Late dinner and no breakfast is a killer combination


Sophia Antipolis, April 18, 2019: People who skip breakfast and have dinner near bedtime have worse results after a heart attack. This is the conclusion of the research published today in European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC) .1

The study found that people with both eating habits were four to five times more likely to die, another heart attack or angina (chest pain) within 30 days after discharge from a heart attack.

This was the first study to evaluate these unhealthy behaviors in patients with acute coronary syndromes. Breakfast was ignored by 58%, the evening dinner by 51% and the two by 41%.

The study involved patients with a particularly severe form of heart attack called ST-segment elevation myocardial infarction (STEMI). "One in 10 STEMI patients die within a year, and nutrition is a relatively inexpensive and easy way to improve prognosis," said study author Dr. Marcos Minicucci of the State University of Sao Paulo, Brazil.

He recommended a minimum of two hours between dinner and bedtime. "They say the best way to live is to have breakfast like a king," he added. "A good breakfast is usually composed of dairy products (no fat or low fat, yogurt and cheese), carbohydrates (whole wheat bread, bagels, cereals) and whole fruits. It should have between 15 and 35% of the total intake daily calorie ".

The study included 113 patients with a mean age of 60 years and 73% were men. Patients were questioned about dietary behaviors on admission to a coronary intensive care unit. The breakfast was skipped like nothing before lunch, excluding drinks such as coffee and water, at least three times a week. The dawn dinner was defined as a meal within two hours before bedtime, at least three times a week.

Dr. Minicucci noted that the late-night dinner was defined by the two-hour interval between dinner and bedtime, rather than eating late at night. But almost all participants in 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 both eating behaviors are independently tied to the most unfavorable outcomes after a heart attack, but having a bunch of bad habits will only make things worse," said Dr. Minicucci. "People who work late can be particularly susceptible to having a late dinner and then not feeling hungry in the morning."

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

In this study, the use of statins before hospital admission was higher in the group with unhealthy eating habits and worse outcome. Dr. Minicucci said: "There are some controversies about the eating habits of patients who use statins." Our study suggests that STEMI patients perceive statins as an alternative pathway to health benefits, but such drugs must be an addition to healthy eating habits , not a substitute. "


Authors: ESC Press Office

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Funding: The study was funded by the Foundation for Research Support of the State of São Paulo (FAPESP-2017 / 23523-0).

Disclosures: None.



1Musse GNV, Moreira T, Kimura MA, et al. Ignoring the breakfast concomitant with late-night dinner is associated with worse outcomes after myocardial infarction with ST segment elevation. Eur J Prev Cardiol. 2019. doi: 10.1177 / 2047487319839546.

About the European Society of Cardiology

The European Society of Cardiology brings together health professionals from more than 150 countries, working to promote cardiovascular medicine and help people lead a longer and healthier life.

Regarding the European Journal of Preventive Cardiology

O European Journal of Preventive Cardiology is the leading preventive cardiology journal in the world, playing a key role in reducing the global burden of cardiovascular disease.

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