No breakfast and late dinner may precipitate another heart attack after first one: ESC

Late dinner and no breakfast is a fatal combination which increases the likelihood of another heart attack after the first one within a month of discharge from hospital. The study has been published in the European Journal of Preventive Cardiology

Many old sayings including Eat your breakfast like a king, lunch like a prince and dinner like pauper have emphasized the breakfast being the most important meal of the day. And also the importance of following a correct eating pattern for overall health. Adding to the importance of breakfast further, a new study has demonstrated that skipping breakfast and eating dinner near your bedtime may worsen post-heart attack outcomes.

The study emphasizes the importance of correct eating habits and eating patterns for overall health and well being.

The study has found that people following the eating pattern as described above increases the likelihood of another heart attack, death or chest pain within 30 days following hospital discharge for heart attack.

Previous studies have found that people who miss breakfast and have a late dinner are more likely to have other unhealthy habits such as smoking and low levels of physical activity. The study conducted by Marcos Minicucci, of São Paolo State University, Brazil, and colleagues shows that the two eating behaviours are independently linked with poorer outcomes after a heart attack, but having a cluster of bad habits will only make things worse.

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This was the first study to evaluate these unhealthy behaviors in patients with acute coronary syndromes. Skipping breakfast was observed in 58%, late-night dinner eating at 51%, and both behaviors in 41%.

The study enrolled patients with a particularly serious form of heart attack called ST-segment elevation myocardial infarction (STEMI). "One in ten patients with STEMI dies within a year, and nutrition is a relatively inexpensive and easy way to improve prognosis," said Dr. Minicucci.

He recommended a minimum of two hour interval between dinner and bedtime. "It is said that the best way to live is to breakfast like a king," he added. "A good breakfast is usually composed of dairy products (fat-free or low-fat milk, yogurt, and cheese), a carbohydrate (whole wheat bread, bagels, cereals), and whole fruits. It should have 15 to 35% of our total daily calorie intake."

The study included 113 patients with a mean age of 60, and 73% were men. Patients were asked about eating behaviors on admission to a coronary intensive care unit. Skipping breakfast was defined as nothing before lunch, excluding beverages, such as coffee and water, at least three times per week. Late-night dinner eating was defined as a meal within two hours before bedtime at least three times per week.

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Dr. Minicucci noted that late-night dinner eating was defined by the two-hour interval between dinner and bedtime, rather than eating late at night. But nearly all participants with this habit were late-eaters.

Previous studies have found that people who miss breakfast and have a late dinner are more likely to have other unhealthy habits such as smoking and low levels of physical activity. "Our research shows that the two eating behaviors are independently linked with poorer outcomes after a heart attack, but having a cluster of bad habits will only make things worse," said Dr. Minicucci. "People who work late may be particularly susceptible to having a late supper and then not being hungry in the morning."

"We also think that the inflammatory response, oxidative stress, and endothelial function could be involved in the association between unhealthy eating behaviors and cardiovascular outcomes," he added.

In this study, statin use before hospital admission was higher in the group with unhealthy eating habits and worse outcome. Dr. Minicucci said: "There are some controversies regarding eating habits of patients using statins. Our study suggests that patients with STEMI perceive statins as an alternative path to health benefits. But these drugs should be an addition to healthy eating habits, not a replacement."

For detailed study log on to http://dx.doi.org/10.1177/2047487319839546.