Rarely or never consuming breakfast increases risk for stroke

Frequency of breakfast intake was inversely associated with increased risk for stroke but not increased risk for CHD, according to a study of Japanese participants published in Stroke.

Researchers investigated whether omission of breakfast correlated to increased risk for stroke and CHD in a Japanese population. They analyzed 82,722 participants (52% women) aged 45 to 74 years from the Japan Public Health Center-based Prospective Study with no history of CVD or cancer from 1995 to 2010, stratifying them by frequency of breakfast consumption: zero to two times per week, three to four times per week, five to six times per week or seven times per week.

During 1,050,030 person-years of follow-up, Yasuhiko Kubota, MD, and colleagues identified 3,772 strokes and 870 cases of CHD. Of the strokes, 1,051 were cerebral hemorrhages, 417 were subarachnoid hemorrhages and 2,286 were cerebral infarctions.

After adjustment for age, sex, diet factors, lifestyle factors and health center, compared with those who ate breakfast seven times per week, those who ate breakfast zero to two times per week had increased risk for any stroke (HR = 1.18; 95% CI, 1.04-1.34), Kubota, from the public health, department of social medicine, Osaka University Graduate School of Medicine, Japan, and colleagues found.

They also found those who ate breakfast zero to two times per week had increased risk for total CVD (HR = 1.14; 95% CI, 1.01-1.27) and cerebral hemorrhage (HR = 1.36; 95% CI, 1.1-1.7) compared with those who ate breakfast every day, but that was not the case for CHD (HR = 0.96; 95% CI, 0.73-1.25), subarachnoid hemorrhage (HR = 1.1; 95% CI, 0.76-1.6) or cerebral infarction (HR = 1.1; 95% CI, 0.92-1.3).

Those who ate breakfast three or four times per week or five or six times per week had no increased risk for any outcome compared with those who ate breakfast every day.

Excluding early CV events, defined as those occurring 5 years or less from baseline, did not change the results.

Kubota and colleagues wrote that the results were driven by cerebral hemorrhage, for which hypertension is a major risk factor, and cerebral hemorrhages are known to frequently occur after a morning surge in BP. A possible explanation for the results could be that those who ate breakfast every day had a numerically lower rate of high BP compared with other subgroups.

“It may be important to reduce the frequency or duration of high [BP] in the morning to prevent cerebral hemorrhage, and eating breakfast every day might achieve this,” they wrote. – by Erik Swain

Disclosure: The researchers report no relevant financial disclosures.

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