Prospective study of breakfast eating and incident coronary heart disease in a cohort of male US health professionals.
Level 3 - non-randomized controlled study
Prospective cohort study
PubMed 23877060 · doi:10.1161/CIRCULATIONAHA.113.001474
What was done
Eating habits, including breakfast consumption and late-night eating, were assessed in 1992 among 26,902 US male health professionals aged 45 to 82 who were free of cardiovascular disease and cancer in the Health Professionals Follow-up Study. Over 16 years of prospective follow-up, Cox proportional hazards models were used to estimate relative risks (RR) and 95% confidence intervals (CI) for incident coronary heart disease (CHD), adjusting for demographics, diet, lifestyle, and clinical risk factors.
What was found
Over 16 years, 1,527 incident CHD cases occurred. Men who skipped breakfast had a 27% higher risk of CHD compared to breakfast eaters (RR 1.27; 95% CI, 1.06-1.53). Men who ate late at night had a 55% higher risk of CHD compared to those who did not (RR 1.55; 95% CI, 1.05-2.29). These associations were mediated by body mass index, hypertension, hypercholesterolemia, and diabetes mellitus. Total eating frequency (times per day) showed no association with CHD risk.
Why it matters
This study provides large-scale prospective evidence that meal timing and skipping habits, independent of overall dietary quality, are associated with long-term coronary heart disease risk.
Limits
The study population was restricted to older male US health professionals, limiting generalizability to women and other socioeconomic or racial groups. Eating habits were assessed observationally by self-report, leaving potential for residual confounding and reporting bias.
Cited by
- supports Longitudinal cohort studies in nurses and health professionals demonstrate that shift work and irregular eating patterns increase cardiovascular disease risk.