Importance of Breakfast in Atherosclerosis Disease

Study Questions:

What is the association between different breakfast patterns and cardiovascular (CV) risk factors and the presence, distribution, and extension of subclinical atherosclerosis?


Cross-sectional analysis was conducted within the PESA (Progression of Early Subclinical Atherosclerosis) study, a Spanish bank employee prospective cohort of asymptomatic (free of CV events at baseline) adults aged 40-54 years. Lifestyle and multivascular imaging data (coronary calcium score and vascular ultrasound), along with clinical covariates, were collected from 4,052 participants. Multivariate logistic regression models were used in the analysis.


Mean age was 45 years. Three patterns of breakfast consumption were studied: high-energy breakfast (HBF) when contributing to >20% of total daily energy intake (27% of the population); low-energy breakfast (LBF) when contributing between 5% and 20% of total daily energy intake (70% of the population); and skipping breakfast (SBF) when consuming <5% of total daily energy (3% of the population). Independently of the presence of traditional and dietary CV risk factors, and compared with HBF, habitual SBF was associated with a higher prevalence of noncoronary (odds ratio [OR], 1.55; 95% confidence interval [CI], 0.97-2.46) and generalized atherosclerosis (OR, 2.57; 95% CI, 1.54-4.31).


Skipping breakfast is associated with increased odds of prevalent noncoronary and generalized atherosclerosis independently of the presence of conventional CV risk factors.


This is an important good-sized longitudinal study that can help determine which behavioral traits impact atherosclerosis independent of classic risk factors. The authors suggested that skipping breakfast is a ‘social-business eating pattern’ and might serve as a marker for a general unhealthy diet or lifestyle, which in turn is associated with the development and progression of atherosclerosis. It was noted that the patients in this cohort were more likely smokers and obese. Unfortunately, there was no information on psychological distress and business and life stress, which may have played a role in both the atherosclerosis and eating patterns.

Keywords: Atherosclerosis, Breakfast, Cardiac Imaging Techniques, Diet, Energy Intake, Life Style, Obesity, Plaque, Atherosclerotic, Primary Prevention, Risk Factors, Smoking, Stress, Psychological, Ultrasonography

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