Men who skip breakfast have a 27 percent higher risk of suffering a heart attack or developing heart disease than those who start the day with something in their stomach, according to a new study.
The study confirms earlier findings that have linked eating habits to elevated risk factors for heart disease, the Harvard researchers said.
"Men who skip breakfast are more likely to gain weight, to develop diabetes, to have hypertension and to have high cholesterol," said Eric Rimm, senior author and associate professor of epidemiology and nutrition at Harvard School of Public Health and associate professor of medicine at the Harvard Medical School.
For example, breakfast skippers are 15 percent more likely to gain a substantial amount of weight and 21 percent more likely to develop Type 2 diabetes, earlier studies have reported.
The new study, published July 22 in the journal Circulation, found that these men also indulged more heavily in other unhealthy lifestyle choices. They were more likely to smoke, engage in less exercise and drink alcohol.
"We've focused so much on the quality of food and what kind of diet everyone should be eating, and we don't talk as often on the manner of eating," said Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City. "This study is not even discussing the type of food. It's just talking about behavior and lifestyle choice. Part of heart-healthy living is eating breakfast because that prevents you from doing a lot of other unhealthy things."
For the new report, researchers analyzed data culled from a 16-year study of nearly 27,000 male health professionals that tracked their eating habits and overall health from 1992 to 2008. During the study period, 1,572 of the men developed heart disease.
The study also found a 55 percent increased risk of heart disease in men who regularly indulge in late-night snacking. However, the researchers did not consider this a public health risk because few men reported eating after they'd gone to bed.
Rimm said there are several possible explanations why skipping breakfast can have such a drastic effect on heart health.
The Harvard study found that men who skip breakfast do not pick up another meal later in the day, which Rimm said indicates that they tend to "feast" on higher-calorie meals when they do eat. Previous studies have found that feasting can result in high cholesterol and elevated blood pressure, compared with nibbling smaller meals.
"It's the extra strain on the body of eating more calories during the few times in a day they do eat," he said.
The type of food that a person consumes during breakfast also might be a factor.
"Breakfast is typically a time when people tend to eat a healthy meal," Rimm said. "By skipping a meal that usually features fiber or fruit or yogurt, you're missing out on an occasion where people can get healthy nutrients."
Younger men tend to skip breakfast more frequently than older men, the investigators found, which leads to another possible explanation. "It may be in line with the fact that these are men who are rushing out to stressful jobs and not eating along the way," Rimm said, noting that stress is bad for heart health and is associated with negative lifestyle choices such as drinking or smoking.
The study did not include women, but Steinbaum believes the same pattern likely occurs in women who skip breakfast. "There haven't been any studies independently on women, but I would suspect we would find the same outcomes," she said.
Rimm said the study reinforces the age-old emphasis on breakfast as a key to good health.
"There is so much we know about reducing risk of heart disease, and some things like exercise or quitting smoking take quite a bit of effort," Rimm said. "But it is easy without a big huge financial or time commitment to have breakfast, even if it is a bowl of oatmeal or a bit of cereal before you start the day."