...And give the dinner to the enemy

Refusing breakfast increased the risk of atherosclerosis

Elizaveta Ivtushok, N+1

Consumption of less than five percent of the daily calorie intake during breakfast leads to a risk of cardiovascular disease. This was found out by an international team of scientists who for six years monitored the daily habits and physical health of four thousand Spaniards. Article by Irina Uzhova et al. The Importance of Breakfast in Atherosclerosis Disease is published in the Journal of the American College of Cardiology.

Some diseases involved in the occurrence of problems with blood vessels and the heart arise, in many respects, due to an incorrect lifestyle - including nutrition. Among these diseases are diabetes mellitus, obesity, dyslipidemia (excess lipids in the blood). Skipping or insufficient calorie content of breakfast is also considered one of the factors in the occurrence of such diseases.

The authors of the new study tested the relationship between skipping breakfast and the occurrence of atherosclerosis – a chronic artery disease that occurs due to a violation of protein and lipid metabolism and cholesterol deposits in the vessels. Among the risk factors for such a disease are obesity and diabetes mellitus, which is why proper nutrition plays an important role in its prevention.

Four thousand Spaniards (average age – 45 years) working in the office took part in the experiment. Breakfast was considered the first meal of the day or a non-alcoholic drink, usually before 10 o'clock in the morning. After collecting data on the eating habits of the experiment participants, the scientists divided them into three groups according to the energy value of their breakfast:

• people who consume more than 20 percent of the recommended daily calorie intake (the average recommended daily calorie intake for the sample participants is 2314 kcal);
• people consuming 5 to 20 percent of the recommended daily calorie intake;
• people who consume less than 5 percent of the recommended daily calorie intake.

Since the energy value of the usual breakfast of the last group corresponds (with the maximum caloric value) to about one cup of coffee with milk and sugar or a glass of orange juice, participants from this group were considered to skip breakfast.

The scientists also collected data on gender, age, marital status, education, tobacco consumption (smoking is one of the main factors influencing the development of atherosclerosis) and alcohol, daily activity (the average accelerometer that measured activity for seven days), as well as family history of cardiovascular diseases and dietary restrictions for the purpose of losing weight. All the collected data were taken into account in the analysis.

As the main indicator of the risk of atherosclerosis, scientists took the number of atheromatous plaques – one of the main markers of the presence of the disease – in the arteries of the participants. Scientists measured the level of plaques in the carotid artery, aorta and femoral artery. The presence of plaques in these vessels was considered an indicator of non-coronary atherosclerosis. Coronary (subclinical) atherosclerosis was also characterized by the formation of calcium salts in the coronary artery. If at least four of the six studied zones were affected (and there was no calcium), atherosclerosis was considered "general". When analyzing the presence of plaques, the participants' complexion, their consumption of tobacco, alcohol and red meat, as well as the presence of diabetes, dyslipidemia and hypertension (high blood pressure) were taken into account.

The results of the analysis showed that the presence of atheromatous plaques in the vessels of people who skip breakfast is one and a half times higher than those who eat a dense or even light breakfast.

A graph of the probability of having (from left to right) non-coronary, subclinical and "general" atherosclerosis among people who consume a dense (highlighted in gray) or light (highlighted in red) breakfast and skip breakfast (highlighted in blue). Drawings from the article by Uzhova et al.

In addition, the authors found that skipping breakfast was associated with a two–fold increase in the chance of developing obesity, and a three-fold increase in metabolic syndrome.

A graph of the probability of obesity (left) and metabolic syndrome (right) among people who consume (from left to right on each graph) a dense or light breakfast and skip breakfast.

The authors of the work believe that such results are due to the fact that people who skip breakfast risk replenishing energy reserves by consuming large amounts of high-calorie foods rich in carbohydrates and fats later in the day. The researchers note that in order to further study the risk of cardiovascular diseases, it is necessary to take into account early factors, such as, for example, nutrition at a younger age.

Scientists are studying the benefits of various products for the prevention of diseases of the cardiovascular system. For example, flavonoids contained in cocoa improve metabolic parameters and reduce the risk of vascular and heart disease.

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