IOWA CITY, Iowa — A study published in the April issue of the Journal of America College of Cardiology found people who never ate breakfast had an 87 percent higher risk of death caused by cardiovascular disease than people who ate breakfast every day.

Skipping breakfast was associated with elevated blood pressure and changes in appetite, such as people not feeling full and overeating later in the day, said Wei Bao, M.D., Ph.D., assistant professor of epidemiology in the Univ. of Iowa’s College of Public Health and leader of the study. Skipping breakfast also was linked to harmful changes in lipid levels, including higher levels of total cholesterol and low-density lipoprotein (LDL) cholesterol, which is known as “bad cholesterol.” Dr. Bao said skipping breakfast was a behavioral marker for unhealthy lifestyle habits, including being overweight, heavy drinking, smoking, being physically inactive and poor diet.

The researchers used data from 6,550 Americans age 40 to 75 gathered between 1988 and 1994 in the National Health and Nutrition Examination Survey. Among them, 5.1 percent said they never ate breakfast, 10.9 percent said they rarely ate breakfast, 25 percent said they ate breakfast some days and 59 percent said they ate breakfast every day.

Deaths and underlying causes of death then were ascertained through death records through Dec. 31, 2011. A total of 2,318 deaths occurred, including 619 deaths from cardiovascular disease. After adjusting for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, body mass index, and cardiovascular risk factors, people who said they never ate breakfast had hazard ratios of 1.87 for cardiovascular mortality and 1.19 for all-cause mortality when compared to people who said they ate breakfast every day.

Using people who ate breakfast every day as a reference, the hazard ratio for people who died from stroke was 3.39 (1.40 to 8.24) for people who never ate breakfast, 0.66 (0.26 to 1.66) for people who rarely ate breakfast and 1.11 (0.53 to 2.32) for people who ate breakfast some days. The hazard ratio for people who died from heart disease was 1.59 (0.90 to 2.80) for people who never ate breakfast, 1.22 (0.72 to 2.08) for people who rarely ate breakfast and 0.90 (0.61 to 1.34) for people who ate breakfast some days.