Association of Breakfast Intake With Incident Stroke and Coronary Heart Disease

Abstract

Background and Purpose-The association between breakfast intake and the risk of cardiovascular disease, including stroke, among Asian people remains unknown. We sought to prospectively investigate whether the omission of breakfast is related to increased risks of stroke and coronary heart disease in general Japanese populations. Methods-A total of 82 772 participants (38 676 men and 44 096 women) aged 45 to 74 years without histories of cardiovascular disease or cancer were followed up from 1995 to 2010. Participants were classified as having breakfast 0 to 2, 3 to 4, 5 to 6, or 7 times/wk. The hazard ratios of cardiovascular disease were estimated using Cox proportional hazards models. Results-During the 1 050 030 person-years of follow-up, we documented a total of 4642 incident cases, 3772 strokes (1051 cerebral hemorrhages, 417 subarachnoid hemorrhages, and 2286 cerebral infarctions), and 870 coronary heart disease. Multivariable analysis showed that those consuming no breakfast per week compared with those consuming breakfast everyday had hazard ratios (95% confidence interval; P for trend) of 1.14 (1.01-1.27; 0.013) for total cardiovascular disease, 1.18 (1.04-1.34; 0.007) for total stroke, and 1.36 (1.10-1.70; 0.004) for cerebral hemorrhage. Similar results were observed even after exclusion of early cardiovascular events. No significant association between the frequency of breakfast intake and the risk of coronary heart disease was observed. Conclusions-The frequency of breakfast intake was inversely associated with the risk of stroke, especially cerebral hemorrhage in Japanese, suggesting that eating breakfast everyday may be beneficial for the prevention of stroke. . Of 116 896 subjects, 3053 subjects were excluded from the present study because they were identified as having died, moved out of the study area, or been lost at the second survey. Therefore, a total of 113 393 patients from the 2 cohorts were eligible for participation in the present study, and the second survey was considered as the baseline for this study. Of 113 393 participants, 88 981 participants (78%) completed the questionnaires, including information on breakfast at the second survey. In addition, we excluded 6209 patients who had a history of stroke, myocardial infarction, angina pectoris, or cancer at the baseline. Ultimately, a total of 82 772 participants (38 676 men and 44 096 women) were included in the present study. The institutional human ethics review boards of Osaka University and the National Cancer Center approved the present study. Main Exposure: Frequency of Breakfast IntakeParticipants were asked to provide information concerning the average frequency of breakfast consumption as follows: "How often do you have breakfast a week? Almost never, 1 to 3 times per month, 1 to 2, 3 to 4, 5 to 6 times per week, or everyday." In the current study, subjects were classified into the following 4 groups for comparison: those who had breakfast 0 to 2 (subjects with almost never, those with 1-3 times/mo, and those with 1-2 times/...

Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association

“…63 In the second study, conducted in Japan, infrequent breakfast consumption was associated with a greater risk of CVD, specifically greater risk of hemorrhagic stroke, after adjustment for age, sex, dietary and lifestyle factors, perceived mental stress, living alone, physical labor, and public health center area. 64 Individuals who consumed breakfast 0 to 2 times a week compared with those with daily breakfast eating had an HR of 1.14 (95% CI, 1.01-1.27) for total CVD, 1.18 (95% CI, 1.04-1.34) for total stroke, and 1.36 (95% CI, 1.10-1.70) for cerebral hemorrhage. In contrast, infrequent breakfast intake was not associated with greater risk of subarachnoid hemorrhage, cerebral infarction, or CHD in this population.…”

“…65,66 The authors speculated that the low prevalence of CHD may explain the lack of association between breakfast skipping and CHD risk in Japan. 64 Epidemiological studies provide strong evidence of a relation between breakfast skipping and cardiometabolic risk. These include greater risk of overweight and obesity, metabolic risk profile, diabetes mellitus, CVD, and hypertension.…”

Daily Total Physical Activity and Incident Stroke

“…Of responders to the third survey, 90,886 participants were eligible for follow-up because individuals in two Public Health Center areas (Tokyo and Osaka) were excluded from the current study because of the incomplete follow-up data (17). Of the 90,886 subjects, 87,169 residents completed the questionnaire about daily physical activity.…”

The Association Between Maternal Factors and Preadolescent Breakfast Skipping: The Mediating Role of Preadolescent Attitudes Toward Breakfast

“…Similarly, a recent review of intervention studies on the positive effects of breakfast on cognitive functions in children and adolescents suggests that memory and task‐requiring attention are enhanced by breakfast consumption (Adolphus, Lawton, Champ, & Dye, ). Research further suggests that regular breakfast intake prevents potential adverse effects, such as risk of mortality from circulatory cardiac diseases, cancer, and stroke (Kubota, Iso, Sawada, & Tsugane, ; Yokoyama et al., ).…”