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Skipping Breakfast Related to Higher Cardiovascular Risks

Aug 31, 2019
Editor: David L. Joffe, BSPharm, CDE, FACA

Author: Amber Satz, PharmD Candidate, LECOM School of Pharmacy

You may want to rethink skipping breakfast in the mornings. Changes in hormones to help control normal blood glucose levels can lead to weight gain and possible heart disease in people who skip breakfast.

Trying to cut calories, caught up in the morning rush, or just not feeling hungry are all reasons why many Americans skip breakfast. A study conducted at Harvard University observed that skipping breakfast can lead to a 27% greater risk for developing heart disease or heart attacks vs. those who do not skip breakfast. When a person skips breakfast, the body is in fasting state, which can cause more stress on the body to meet all its metabolic needs. According to Christian J. Gastelum, an endocrinologist at PIH Health in California, the body’s changes in hormones to help control normal blood glucose levels can lead to an increase in weight gain occurring in patients who skip breakfast, which has been associated with heart disease. So, grabbing a bite to eat in the mornings just may save your life.


The journal of American College of Cardiology published a study that examined how skipping breakfast can lead to an increase in cardiovascular disease and all-cause mortality. The National Health and Nutrition Examination Survey conducted a prospective cohort study on 6,550 adults, 40 to 75 years of age, who reported their breakfast schedules and how often they ate breakfast. The data was collected from the years 1988 to 1994. The survey was designed for participants to explain what meal they considered breakfast. Death and underlying causes of death were linked to death records through December 31, 2011. Participants included in the study had no past history of cardiovascular disease, cancer at baseline, and follow-up information related to underlying cause of mortality. Exclusions of the study included participants who were pregnant, who intake more than 500 kcal or less than 5,000 kcal in daily total energy, or who had any information missing on breakfast consumption. The Cox proportional hazards regression model was used to determine the association between breakfast consumption frequency and cardiovascular and all-cause mortality. The study measured how often breakfast was consumed and summed by the overall frequency of breakfast eating. The study had limitations on the specifics of food and drinks that were consumed. Also, the study did not survey whether the participant’s breakfast consumption schedule changed from 1994 to when the mortality data records were observed in 2011. 

Amongst the participants in the study, 5.1% never consumed breakfast, 10.9% rarely consumed breakfast, 25.0% consumed breakfast some days, and 59.0% consumed breakfast every day. Of 2,318 deaths, 619 deaths occurred due to cardiovascular disease. Following adjustments with age, sex, race/ethnicity, socioeconomic factors, dietary and lifestyle factors, body mass index, and cardiovascular risk factors, participants who never consumed breakfast vs. those who consumed daily breakfast had a hazard ratio of 1.87 (95% confidence interval: 1.14 to 3.04) for cardiovascular mortality, which indicated there were twice as many deaths that occurred compared to those who consumed breakfast daily. All-cause mortality had a hazard ratio 1.19 (95% confidence interval: 0.99 to 1.42), indicating the same interpretation of the number of deaths that occurred vs. those who consumed breakfast daily. Results in this study summed that skipping breakfast has an impact on increased cardiovascular disease and all-cause mortality.

Past studies have also shown that skipping meals is associated with impaired glucose tolerance. When breakfast is skipped, the body is trying to compensate from being in fasting state. Thus, when food is consumed the body can become resistant to insulin due to the strain placed on the body and blood glucose levels can remain high. Therefore, it is important for patients with prediabetes or diabetes to eat a full breakfast. Overall, consuming breakfast has been shown to promote cardiovascular health and a lower risk of death.

Practice Pearls:

  • Studies have shown that eating breakfast supports cardiovascular health.
  • Skipping meals has been related to the increase of obesity, cholesterol, and fats in the body, which lead to high blood pressure, type 2 diabetes, and heart disease.
  • The National Health and Nutrition Examination Survey found there was a high cardiovascular mortality and all-cause mortality risk for patients who did not consume breakfast.


Journal of the American College of Cardiology; Volume 73, Issue 16, April 2019; DOI: 10.1016/j.jacc.2019.01.065

 “Skipping Breakfast Might Come with Deadly Risk.” CNN, Cable News Network, 23 Apr. 2019, www.cnn.com/2019/04/22/health/skipping-breakfast-cardiovascular-death-study/index.html.


Amber Satz, PharmD Candidate, LECOM School of Pharmacy