Author + information
- Received July 24, 2017
- Accepted August 16, 2017
- Published online October 2, 2017.
- Irina Uzhova, MSca,
- Valentín Fuster, MD, PhDa,b,∗∗ (, )
- Antonio Fernández-Ortiz, MD, PhDa,c,d,e,
- José M. Ordovás, PhDa,f,g,
- Javier Sanz, MDa,b,
- Leticia Fernández-Friera, MD, PhDa,c,h,
- Beatriz López-Melgar, MD, PhDa,h,
- José M. Mendiguren, MDi,
- Borja Ibáñez, MD, PhDa,c,j,
- Héctor Bueno, MD, PhDa,d,k and
- José L. Peñalvo, PhDl,∗ ()
- aCentro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
- bIcahn School of Medicine at Mount Sinai, New York, New York
- cCIBER de Enfermedades CardioVasculares, Madrid, Spain
- dUniversidad Complutense, Madrid, Spain
- eCardiovascular Institute, IDISSC, Hospital Clínico San Carlos, Madrid, Spain
- fU.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
- gIMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain
- hHM Hospitales-Centro Integral de Enfermedades Cardiovasculares, Madrid, Spain
- iBanco de Santander, Madrid, Spain
- jIIS-Fundación Jiménez Díaz Hospital, Universidad Autónoma, Madrid, Spain
- ki+12 Research Institute and Cardiology Department, Hospital 12 de Octubre, Madrid, Spain
- lFriedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- ↵∗Address for correspondence:
Dr. Jose L. Peñalvo, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, Massachusetts 02111.
- ↵∗∗Dr. Valentin Fuster, Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Melchor Fernández Almagro 3, 28029 Madrid, Spain.
Background Daily habits, including the number and quality of eating occasions, are potential targets for primary prevention strategies with large health impacts. Skipping breakfast is considered a frequent and unhealthy habit associated with an increased cardiovascular (CV) risk.
Objectives The study sought to explore the association between different breakfast patterns and CV risk factors and the presence, distribution, and extension of subclinical atherosclerosis.
Methods Cross-sectional analysis was performed within the PESA (Progression of Early Subclinical Atherosclerosis) study, a prospective cohort of asymptomatic (free of CV events at baseline) adults 40 to 54 years of age. Lifestyle and multivascular imaging data along with clinical covariates were collected from 4,052 participants. Multivariate logistic regression models were used in the analysis.
Results Three patterns of breakfast consumption were studied: high-energy breakfast, when contributing to >20% of total daily energy intake (27% of the population); low-energy breakfast, when contributing between 5% and 20% of total daily energy intake (70% of the population); and skipping breakfast, when consuming <5% of total daily energy (3% of the population). Independent of the presence of traditional and dietary CV risk factors, and compared with high-energy breakfast, habitual skipping breakfast was associated with a higher prevalence of noncoronary (odds ratio: 1.55; 95% confidence interval: 0.97 to 2.46) and generalized (odds ratio: 2.57; 95% confidence interval: 1.54 to 4.31) atherosclerosis.
Conclusion Skipping breakfast is associated with an increased odds of prevalent noncoronary and generalized atherosclerosis independently of the presence of conventional CV risk factors. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318)
The PESA (Progression of Early Subclinical Atherosclerosis) study is co-funded equally by the Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) (Madrid, Spain) and Banco Santander (Madrid, Spain). The study also receives funding from the Institute of Health Carlos III (PI15/02019) and the European Regional Development Fund. The CNIC is supported by the Ministry of Economy, Industry and Competitiveness (MINECO) and the Pro-CNIC Foundation, and is a Severo Ochoa Center of Excellence (MINECO award SEV-2015-0505). Dr. Bueno was funded by the Instituto de Salud Carlos III (PIE16/00021); has received research funding from AstraZeneca, Bristol-Myers Squibb, Janssen, and Novartis; consulting fees from Abbott, AstraZeneca, Bayer, Bristol-Myers Squibb/Pfizer, and Novartis; and speaking fees or support for attending scientific meetings from AstraZeneca, Bayer, Bristol-Myers Squibb/Pfizer, Ferrer, Novartis, Servier, and theheart.org/Medscape. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Dr. Peñalvo is currently an employee at Merck KGaA. P.K. Shah, MD, served as Guest Editor for this paper.
- Received July 24, 2017.
- Accepted August 16, 2017.
- 2017 American College of Cardiology Foundation