HealthDay News — Men middle aged or older who skip breakfast and eat late at night may be at higher risk for developing coronary heart disease, study results suggest.

Among a cohort of male health professionals, those that said they regularly skipped breakfast were 27% more likely to die during a 16-year follow-up period than those who ate breakfast, Leah E. Cahill, PhD, from Harvard School of Public Health in Boston, and colleagues reported in Circulation.

Those who said they ate late at night were also 55% more likely to die. However, both results were just short of achieving statistical significance after the researchers adjusted for BMI, hypertension, hypercolesterolemia and diabetes, “suggesting eating habits may affect risk of coronary heart disease through pathways associated with these traditional risk factors.”

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They called for additional studies to validate the findings.

“If replicated in women and other ethno-cultural groups, the findings from the present study provide evidence to support a recommendation of daily breakfast eating by clinicians and health authorities to prevent coronary heart disease and to improve health at both the individual and population levels,” the researchers wrote.

Cahill and colleagues assessed eating habits in 26,902 American male health professionals aged 45 to 82 years old who participated in the Health Professionals Follow-Up Study (HPFS) and were free of cardiovascular disease and cancer at baseline.

At the start of the study in 1992, 13% said they did not eat breakfast and 0.2% said they ate late at night. Through follow-up, a total of 1,527 incident cases of coronary heart disease, defined as nonfatal MI or fatal coronary heart disease were documented.

Both skipping breakfast (relative risk 1.27, 95% CI: 1.06–1.53) and eating late at night (RR 1.55, 95% CI:1.05-2.29) were associated with a significantly higher risk of coronary heart disease. But the relationship became nonsignificant after adjusting for potential mediating factors — RR 1.18 (95% CI 0.98-1.43) for skipping breakfast and RR 1.41 (95% CI 0.95-2.08) for late-night eating.

The researchers pointed out that the study was underpowered to conducted a detailed analysis of the effect of late-night eating.

“The late-night eaters in our study represented only a small percentage of the HPFS population, and too few other population studies have reported the frequency of late-night eating for an accurate assessment of whether late-night eating is a common habit,” they wrote. “Therefore, it remains unknown whether the association that we observed between late-night eating and risk of coronary heart disease is relevant as a public health concern.”

There was no association found between eating frequency and coronary heart disease.

Study limitations included lack of data on circadian rhythm and exposure to light and dark, low rates of participants who worked night shifts, the availability of data on regular eating habits only and a nearly all-white cohort.

“Future studies to confirm our findings are necessary, as are studies of other cardiovascular outcomes such as hypertension and stroke that may have modestly different etiologic pathways,” the researchers wrote.


  1. Cahill L et al. Circulation. 2013; doi: 10.1161/CIRCULATIONAHA.113.001474.