. During a median follow-up of 22.2 years, 3,573 deaths occurred with 795 being related to cancer. In models adjusting for sociodemographic factors, smoking, physical activity, body mass index, hypertension, diabetes, cholesterol levels, total energy intake and diet quality, persons who rarely consumed breakfast had a higher risk of cancer-related mortality (HR = 1.52; CI:1.06-2.18) and all-cause (HR = 1.69; CI: 1.42-2.02) compared to those who took breakfast every day. CONCLUSION In this nationally representative sample, skipping breakfast was associated with elevated risks for all-cause and cancer-related mortality. This study provides evidence for the benefits of regular breakfast consumption in reducing the risk of all-cause and cancer mortality.
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Affiliation(s)
- Dena Helo
- Department of Public Health, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 9430, Lubbock, TX, 79430, USA
| | - Linda Appiah
- College of Education, Texas Tech University, Lubbock, TX, USA
| | - Kishor M Bhende
- Department of Pediatrics, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Theresa L Byrd
- Department of Public Health, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 9430, Lubbock, TX, 79430, USA
| | - Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 9430, Lubbock, TX, 79430, USA.
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Santos HO, Genario R, Macedo RCO, Pareek M, Tinsley GM. Association of breakfast skipping with cardiovascular outcomes and cardiometabolic risk factors: an updated review of clinical evidence. Crit Rev Food Sci Nutr 2020; 62:466-474. [PMID: 32935557 DOI: 10.1080/10408398.2020.1819768] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
"Eat breakfast like a king, lunch like a prince and dinner like a pauper" (Adelle Davis, 1904-1974) is a concept that appears to align with some contemporary evidence concerning the appropriate proportioning of daily meals. At the same time, with the popular and scientific dissemination of the concepts of intermittent fasting and time-restricted feeding, well-controlled clinical trials have emerged showing the safety or even possible benefits of skipping breakfast. In this comprehensive literature review, we discuss recent evidence regarding breakfast intake, cardiovascular outcomes and cardiovascular risk markers. Overall, breakfast omission appears to be associated with a higher risk for atherosclerotic and adverse cardiovascular outcomes. However, caution should be employed when deciphering these data as many complex, unmeasured confounders may have contributed. Unfortunately, long-term randomized, clinical trials with detailed dietary control that have assessed clinical outcomes are sparse. Notwithstanding the observational findings, current trials conducted so far-albeit apparently smaller number-have shown that breakfast addition in subjects who do not habitually consume this meal may increase body weight, particularly fat mass, through caloric excess, whereas skipping breakfast may be a feasible strategy for some people aiming for calorie restriction. To date, definitive benefits of breakfast omission or consumption are not supported by the best evidence-based research, and the question of whether skipping breakfast per se is causally associated with cardiovascular outcomes remains unresolved.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | | | | | - Manan Pareek
- Department of Cardiology, North Zealand Hospital, Hilleroed, Denmark.,Department of Internal Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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Ofori-Asenso R, Owen AJ, Liew D. Skipping Breakfast and the Risk of Cardiovascular Disease and Death: A Systematic Review of Prospective Cohort Studies in Primary Prevention Settings. J Cardiovasc Dev Dis 2019; 6:E30. [PMID: 31443394 PMCID: PMC6787634 DOI: 10.3390/jcdd6030030] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/07/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022] Open
Abstract
Several studies have associated skipping (not having) breakfast with cardiometabolic risk factors such as obesity, high blood pressure, unfavorable lipid profiles, diabetes, and metabolic syndrome. We examined the available evidence regarding the effect of skipping breakfast on cardiovascular morbidity and mortality, as well as all-cause mortality. Medline, Embase, and Web of Science were searched from inception until May 2019 to identify prospective cohort studies that examined the association between skipping breakfast and the risk of cardiovascular morbidity and mortality and all-cause death. Electronic searches were supplemented by manual screening of the references of retrieved studies. Out of 456 citations identified, four studies (from Japan and the US) were included. The included studies involved a total of 199,634 adults (aged ≥40 years; 48.5% female) without known cardiovascular disease (CVD) at baseline followed over a median duration of 17.4 years. The pooled data suggested that people who regularly skipped breakfast were about 21% more likely (hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.08-1.35; I2 = 17.3%, p = 0.304) to experience incident CVD or die from it than people who regularly consumed breakfast. Also, the risk of all-cause death was 32% higher (HR 1.32, 95% CI 1.17-1.48; I2 = 7.6%, p = 0.339) in people who regularly skipped breakfast than in people who regularly consumed breakfast. However, the definition of skipping breakfast was heterogenous and adjustment for confounders varied significantly. Therefore, residual confounding could not be ruled out and caution is required in the interpretation of the findings. Hence, large prospective studies with a consistent definition of skipping breakfast, and conducted across different populations, are needed to provide more robust evidence of the health effects of skipping breakfast.
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Affiliation(s)
- Richard Ofori-Asenso
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, VIC 3004, Australia.
| | - Alice J Owen
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, VIC 3004, Australia
| | - Danny Liew
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, VIC 3004, Australia
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Didikoglu A, Maharani A, Payton A, Pendleton N, Canal MM. Longitudinal change of sleep timing: association between chronotype and longevity in older adults. Chronobiol Int 2019; 36:1285-1300. [PMID: 31328571 DOI: 10.1080/07420528.2019.1641111] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Evening-oriented sleep timing preferences have been associated with risk of diabetes, cardiovascular diseases, obesity, psychiatric disorders, and increased mortality. This research aims to explore the relationship between diurnal preferences (chronotype), daily habits, metabolic health, and mortality, using longitudinal data from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age (6375 participants at inception, recruited in the North of England) with a long follow-up period (up to 35.5 years). Mixed models were used to investigate the influence of aging, socio-demographic, and seasonal factors on sleep timing. Results show that sleep timing shifted towards earlier time with aging. Test seasons influence chronotype of older adults but working schedules challenge seasonality of sleep timing. Moreover, the season of birth may set chronotype in adulthood. Individual chronotype trajectories were clustered using latent class analysis and analyzed against metabolic health and mortality. We observed a higher risk of hypertension in the evening-type cluster compared to morning-type individuals (Odds ratio = 1.88, 95%CI = 1.02/3.47, p = .04). Evening-type cluster was also associated with traits related to lower health such as reduced sport participation, increased risk of depression and psychoticism personality, late eating, and increased smoking and alcohol usage. Finally, Cox regression of proportional hazards was used to study the effects of chronotype on longevity after adjusting for sleep duration, age, gender, smoking, alcohol usage, general health, and social class. The survival analysis (82.6% censored by death) revealed that evening-type chronotype increased the likelihood of mortality (Hazard ratio = 1.15, 95%CI = 1.04/1.26, p = .005). Taken together, chronotype is influenced by aging and seasonal effects. Evening-type preference may have detrimental outcomes for human well-being and longevity.
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Affiliation(s)
- Altug Didikoglu
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
| | - Asri Maharani
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
| | - Antony Payton
- b Division of Informatics, Imaging & Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester , Manchester , UK
| | - Neil Pendleton
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
| | - Maria Mercè Canal
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
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