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Skipping Breakfast Associated With 87 Percent Increase in Risk of Heart Death

Skipping Breakfast Associated With 87 Percent Increase in Risk of Heart Death

A new study from the University of Iowa found strong associations between those who skipped breakfast and death from cardiovascular disease.

Don’t have time for breakfast in the morning? You may want to reconsider. A new study from the University of Iowa suggests it should become a priority. An analysis of 6,550 individuals from the National Health and Nutrition Examination Survey III found those who skipped breakfast faced an 87 percent higher risk of cardiovascular disease and heart-related death.

The participants went through an in-house interview on their breakfast frequency during this survey, where they shared whether they consumed breakfast every day, sometimes, rarely, or never. There were no parameters for what “breakfast” needed to look like calorically or nutritionally. 59 percent of participants ate breakfast every day and 5.1 percent never did.

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Out of the 6,550 individuals from the survey, there were 2,318 deaths over the 17-23 years of follow-up—619 from cardiovascular disease. Then the researchers adjusted for age, sex, race and ethnicity, socioeconomic status, diet and lifestyle behaviors, BMI, and risk factors for cardiovascular disease, such as diabetes and hypertension. What they found were strong associations between breakfast habits and a chance of dying from stroke, heart disease, or cardiovascular disease.

However, Krista Varady, associate professor of nutrition at the University of Illinois, Chicago, told CNN it’s important to digest this study knowing those who skipped breakfast also likely had the most unhealthy lifestyle habits over all. They were probably more likely to smoke, drink heavily, be physically inactive, follow an unhealthy diet, and have a lower income than the other participants.

Interested in learning more about how to protect your heart?

The bottom line: Clearly eating a healthy breakfast is part of an overall healthy lifestyle, but there is more to it than simply tossing a pop tart down your gullet every day. If you aren't eating a healthy breakfast, it's probably time to start. But it is important to opt for a heart-healthy breakfast, low in saturated fat and added sugars, as well as adopt healthy diet and lifestyle behaviors outside of breakfast time if you are concerned about your heart or overall health.

5 Reasons Why You Should Never Skip Breakfast

How many times do you need to be told that breakfast is the most important meal of the day before you start believing it? Filling yourself up first thing in the morning is beneficial in so many ways, and we've got the studies to prove it. That being said, if your stomach can't take more than a cup of joe in the a.m., there's obviously no need to choke down a bowl of oatmeal or an omelet because you feel like you have to. We're just here to tell you that if you're hungry in the morning, you shouldn't fight the urge to whip up a sunrise spread, especially if you're making any of these 15 Healthy Breakfast Ideas.

Absolutely Important

There are two main ways that you can represent a difference in risk between two events: the relative and absolute risk difference*. And while the two options may seem a bit complex, in reality they are incredibly simple to understand.

Human beings are, by and large, terrible at understanding risk. But that’s mostly because no one has ever explained it properly.

Relative risk is the ratio between one risk and another. Basically this means that you take the likelihood of one event happening and divide it by another. Absolute risk is the absolute difference between the two risks, which just means that instead of dividing one risk by another you subtract.

Let’s look at an example. There will be maths, but stay with me.

One risk that’s often in the headlines is the risk from skipping breakfast. A recent study found that people who skipped breakfast had about double the risk of dying from heart disease as people who ate breakfast every day.

The thing is, as risk go, dying from heart disease is relatively low overall. Many of us will, eventually, succumb to heart attacks, but if you look at the general population — including people aged 20 and above — the rate of heart disease deaths is fairly low.

In the study I mentioned above, the rate of heart disease deaths per year in people who always ate breakfast was 0.64%. The rate of deaths for people who never ate breakfast was 0.73%.

Let’s look at the crude relative and absolute risks here:

RELATIVE RISK = ratio of one risk to another = 0.73/0.64 = 1.14 = 14% increased risk

ABSOLUTE RISK = one risk subtracted from the other = 0.73–0.64 = 0.09 =0.09% increased risk

So we could either say that there was a 14% increased risk or a 0.09% increased risk of heart death associated with skipping breakfast.

Another way to put this is that 6 in 1,000 people who always eat breakfast die from heart disease each year, whereas 7 in 1,000 people who never eat breakfast do.

It sounds much less scary than the headlines when I put it like that.

Opioids Raise Deadly Heart Risks for Some

TUESDAY, June 14, 2016 (HealthDay News) -- While the dangers of overdose among patients prescribed powerful opioid painkillers such as Oxycontin and fentanyl are well known, a new study found unexpected heart risks with the medications.

Patients who had just been prescribed an opioid painkiller had a 64 percent higher risk of early death when compared to patients who were given an alternative pain medication. But much of that increased risk was related to the onset of breathing difficulties during sleep, followed by heart rhythm irregularities and other cardiovascular complications.

"We were not surprised by the increased risk for overdose deaths, which is well known," noted study author Wayne Ray, from the department of health policy at Vanderbilt University School of Medicine in Nashville, Tenn.

"However, the large increase in cardiovascular death risk is a novel finding," Ray said. "[And] it suggests being even more cautious with opioids for patients who are at high cardiovascular risk, such as those who have had a heart attack or have diabetes."


In the study, the team analyzed data collected between 1999 and 2012 on nearly 23,000 patients, average age 48, who had just been prescribed a long-acting opioid medication. The researchers compared that to data on an equal number of patients who had been given an alternate pain medication.

The alternate medications included anticonvulsants such as Neurontin (gabapentin), Lyrica (pregabalin) and Tegretol (carbamazepine) and low-dose antidepressants. Anticonvulsants are used to control seizures, bipolar disorder and/or nerve pain.

During an average tracking period of about four to six months, there were 185 deaths in the opioid group versus 87 deaths in the alternate medication group.

In all, the opioid group was found to face a 64 percent increased risk of death due to any reason, the team found.

But the opioid patients also faced a 65 percent increased risk of death specifically related to new heart complications, the findings showed.

The study authors concluded that alternate pain medications should be favored over long-acting opioids whenever possible, particularly for those patients who have a history of heart disease, heart attack or diabetes.


"Our opinion, which is consistent with the recent guidelines from the Centers for Disease Control and Prevention, is that opioids should be used as a last resort," said Ray. "The best way to decide if the benefits outweigh the risks is through a careful practitioner-patient discussion."

Dr. Joseph Frank is an assistant professor of medicine in the division of general internal medicine at the University of Colorado School of Medicine. He cautioned that while "we have learned a great deal about the risks of opioid medications in recent years, [we] still have a long way to go."

And, he added, "There may be patients for whom the improvement in function due to opioids outweighs the modest risk found in this study, but this balance is often challenging to assess and communicate to patients, particularly in busy primary care settings."

Frank, who is also a general internist at the VA Medical Center in Denver, agreed that non-opioid pain treatment is preferable when possible.


But since the study focused exclusively on the risks faced by first-time opioid users, he stressed the need for more research to assess the risks faced by those trying to kick a long-term opioid habit, "as this transition can be very difficult, and may actually increase risk of some adverse events for some patients."

Ray and his team published their findings June 14 in the Journal of the American Medical Association.

Eating Too Much Saturated Fat


There's been some confusion around fats and cholesterol and heart health in recent years, but the latest science is this: According to the American Heart Association, eating foods high in saturated fat raises LDL cholesterol in your blood, which increases your risk of heart attack and stroke. What foods are high in sat fat? Red meat, chicken with skin, butter and cheese.

The Rx: For good heart health, the AHA recommends that you consume only 13 grams of saturated fat per day. (For context, a 1 oz slice of Swiss cheese contains 5 grams of saturated fat. A McDonald's Quarter Pounder With Cheese contains exactly 13 grams.) Focus your diet on lean protein and as many colorful fruits and vegetables as possible.

Skipping breakfast

Skipping breakfast was shown to be common in the most recent national nutrition survey of Australian children and adolescents, although the majority did not skip breakfast consistently.

Those most likely to skip breakfast were older females, and people who:

  • are under or overweight
  • have a poor diet
  • have lower physical activity levels
  • do not get enough sleep
  • are from single-parent or lower income households.

Some common reasons for skipping breakfast include:

  • not having enough time or wanting to spend the extra time being in bed
  • trying to lose weight
  • too tired to bother
  • bored of the same breakfast foods
  • don't feel hungry in the morning
  • no breakfast foods readily available in the house
  • the cost of buying breakfast foods
  • cultural reasons.

While skipping breakfast is not recommended, good nutrition is not just about the number of meals you have each day. If you don’t have breakfast, aim to make up for the nutritional content you missed at breakfast with your lunch and dinner.

What&rsquos the harm in getting too much protein?

The main problem is that often the extra protein is coming from meats high in saturated fats, which can add to elevated cholesterol levels of the LDL &mdash or &ldquobad&rdquo &mdash cholesterol. And, Dr. Wylie-Rosett says, eating more protein is coming at the expense of other food groups that most Americans struggle to get enough of. &ldquoIf people would just eat the recommended servings of fruits and vegetables, we&rsquod be full on low-calorie foods,&rdquo she said.

If you skip meals, you'll force your body into survival mode

The process of catabolism is a major part of the larger bodily process known as metabolism. Although "metabolism" is a word you've probably heard countless times, you may be surprised to learn just how vital metabolism is for living. In fact, the term is defined as "the chemical processes that occur within a living organism in order to maintain life." When you skip meals, the ability to literally maintain life is threatened.

"Our bodies are programmed to survive at all costs," Kristin Kirkpatrick, registered dietitian and manager of wellness nutrition services at the Cleveland Clinic, told Seventeen. "It dates back to caveman days: If a caveman was in the forest and all his food ran out, his body would lower his metabolism — so he wouldn't need as many calories to stay alive."

This is a fail-safe, of course, but the body can't differentiate between you purposely skipping breakfast and you not being able to find food at all. Thus, when you "skip a meal or go a long time without eating," your body is forced into "survival mode," according to Haley Robinson, a clinical dietitian.

There are few reasons to fear oats, unless you have a specific food allergy to oats. If you are avoiding gluten due to a medical reason, oats are often the victim of cross-contamination with products that contain gluten (wheat, barley, or rye) during processing. In that event, it’s critical to consume oats that are specifically labeled gluten-free. (13) Certainly, eating overly large servings of oats can lead to weight gain, as can topping it with too many fatty or sugary treats.

You’re free to eat oats as is — sprinkle them atop yogurt for added crunch and stick-to-your-ribs carbs or toss a couple of tablespoons into a smoothie to add a dose of whole gains and pleasant chewiness.

More popular than eating them raw: cooking them into a warm breakfast cereal, often overnight. Here’s how to make the varying types of oats, organized by longest to shortest cook time. (Unless otherwise noted, each makes one serving. Always check the back of the package of oats for the proper cooking technique for that specific brand.)

Steel-Cut Oats On the stove top, boil 1 ½ cups liquid (water, milk, or nondairy milk). Stir in ¼ cup oats. Simmer for 25 to 30 minutes, stirring occasionally. In a Crock-Pot (yep, a Crock-Pot), spray the insert with cooking spray. Combine 8 cups liquid (water or half water, half milk) with 2 cups of oats. Cover and cook on low for 7 to 8 hours. This makes 8 servings of oatmeal that is relatively mushier in texture. (17)

Old-Fashioned Oats In the microwave, combine ½ cup oats to 1 cup liquid of choice. Cook on high for 2 ½ to 3 minutes. On the stovetop, boil liquid of choice, stir in oats and cook for 5 minutes over medium heat. Stir occasionally (to prevent it from bubbling over). (18)

Quick, or One-Minute Oats Boil 1 cup liquid. Add ½ cup oats. Cook for 1 minute over medium heat. In a microwave, combine the liquid and oats and microwave on high for 1 ½ to 2 minutes. (19)

Instant Oats These are usually going to come in a packet, and may be convenient if you’re on the go. In a bowl, combine the packet and about ½ cup hot milk or boiling water. Stir and let stand for two minutes. If you have a microwave handy, you can add ¾ cup of liquid to the packet then microwave on high for 60 to 75 seconds. Let stand to reach desired thickness. (20)

Underlying causes of low blood pressure

Low blood pressure can occur with:

  • Prolonged bed rest
  • Pregnancy: During the first 24 weeks of pregnancy, it&rsquos common for blood pressure to drop.
  • Decreases in blood volume: A decrease in blood volume can also cause blood pressure to drop. A significant loss of blood from major trauma, dehydration or severe internal bleeding reduces blood volume, leading to a severe drop in blood pressure.
  • Certain medications: A number of drugs can cause low blood pressure, including diuretics and other drugs that treat hypertension heart medications such as beta blockers drugs for Parkinson&rsquos disease tricyclic antidepressants erectile dysfunction drugs, particularly in combination with nitroglycerine narcotics and alcohol. Other prescription and over-the-counter drugs may cause low blood pressure when taken in combination with high blood pressure medications.
  • Heart problems: Among the heart conditions that can lead to low blood pressure are an abnormally low heart rate (bradycardia), problems with heart valves, heart attack and heart failure. Your heart may not be able to circulate enough blood to meet your body&rsquos needs.
  • Endocrine problems: Such problems include complications with hormone-producing glands in the body&rsquos endocrine systems specifically, an underactive thyroid (hypothyroidism), parathyroid disease, adrenal insufficiency (Addison&rsquos disease), low blood sugar and, in some cases, diabetes.
  • Severe infection (septic shock): Septic shock can occur when bacteria leave the original site of an infection (most often in the lungs, abdomen or urinary tract) and enter the bloodstream. The bacteria then produce toxins that affect blood vessels, leading to a profound and life-threatening decline in blood pressure.
  • Allergic reaction (anaphylaxis): Anaphylactic shock is a sometimes-fatal allergic reaction that can occur in people who are highly sensitive to drugs such as penicillin, to certain foods such as peanuts or to bee or wasp stings. This type of shock is characterized by breathing problems, hives, itching, a swollen throat and a sudden, dramatic fall in blood pressure.
  • Neurally mediated hypotension: Unlike orthostatic hypotension, this disorder causes blood pressure to drop after standing for long periods, leading to symptoms such as dizziness, nausea and fainting. This condition primarily affects young people and occurs because of a miscommunication between the heart and the brain.
  • Nutritional deficiencies: A lack of the essential vitamins B-12 and folic acid can cause anemia, which in turn can lead to low blood pressure.