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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Association of breakfast skipping with cardiovascular outcomes and cardiometabolic risk factors: an updated review of clinical evidence

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  • Heitor O Santos
  • Rafael Genario
  • Rodrigo C O Macedo
  • Manan Pareek
  • Grant M Tinsley
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"Eat breakfast like a king, lunch like a prince and dinner like a pauper" (Adelle Davis, 1904-1974) is a concept that appears to align with some contemporary evidence concerning the appropriate proportioning of daily meals. At the same time, with the popular and scientific dissemination of the concepts of intermittent fasting and time-restricted feeding, well-controlled clinical trials have emerged showing the safety or even possible benefits of skipping breakfast. In this comprehensive literature review, we discuss recent evidence regarding breakfast intake, cardiovascular outcomes and cardiovascular risk markers. Overall, breakfast omission appears to be associated with a higher risk for atherosclerotic and adverse cardiovascular outcomes. However, caution should be employed when deciphering these data as many complex, unmeasured confounders may have contributed. Unfortunately, long-term randomized, clinical trials with detailed dietary control that have assessed clinical outcomes are sparse. Notwithstanding the observational findings, current trials conducted so far-albeit apparently smaller number-have shown that breakfast addition in subjects who do not habitually consume this meal may increase body weight, particularly fat mass, through caloric excess, whereas skipping breakfast may be a feasible strategy for some people aiming for calorie restriction. To date, definitive benefits of breakfast omission or consumption are not supported by the best evidence-based research, and the question of whether skipping breakfast per se is causally associated with cardiovascular outcomes remains unresolved.

Original languageEnglish
JournalCritical reviews in food science and nutrition
Pages (from-to)1-9
Number of pages9
Publication statusE-pub ahead of print - 16 Sep 2020

Bibliographical note

Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.

Copyright 2020 Elsevier B.V., All rights reserved.

    Research areas

  • Cardiovascular disease, clinical nutrition, intermittent fasting, skipping breakfast, time-restricted feeding

ID: 61014333