Having a quality breakfast that provides the right amount of energy to face the day, around a quarter of daily intake, reduces the risk of cardiovascular disease. This is highlighted by a study conducted by the Hospital del Mar Research Institute and published in the Journal of Nutrition, Health and Aging. The study followed the progress of 383 participants in the PREDIMED-Plus project, a randomized clinical trial comparing the effects of a Mediterranean diet combined with physical activity versus dietary recommendations alone on cardiovascular disease. No previous study had analyzed the impact of energy intake and the nutritional quality of breakfast on these risk factors.
This new work considered two factors. First, the energy intake from breakfast relative to the total daily intake, distinguishing between an adequate calorie intake (20–30% of the daily total) and other levels. Second, the researchers analyzed the effects of consuming a high-quality breakfast with a proper balance of proteins, fats, fiber, and other nutrients. They found that consuming an adequate amount of energy in the morning and doing so with high-quality food contributed to reducing cardiovascular risk factors.
A good breakfast reduces obesity
The study followed participants for three years. All were aged between 55 and 75 and had overweight or obesity. Various cardiovascular risk factors were evaluated, including weight, waist circumference an indicator of abdominal obesity, lipid profile cholesterol and triglyceride levels, blood pressure, and diabetes markers.
The results indicate that participants who consumed 20–30% of daily energy intake in the morning had better outcomes for several risk factors. Their body weight evolved more favorably compared to participants who consumed more or less energy at breakfast. By the end of the study, these participants had a 2–3.5% lower body mass index and a 2–4% smaller waist circumference. Adequate energy intake at breakfast was also linked to significantly lower triglyceride levels (9–18% reduction) and higher HDL cholesterol levels (4–8.5% increase). Other markers showed less significant changes.
In terms of breakfast quality, the results were also positive. Participants who had a high-quality breakfast had 1.5% smaller waist circumference, 4% lower triglycerides, and 3% higher HDL cholesterol. A high-quality breakfast includes the right amounts of protein, high-value fats, fiber, and minerals such as potassium and iron, while avoiding excessive added sugars and saturated fats.
According to Álvaro Hernáez, researcher at the Hospital del Mar Research Institute, CIBER for Cardiovascular Diseases (CIBERCV), and professor at the Blanquerna Faculty of Health Sciences at Ramon Llull University, "Breakfast is the most important meal of the day, but what and how you eat it matters. Eating controlled amounts-;not too much or too little-;and ensuring good nutritional composition is crucial. Our data show that quality is associated with better cardiovascular risk factor outcomes. It's as important to have breakfast as it is to have a quality one."
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Dr. Montse Fitó, coordinator of the Cardiovascular Risk and Nutrition Research Group at the Hospital del Mar Research Institute and CIBER for Obesity and Nutrition (CIBEROBN), emphasizes that both energy adequacy and quality are key to preventing cardiovascular risk. "We have confirmed that dietary recommendations about food quality have been effective in improving risk factor evolution over time in adults at high cardiovascular risk," she says.
The study's results were adjusted to ensure they are attributable to breakfast energy intake and food quality rather than other factors. This leads Karla-Alejandra Pérez-Vega, a researcher at Hospital del Mar and CIBEROBN, to conclude, "Promoting healthy breakfast habits can contribute to healthy aging by reducing the risk of metabolic syndrome and associated chronic diseases, thereby improving quality of life."
The study also involved researchers from the CIBER for Epidemiology and Public Health (CIBERESP) and received funding from the Carlos III Health Institute, the European Union, the European Research Council, the Government of Catalonia, and the Blanquerna Faculty of Health Sciences.
IMIM (Hospital del Mar Medical Research Institute)
Journal reference:
Pérez-Vega, K.-A., et al. (2024). Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older adults. The Journal of Nutrition, Health and Aging. doi.org/10.1016/j.jnha.2024.100406.