February 27, 2021
Cardiovascular diseases (CVDs) remain the leading contributors to the burden of diseases and deaths worldwide. In 2015, there were more than 422 million cases of CVDs, resulting in over 17.9 million deaths (~31% of all global deaths). Much of CVDs are preventable –you should be physically active, not smoke, and consume only a healthy diet.
Whilst most nutritional guidelines for adults lack evidence-based recommendations related to eating habits (timing, quantity, energy content and frequency), for many decades now, breakfast has been touted as the most important meal of the day. Indeed, some have even suggested that approximately 15-30% of the daily energy intake should be consumed at breakfast. Yet, more than a quarter of adults worldwide skip this presumably most important meal of the day; this is especially true of people who work in shifts, and those with excessive working hours, as well as people who have no fondness for food such as those with depression, or with poor health literacy.
Epidemiological studies have demonstrated a higher prevalence of cardiometabolic risk factors such as obesity, high blood pressure, unfavourable lipid profiles, diabetes and metabolic syndrome among people who skip breakfast, which may ultimately contribute to increased risk of CVD.
In a study conducted at multiple European centres by Musse et al, it was found that people who regularly skipped breakfast were about 21% more likely to suffer a CVD event or die from it, and 32% were more likely to die from these causes compared to people who regularly had breakfast. The same study also concluded that there was a 4-5-fold increased likelihood of death, re-infarction and post-infarction angina within 30 days after hospital discharge among patients with ST-segment elevation myocardial infarction who skipped breakfast and had late night dinner.
Omitting breakfast has also been associated with obesity, hypertension, diabetes and atrial fibrillation, and may also impair serum lipids and postprandial insulin sensitivity. Such a lifestyle has shown to have an adverse effect on arterial stiffness and carotid atheromatic burden.
The message here is that you should have healthy food at regular timings, and also think twice before skipping your breakfast.
Dr. Manjunath S. Pandit, MBBS, MD, DM (cardiology) is an Interventional Cardiologist at Indiana Hospital & Heart Institute, Mangaluru
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