#VisualAbstract: Association of Skipping Breakfast With Cardiovascular and All-Cause Mortality

1. In this prospective cohort study based on data from the National Health and Nutrition Examination Survey III (1988 – 1994), people who self-reported never eating breakfast had almost double the cardiovascular mortality compared to those who always reported eating breakfast.

2. There was a non-significant trend towards increased all-cause mortality amongst those who self-reported never eating breakfast.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Cardiovascular disease is a leading cause of mortality and morbidity in North America. There is a small amount of evidence that skipping breakfast is linked with several chronic diseases, but the impact on mortality is not clear. In this nationally representative prospective cohort study from the United States, self-reported ‘never’ eating breakfast was associated with an increased risk of cardiovascular mortality and a signal towards increased all-cause mortality compared with ‘always’ eating breakfast. Although ‘never’ eating breakfast was associated with obesity, dyslipidemia, former smoking, heavy drinking, lower income, physical inactivity, and being unmarried, the above elevated mortality risk remained after correcting for these factors.

Strengths of the study included using a validated survey, obtaining large amount of demographic information, using a nationally-representative group of people, and the long term follow up data. The main limitations of this study included the self-reported nature of breakfast intake (which introduces recall bias), lack of breakfast intake data during the decades of follow up, and the low numbers in the ‘never-breakfast’ group.

Click to read the study in JACC

Click to read an accompanying editorial in JACC

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