Should You Eat Breakfast Every Day?
Author: Dr. Stephen Chaney
Does skipping breakfast actually increase your risk of heart attacks? You’ve probably heard the saying “Eat breakfast like a king, lunch like a prince, and dinner like a pauper”.
You’ve probably also heard that skipping breakfast is associated with increased risk of things like:
- obesity
- high blood pressure
- and diabetes
If you believe those associations are true, the latest study showing an association between skipping breakfast and heart disease risk just makes sense. After all, obesity, high blood pressure and diabetes all increase the risk of heart disease.
But, how good is the evidence skipping breakfast actually increases the risk of any of those things?
The evidence for the link between skipping breakfast and heart disease risk:
Let’s start with the current study linking breakfast skipping with heart disease (Cahill et al, Circulation, 128: 337-343, 2013) because its study design is similar to the studies linking breakfast skipping to obesity, high blood pressure and diabetes. This study surveyed the eating habits of 27,000 men (45+ years old) enrolled in the Health Professionals Follow-Up Study in 1992 and followed those men for 16 years.
The results were pretty dramatic. After correcting for other factors that might influence heart disease risk, the men who skipped breakfast were 27% more likely to develop heart disease over the next 16 years than the men who ate breakfast on a daily basis.
As impressive as the association between breakfast and heart disease was, there was an even more impressive association that never made it into the headlines.
There was no association between skipping breakfast and eating late in the evening. However, those men who ate late in the evening were 53% more like to develop heart disease than men who did not.
The pros and cons of the study:
The pros:
1) The strength of this study is that it is large (27,000 participants), long (16 years) and well designed. The results were statistically very significant.
The cons:
1) This study only shows associations. It does not prove cause and effect. Having said that, it would be really, really hard to design a placebo controlled study for breakfast versus no breakfast. So cause and effect is almost impossible to prove for this type of comparison.
2) The study did not ask what kind of breakfast the participants were eating. We don’t know whether the breakfasts were a Danish and coffee, an Egg McMuffin and hash browns or a high protein smoothie with perhaps some fruit or oatmeal– and, believe me, there is a difference among those three breakfasts!
The Bottom Line:
1) Eating breakfast is probably a good thing. Yes, the evidence that skipping breakfast increases heart disease risk is circumstantial, but it is also substantial. This is a large, well designed study.
2) Not all breakfasts are equal. You probably already knew that! I recommend a breakfast with fruit, nuts, whole grains in moderation and lean protein sources.
3) While this particular study only included men, previous studies suggest that the potential health risks of skipping breakfast are equally strong for women.
4) Finally, while skipping breakfast grabbed all the headlines, the data suggest that eating late at night is an even stronger predictor of heart disease risk.
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.