Breakfast Skipping Increases the Risk of Coronary Heart Disease and Myocardial Infarction: Evidence From the Mendelian Randomization Study
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Published on: July 29, 2020
Si Cao1, Youjie Zeng1, Gong Chen1
1Department of Anesthesiology Third Xiangya Hospital, Central South University Changsha Hunan China.
Insights
Skipping breakfast significantly increases the risk of coronary heart disease (CHD) and myocardial infarction (MI). Prioritizing a healthy breakfast is crucial for preventing these cardiovascular conditions.
Area of Science:
- Cardiovascular Epidemiology
- Genetic Epidemiology
- Nutritional Science
Background:
- Observational studies suggest a link between skipping breakfast and increased risk of coronary heart disease (CHD) and myocardial infarction (MI).
- The causal relationship is uncertain due to potential confounding factors and reverse causation.
- Mendelian randomization (MR) offers a method to investigate causality using genetic variants.
Purpose of the Study:
- To comprehensively assess the causal effect of skipping breakfast on the risk of CHD and MI.
- To utilize a two-sample Mendelian randomization (MR) analysis for robust causal inference.
- To provide evidence for breakfast consumption as a primary prevention strategy for cardiovascular diseases.
Main Methods:
- Two-sample Mendelian randomization (MR) analysis using genome-wide summary statistics for breakfast skipping, CHD, and MI.
- Instrumental variables (IVs) for breakfast skipping were selected based on strict (p < 5e-8) and lenient (p < 1e-5) thresholds.
- Inverse variance weighted (IVW) method was the primary analysis, supplemented by MR-Egger, weighted median, and maximum likelihood methods. Meta-analysis integrated results from CARDIoGRAMplusC4D and FinnGen cohorts.
Main Results:
- Quality control tests indicated no significant heterogeneity or horizontal pleiotropy among the selected IVs.
- Meta-analysis using the IVW method revealed that skipping breakfast significantly increases the risk of CHD (OR = 1.358, p = 3.95E-02) and MI (OR = 1.449, p = 4.17E-02) under strict IV screening.
- Similar detrimental effects were observed under lenient IV screening thresholds for both CHD (OR = 1.198, p = 5.55E-03) and MI (OR = 1.378, p = 4.08E-05). Supplementary MR methods corroborated these findings.
Conclusions:
- This MR study provides strong evidence that skipping breakfast is causally associated with an increased risk of CHD and MI.
- The findings highlight the detrimental impact of breakfast skipping on cardiovascular health.
- Maintaining regular, high-quality breakfast intake should be recommended as a key primary prevention strategy for CHD and MI.
Abstract:
Observational studies have suggested a potential association between breakfast skipping and the risk of coronary heart disease (CHD) and myocardial infarction (MI). Nevertheless, due to potential confounders and reverse causation, the causal relationship remains unclear. This study aims to comprehensively assess the causal effect of breakfast skipping on CHD and MI through a two-sample Mendelian randomization (MR) analysis. Genome-wide summary statistics of breakfast skipping, CHD, and MI were obtained from public databases. Instrument variables (IVs) proxying for breakfast skipping were screened based on strict (p < 5e-8) and lenient (p < 1e-5) thresholds. Quality control of IVs was performed using Cochran's Q test, MR-Egger intercept test, and MR PRESSO global test. Inverse variance weighted (IVW) served as the primary MR method for assessing causal associations, while MR-Egger, weighted median, and maximum likelihood were used as supplementary methods. The effect of breakfast skipping on CHD and MI in both CARDIoGRAMplusC4D and FinnGen cohorts was assessed, and the results were integrated using meta-analysis. Quality control tests showed no heterogeneity or horizontal pleiotropy in IVs. After conducting a meta-analysis of the MR results from the IVW method under strict IV screening thresholds, breakfast skipping significantly increases the risk of CHD [odds ratio (OR) = 1.358, p = 3.95E-02] and MI (OR = 1.449, p = 4.17E-02). Similarly, meta-analysis of the IVW results under lenient IV screening thresholds also demonstrated the detrimental effects of breakfast skipping on CHD (OR = 1.198, p = 5.55E-03) and MI (OR = 1.378, p = 4.08E-05). Three other MR methods showed parallel results to IVW (OR > 1). Overall, the present study demonstrates that breakfast skipping significantly increases the risk of CHD and MI. Therefore, maintaining a high-quality breakfast intake can be considered an essential primary prevention measure for CHD and MI.
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