3:00am

Tue July 23, 2013
The Salt

Why Skipping Breakfast Might Raise Risk Of Heart Disease

Originally published on Thu July 25, 2013 3:18 pm

Breakfast has long gotten a good rap for everything from aiding weight loss to improving focus in the classroom.

And ever since the Alameda County study in California back in the 1960s linked breakfast — along with a host of other habits — to a longer lifespan, there's been a societal push towards breaking the fast.

"It's such a simple lifestyle change that people can make," says researcher Eric Rimm of the Harvard School of Public Health.

Rimm is the co-author of fresh research that links yet another significant benefit to eating a morning meal: reducing the risk of heart attack.

The new study, published in the journal Circulation, finds that men who routinely skipped breakfast had a 27 percent higher risk of having a heart attack or dying from coronary heart disease compared to men who ate breakfast.

The long-term, 16-year study included nearly 27,000 men.

"Don't skip breakfast," concludes study author Leah Cahill, a research fellow at the Harvard School of Public Health.

Now a lot of folks may be wondering: Is there something truly beneficial about the timing of breakfast? Or is it just the case that people who eat a morning meal also tend to have a lot of other good habits, such as exercising more and smoking less, compared to those who skip?

Rimm and his colleagues took pains to account for the fact that the breakfast eaters in their study were different. Still, the findings held.

"It was somewhat surprising to us that even after we statistically accounted for differences in diet, smoking patterns and exercise patterns ... you still see an elevated risk of heart attack [among the non-breakfast eaters]," Rimm says.

The researchers aren't certain what accounts for the benefits, but they believe several biological mechanisms could be at play.

Cahill says when you prolong fasting by skipping breakfast you can put a strain on the body. "And over many years ... it can lead to insulin sensitivity, which can lead to [type-2] diabetes, [and] it can lead to high blood pressure," she says, which over time can lead to heart disease.

In other words, she's making the case that the timing of meals really does seem to matter.

"We really saw that breakfast itself was important," concludes Cahill. Whether it's skipping breakfast in the morning or eating very late at night, this pattern of eating may lead to adverse metabolic effects that set the stage for heart disease.

Researchers who study circadian rhythms say these findings make sense, given that the act of eating plays a critical role in resetting our internal clocks.

"For a very long time we thought that light is the cue that resets the brain clock," says Satchin Panda, an associate professor in the Regulatory Biology Laboratory at the Salk Institute. "But slowly we are learning that actually it's food that's the biggest cue to reset the clock."

He says the resetting of the clock is key since it helps our bodies perform optimally.

If you change the timing of food on different days, then the clock is not getting the same cue everyday Panda says, so "the clock goes haywire and our body becomes less efficient in processing the food."

Now, there are plenty of healthy people out there who don't eat a meal right after waking up.

"I don't tend to wake up real hungry," says Rachel Johnson, a professor of nutrition at the University of Vermont and a spokesperson for the American Heart Association.

Johnson says she usually eats a mid-morning breakfast, and this is OK. She says she is convinced by the body of evidence that breakfast has its benefits, but her advice: Don't force it.

"If you're not a breakfast eater, don't just add the calories on top of what you're doing and expect you're going to be be miraculously healthier," says Johnson.

She says when it comes to eating in the morning, let hunger pangs be your guide.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

DAVID GREENE, HOST:

I don't know about you but I eat breakfast every morning - either an egg or maybe cereal before going into the studio. At 4:30 in the morning, mostly it's hunger but there is that advice about breakfast being healthy. Well, now that advice seems even more solid. NPR's Allison Aubrey has seen a new study published in the journal Circulation.

ALLISON AUBREY, BYLINE: It's likely an understatement to say that most of us are creatures of habit and one daily habit for Randy Mateka(ph) is, you guessed it, breakfast.

RANDY MATEKA: I usually every morning eat a yogurt and a banana.

AUBREY: I caught up with Mateka as he and a few coworkers made their way from a neighborhood breakfast shop here in D.C., cups of coffee still in hand. So this is a habit you've got.

MATEKA: Yes. You know, I definitely do it every morning.

AUBREY: Now, breakfast has long gotten a good rap for everything from improving focus to losing weight. And ever since the 1960s when researchers in Alameda County, California linked eating breakfast - along with other healthy habits - to a longer lifespan, there's been a societal push towards breaking the fast.

ERIC RIMM: Yes. It's such a - it's really one of the simplest lifestyle changes we can make.

AUBREY: That's Eric Rimm of the Harvard School of Public Health. Yet, he says, not everyone has gotten on board.

RIMM: We still see that 15 to 20 percent of the U.S. population does not eat breakfast in the morning. And to me that's a lot.

AUBREY: So what's the possible downside of skipping breakfast? Well, prior research suggests it's harder to lose weight and keep it off if you don't eat a morning meal. And Rimm was curious about a possible influence on heart health. So as part of a large, long-term study evaluating the effect of diet on cardiovascular health, he and his colleagues kept track of the breakfast habits of nearly 27,000 men and followed up to see who among them had heart attacks.

RIMM: We found that men who skipped breakfast had a 27 percent higher risk of having a heart attack, over the 16 years of the study.

AUBREY: It sounds like a pretty good reason to eat breakfast, right? But wait a second. Is this a real biological phenomenon or is it just that people who tend to eat breakfast also tend to have lots of other good habits? They tend to smoke less and exercise more. Maybe that's what explains the benefits. Researcher Eric Rimm says he and his colleagues did take into account the fact that the habits of the non-breakfast eaters in their study were different. But he says this did not negate the benefits.

RIMM: It was somewhat surprising to us that even after we statistically account for differences in diet and smoking patterns and exercise patterns, even after accounting for all of that, you still see that there's the elevated risk of heart attack.

AUBREY: And interestingly, men who ate late at night also had a significantly higher risk of heart attack. So what's going on here? One possibility is that the timing of meals does matter. Researchers who study circadian rhythms say since eating helps to reset our internal clocks, eating in the morning may help keep our bodies and metabolisms on track.

For now there's no way to establish a clear cause and effect here and certainly there are plenty of healthy people out there who don't eat a meal right after waking up. Take, for instance, dietician Rachel Johnson of the University of Vermont.

RACHEL JOHNSON: I don't tend to wake up real hungry and so I generally wait until I'm hungry.

AUBREY: Usually this means a mid- to late-morning meal. Johnson says while there is a whole body of evidence pointing towards the benefits of breakfast, her advice is this: Don't force it.

JOHNSON: If you're not a breakfast eater, don't just add the calories in breakfast on top of what you're currently doing and expect that you're going to be sort of miraculously healthy.

AUBREY: Johnson says when it comes to eating in the morning, let hunger pangs - not the clock - be your guide. Allison Aubrey, NPR News.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

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