• Dana E King and Jun Xiang.
• From the Department of Family Medicine, West Virginia University School of Medicine, Morgantown, WV 26505 (DEK, JX). kingdana@wvumedicine.org.
• J Am Board Fam Med. 2021 Jul 1; 34 (4): 678-687.

BackgroundRecent studies suggest that intermittent fasting or skipping breakfast may be good strategies for weight loss and better health. The objective of this study was to determine whether regular breakfast is associated with overall or cardiovascular mortality.MethodsCohort study with follow-up mortality data from the NHANES 1999-2002. National weighted sample. Outcomes were overall and cardiovascular mortality; secondary was fiber intake.ResultsOut of 5761 participants, there were 4778 (82.9%) identified as breakfast eaters and 2027 deaths (35.2%); 469 (23.1%) deaths were due to cardiovascular diseases. The average daily intake of calories was 2015, and fiber was 16.3 g/day. A total of 17.7%, 66.0%, and 11.4% of participants had diabetes, hypertension, and cardiovascular diseases, respectively. Analysis showed breakfast eaters were older, had lower body mass index, and ate more calories and fiber daily than non-breakfast eaters. Cox proportional hazard regression analyses showed that compared to non-breakfast eaters, the breakfast eaters were less likely to experience mortality after multivariable adjustments (overall mortality: hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.57-0.84 and cardiovascular mortality: HR, 0.45; 95% CI, 0.32-0.63). For the breakfast eaters, fiber intake >25 g/day was associated with 21% (HR, 0.79; 95% CI, 0.66-0.96) reduction in all-cause mortality after multivariable adjustments.ConclusionsRegular daily intake of breakfast appears to be associated with lower overall and cardiovascular mortality, particularly when consuming fiber >25 g/day. Further studies examining specific breakfast foods and the timing of foods would be helpful.© Copyright 2021 by the American Board of Family Medicine.

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