relevant. It's a factor roughly equivalent to the difference between exercising two or three times a week and not at all. "These findings overwhelmingly point to a very positive public health message: if you'd like to decrease your chance of heart disease, then you should definitely eat breakfast." Previous studies have highlighted breakfast's importance for lowering "associated risk factors" for CHD, such as diabetes, obesity, high blood pressure and cholesterol. Until now, however, a direct link to CHD has never been made. Rimm said: "There are lots of studies exploring the short-term health effects of skipping breakfast but ours was the first to look at those long-term, confirming a high relative
risk of heart disease for skippers." The researchers analysed questionnaire data and health outcomes for 26,902 male health professionals, aged 45-82. During the 16-year study period, 1,572 new cases of CHD were diagnosed. (Interestingly, although only 1.5% of the participants reported eating late at night, those who did were found to have a 55% increase in risk of CHD.) The results are published this week in the American journal Circulation. Despite only men being analysed, the results are thought to have wider implications, said Rimm. "We do have a parallel studyrunning which looks at similar factors in women, and the early results may be indicating the effects on diabetes, weight gain and blood
pressure are actually stronger than those in men … I think that lifestyle factors tend to be stronger in women than men. Women with diabetes, for instance, tend to have a higher risk of heart attack than men with diabetes." The study outlined how participants who missed breakfast had similar calorie intakes to those who did not,suggesting they ate more at later points in the day. The problem, Rimm said, is that this concentrated calorie intake over fewer meals puts"unnecessary stress" on the body, creating unhealthily large spikes of blood glucose that would be reduced by smaller, more frequent meals. Victoria Taylor, a senior dietitian at the British Heart Foundation, said: "In the morning rush it can be all too easy to skip breakfast, but this study suggests this could have a bigger impact on our health than we might think. "However, these researchers only looked at men aged over 45, so we would need to see further research to confirm that breakfast has the same impact on the heart health of
other groups of people."Rim acknowledges this point, but points out that other studies have found similarly adverse effects on younger people of skipping breakfast. More difficult in this study, Rimm said, was accounting for lifestyle differences between skippers and eaters, such as smoking, alcohol consumption and exercise. "We took those into account to the best of our abilities but of course there's still a chance that there are some residual effects that we can't account for statistically," he said."We realise this is only an observational study, but what we're seeing is probably more causation than correlation - if only because there's a whole body of literature now that suggests a biological phenomenon related to skipping breakfast."
