Share on PinterestA good breakfast could help keep the cardiovascular system healthy, recent research shows. Image credit: Mami Kumagai/Stocksy.
- For a healthy heart, the best breakfast is one that provides 20% to 30% of the energy you will need for the day, says a new study.
- Eating either less or more may increase certain cardiometabolic risk factors in older adults.
- Food quality also counts, with lower quality causing a potential increase in several measurements of cardiometabolic risk.
A recent study, published in the Journal of Nutrition, Health and Aging, demonstrates that a good breakfast may reduce risk factors for cardiovascular disease in older adults.
The study is unique in that it investigates both the caloric content of one’s breakfast and the quality of the foods consumed and their effect on heart health.
The study was conducted at the Hospital del Mar Research Institute in Spain using data from the PREDIMED-PLUS trial. The original trial investigated the relative benefits of a Mediterranean diet with and without significant physical activity.
There were 383 individuals included in the study. Women were between 60 and 75 years old, and the men were aged 55 to 75.
They all had overweight or obesity, with a body mass index (BMI) of between 27 and 40 kilograms per square meter (kg/m2). They also had at least three markers of metabolic syndrome. The study followed up on participants’ progress for 36 months.
Researchers determined that an optimal breakfast might provide 20% to 30% of participants’ daily energy needs (calories). This closely aligns with current recommendations ranging from 20% to 25%.
They tracked measurements associated with cardiovascular health for individuals who ate either less than that amount or more than that amount.
At the end of the study, people who consumed less than 20% or more than 30% of their daily calories at breakfast had a greater increase in BMI and waist circumference than those getting the recommended amount.
They also had significantly higher levels of triglycerides and lower levels of HDL, or “good” cholesterol, than the those consuming 20–30% of their energy at the start of the day.
For their assessment of breakfast food quality, the researchers used the Meal Balance Index, which estimates meal quality based on its content of nine nutrients. These include protein, total fat, fiber, potassium, calcium, iron, sodium, added sugars, and saturated fat.
Participants’ weighted averages of breakfast quality were scored as “median,” “low,” or “high” based on a 0 to 100 scale.
After 36 months, for those eating a low-quality breakfast, the researchers observed a greater increase in waistline circumference, higher triglycerides, lower HDL cholesterol, and a decline in their estimated glomerular filtration rate compared to those eating a median- or high-quality breakfast.
Triglycerides are fats in the blood that can contribute to heart attack and stroke risk. The glomerular filtration rate is a measurement of kidney function.
Losing weight for heart health? Don’t skip breakfast
Eliminating a meal’s worth of calories each day might intuitively seem like it would lead to a healthier body. However, this study suggests that not consuming enough of the energy you will need to get through the day may result in a higher risk of cardiovascular issues.
“Consuming too little for breakfast may increase the risk of adiposity and BMI by leading to overeating later in the day, poor appetite regulation, and reduced thermogenesis,” said Michelle Routhenstein, MS, RD, CDCES, CDN, of Entirely Nourished, a registered dietitian who specializes in heart disease, who was not involved in this study.
Cardiologist Jayne Morgan, MD, vice president of medical affairs at Hello Heart, also not involved in this study, noted that breakfast is particularly important for people with diabetes, “where regular intake of calories can improve insulin sensitivity and maintain less fluctuation in blood glucose levels throughout the day.”
“This is especially important for those with type 2 diabetes, where weight and cardiometabolic conditions are often confounding factors, with all being risks for heart disease,” Morgan told Medical News Today.
She also noted that forgoing breakfast has been linked to higher blood pressure.
Are the findings surprising?
The authors of the study state that they consider it a novel finding that people who consumed more than 30% of their daily energy needs at breakfast developed increases in waistline circumference, higher triglycerides, and lower HDL cholesterol.
Morgan explained why some might consider this surprising:
“What they are referencing is that if there is a high-energy intake earlier in the day, then there is a longer period of time to burn that energy. Further, it also implies that fewer calories are consumed later in the day, when people are generally less active and have fewer hours to burn calories before bedtime.”
However, as Routhenstein noted speaking to MNT, “eating too much can contribute to adiposity due to an increased metabolic load, disruption in hunger cues, and promotion of fat storage rather than utilizing it for necessary metabolic functions.”
What makes a healthy breakfast?
There is a broad consensus that a Mediterranean diet represents a healthy way to eat throughout one’s day.
Routhenstein offered some general heart-healthy guidance, advising that “a quality breakfast should include lean proteins [such as] yogurt, eggs, tofu, fish, or beans, fiber [from] vegetables, fruits, or whole grains, and healthy fats [from, for example] avocado, nuts, or seeds.”
“This combination helps reduce atherogenic LDL cholesterol [‘bad’ cholesterol that contributes to the clogging of arteries], stabilize blood sugar, and lower inflammation — key factors in cardiovascular health,” she explained.
To round out the meal, she added:
“Some great options to complement an energy-balanced breakfast include citrus — rich in hesperidin, a potent antioxidant that supports heart health — leafy greens that help regulate blood pressure and improve blood vessel function, chia or flaxseeds packed with plant-based omega-3s for reducing inflammation, oats that help lower cholesterol, and green tea, known for its anti-inflammatory properties.”
Why do healthy breakfasts lead to weight loss in the short term?
One aspect that Morgan found “interesting” was “that it is noted in the study design that both groups experienced weight loss in the first 12 months,” as the effect had disappeared by the end of the study.
She hypothesized that “this is likely due to the Hawthorne Effect, where the knowledge of observation changes/alters behaviors subconsciously, especially since participants had full discretion over their selections of breakfast items within the advice proscribed.”
She also raised the issue of the many confounding factors involved in a study such as this, which the authors themselves cited as being difficult to account for, particularly with a study based on self-reporting such as this one.
These include levels of participant exercise, smoking, coffee intake, access to healthcare, quality of food during the remainder of the day, and so on.
As a matter of habit, Routhenstein advised, “when planning your breakfast, view it as the foundation for proper nourishment — an opportunity to fuel your day while supporting long-term cardiovascular and metabolic health.”
“The quality and choice of foods is extremely important,” Morgan also affirmed. “Choosing unprocessed foods, and selecting fruits and grains are critical factors. Portion size and discretion also play a role, as well as keeping active and mirroring those same eating habits throughout the day.”
