Think breakfast isn’t the most important meal of the day?

Think again, say researchers behind a new study that found the risk of heart-related death rises dramatically for folks who skip the morning repast.

Compared to people who always ate breakfast, those who say they never did had a 87% higher odds of dying from heart-related causes, according to a study that tracked the health of 6,550 Americans for about 20 years.

The odds for stroke, in particular, were especially elevated if people said they always skipped breakfast. These individuals had more than three times the odds of fatal stroke, compared to people who said they always ate in the a.m.

Why is skipping breakfast such a toxic habit? Researchers led by Dr. Wei Bao of the University of Iowa said there could be many reasons.

Most notably, skipping breakfast is tied to a boost in appetite later in the day, which “might lead to overeating later,” the research team said. Chronic overeating could bring on obesity.

Insulin sensitivity — a hormonal factor that’s linked to obesity and diabetes — is also impaired when the morning “fast” lasts too long, Bao and his colleagues said. Holding back on breakfast might also affect other hormonal processes that could help raise blood pressure, they said.

Finally, waiting too late in the day to begin eating has also been linked to a worsening of cholesterol, the research team said.

One heart expert agreed it’s healthier to eat something soon after rising.

“It has been well-documented that eating a complete breakfast leads to better cardiovascular health,” said Dr. Mohammad Imam, who wasn’t involved in the new study. He directs cardiothoracic surgery at Staten Island University Hospital in New York City.

More Americans than ever are opting out of a morning meal, Bao and his team noted.

“There has been an increasing prevalence of skipping breakfast over the past 50 years in the United States, with as many as 23.8% of young people skipping breakfast every day,” they said.

How might that affect long-term heart health?

To find out, Bao and colleagues tracked the death rates of 6,550 Americans ages 40 to 75, starting in 1988 and ending by 2011. They found that about 16% said they ate breakfast either “never” or “rarely.”

After adjusting for race, age and gender, always skipping breakfast raised the odds for death from any cause by 19%, the study found, and by 87% for deaths tied to heart events such as heart attack or stroke.

The findings were published April 22 in the Journal of the American College of Cardiology.

Of course, the study couldn’t prove cause and effect. But another cardiologist who reviewed the results said the findings make sense, especially when it comes to the risk for obesity.

“Many people try to skip meals throughout the day to lose weight, but often this backfires and leads to overeating/binge eating at the end of the day,” explained Dr. Sunny Intwala. He directs sports cardiology at Lenox Hill Hospital in New York City.

Intwala stressed that what folks eat for breakfast is key as well.

If breakfast means “pastries and breakfast cereals with up to 20 grams of sugar per serving, it is hard to see how eating these types of foods will lead to decreased health risks in the long run,” Intwala said.

Instead, “I recommend skipping these items and choosing a nutritious breakfast with whole-grain cereals, fruits, nuts and high-quality protein,” he said.

“Getting off to a good start at the beginning of the day can lead to better decision-making [on nutrition] throughout the day,” Intwala added.

More information

The U.S. Office of Disease Prevention and Health Promotion has more on heart-healthy foods.

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