Abstract 017: A Prospective Study of Eating Habits and Incident Coronary Heart Disease in a Cohort of Male U.S. Health Professionals

Introduction: The 2010 Dietary Guidelines for Americans concludes that there is currently not enough evidence to support a specific recommendation for behaviors such as snacking and frequency of eating, but does recommend eating breakfast daily to prevent obesity, especially for children and adolescents. Among adults, skipping meals has been shown to be positively associated with excess weight, dyslipidemia, hyperglycemia, and total mortality. However, the influence of eating frequency on risk of coronary heart disease (CHD) remains unclear. Objective and Hypothesis: The objective of this study was to test the hypothesis that abnormal eating habits are related to an increased risk of fatal CHD and non-fatal myocardial infarction. Methods: Eating frequency (meals and/or snacks per day), breakfast consumption (yes or no) and eating after going to bed at night (yes or no) were assessed in 1992 in 35,221 men from the prospective Health Professionals Follow-up Study. Between 1992 and 2008, 2761 incident CHD cases were diagnosed. Multivariate Cox proportional hazards regression models were used to estimate relative risks (RR) and 95% confidence intervals (CI) for these eating habits. Results: Men who ate <3 times/day, compared to the men who ate 3 times/day, had a 22% higher risk of CHD ( table ). Men who skipped breakfast had a significant 18% higher risk of CHD compared to men who ate breakfast. Those who reported eating after going to bed had a 34% higher risk of CHD compared to the men who did not. Conclusions: Even when controlling for known CHD risk factors including diet quality, general infrequent eating was associated with increased CHD risk, as were skipping breakfast and eating after bedtime. Table Multivariate * RR and 95% CI of CHD by categories of eating habit Cases (n) Person Years Age-RR (95% CI) MV-RR (95% CI) p (trend) Eating Frequency < 3 times/day 503 85,920 1.26 (1.14-1.40) 1.22 (1.08-1.37) 0.01 3 times/day 1222 217,400 1.00 (Ref) 1.00 (Ref) > 3 times/day 1036 191,974 1.08 (0.99-1.17) 0.98 (0.90-1.07) Breakfast Eating Yes 2164 380,491 1.00 (Ref) 1.00 (Ref) 0.005 No 597 114,802 1.28 (1.16-1.40) 1.18 (1.06-1.31) Eating After Bedtime Yes 49 5,515 1.64 (1.23-2.17) 1.34 (1.00-1.79) 0.0009 No 2712 489,531 1.00 (Ref) 1.00 (Ref) * Adjusted for: smoking status, race, diabetes, parental MI before 60 years of age, hypercholesterolemia, hypertension, aspirin use, multivitamin use, alternative Healthy Eating Index score, alcohol intake, total energy intake, BMI, and physical activity.