BACKGROUND Skipping breakfast is common among U.S. adults. Limited evidence suggests that skipping breakfast is associated with atherosclerosis and cardiovascular disease. OBJECTIVES The authors sought to examine the association of skipping breakfast with cardiovascular and all-cause mortality. METHODS This is a prospective cohort study of a nationally representative sample of 6,550 adults 40 to 75 years of age who participated in the National Health and Nutrition Examination Survey III 1988 to 1994. Frequency of breakfast eating was reported during an in-house interview. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2011. The associations between breakfast consumption frequency and cardiovascular and all-cause mortality were investigated by using weighted Cox proportional hazards regression models. RESULTS Among the 6,550 participants (mean age 53.2 years; 48.0% male) in this study, 5.1% never consumed breakfast, 10.9% rarely consumed breakfast, 25.0% consumed breakfast some days, and 59.0% consumed breakfast every day. During 112,148 person-years of follow-up, 2,318 deaths occurred including 619 deaths from cardiovascular disease. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, body mass index, and cardiovascular risk factors, participants who never consumed breakfast compared with those consuming breakfast everyday had hazard ratios of 1.87 (95% confidence interval: 1.14 to 3.04) for cardiovascular mortality and 1.19 (95% confidence interval: 0.99 to 1.42) for all-cause mortality. CONCLUSIONS In a nationally representative cohort with 17 to 23 years of follow-up, skipping breakfast was associated with a significantly increased risk of mortality from cardiovascular disease. Our study supports the benefits of eating breakfast in promoting cardiovascular health.

中文翻译：

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不吃早餐与心血管和全因死亡率的关联

背景不吃早餐在美国成年人中很常见。有限的证据表明，不吃早餐与动脉粥样硬化和心血管疾病有关。目的 作者试图检验不吃早餐与心血管和全因死亡率之间的关联。方法 这是一项前瞻性队列研究，对 6,550 名 40 至 75 岁的成年人参加了 1988 年至 1994 年的国家健康和营养检查调查 III 的全国代表性样本。在内部采访中报告了早餐吃的频率。通过与截至 2011 年 12 月 31 日的死亡记录相关联来确定死亡和潜在死亡原因。通过使用加权 Cox 比例风险回归模型研究早餐消费频率与心血管和全因死亡率之间的关联。结果 在本研究的 6,550 名参与者（平均年龄 53.2 岁；48.0% 男性）中，5.1% 从不吃早餐，10.9% 很少吃早餐，25.0% 有时吃早餐，59.0% 每天吃早餐。在 112,148 人年的随访中，发生了 2,318 人死亡，其中 619 人死于心血管疾病。在调整年龄、性别、种族/民族、社会经济地位、饮食和生活方式因素、体重指数和心血管危险因素后，与每天吃早餐的参与者相比，从不吃早餐的参与者的风险比为 1.87（95% 置信区间： 1.14 到 3。04）心血管死亡率和 1.19（95% 置信区间：0.99 至 1.42）全因死亡率。结论 在一项具有 17 至 23 年随访的全国代表性队列中，不吃早餐与心血管疾病死亡风险显着增加相关。我们的研究支持吃早餐对促进心血管健康的好处。