Discover how a nutrient-packed breakfast, balanced in calories, can transform cardiometabolic health and reduce risks for heart and kidney issues in aging adults.

Study: Breakfast energy intake and dietary quality and trajectories of cardiometabolic risk factors in older adults. Image Credit: Oksana Mizina / Shutterstock.com

In a recent article published in The Journal of Nutrition, Health, and Aging, researchers investigated the impact of diet quality and energy intake during breakfast on cardiometabolic health among older adults. Both high- and low-energy breakfasts and low-quality breakfasts were found to increase triglyceride levels and body fat, worsen kidney function, and reduce high-density lipoprotein (HDL) cholesterol levels.

The importance of breakfast

Breakfast is crucial in daily nutrition, providing 20-25% of total energy intake. Skipping breakfast has been associated with an increased risk of various metabolic conditions, obesity, and diabetes.

Regular breakfast consumption is associated with better overall diet quality and lower risks of hypertension, metabolic syndrome, cardiovascular diseases, and obesity. However, guidelines on what constitutes a “high-quality” breakfast remain lacking.

Previous studies, though cross-sectional, suggest that a nutritious breakfast rich in vegetables, healthy fats, fruits, vegetables, and whole grains may improve cardiometabolic health. To date, no prospective studies have examined the impact of breakfast calorie intake and quality on long-term cardiometabolic outcomes.

About the study

In the current study, researchers explore how the proportion of daily energy consumed at breakfast and breakfast quality relate to changes over time in cardiometabolic traits like body mass index (BMI), blood pressure, triglycerides, and kidney function in older adults with metabolic syndrome.

The study was part of a larger intervention investigating the effects of a Mediterranean diet (MedDiet) with and without exercise on cardiovascular disease in adults with metabolic syndrome. Study participants between 55 and 75 years of age followed a MedDiet with breakfast consisting of low-fat dairy, whole grains, protein, olive oil, nuts, and fruits, without specific guidance on portion sizes.

To assess breakfast habits, all study participants completed three-day food records at baseline, 24 months, and 36 months. This allowed the researchers to analyze energy intake at breakfast and meal quality using the Meal Balance Index.

Cardiometabolic risk factors were measured at various intervals, and various statistical models were utilized to evaluate how breakfast energy and quality influenced these factors over time. All results were adjusted for confounding factors, including baseline health conditions such as hypertension and diabetes, physical activity, sex, and age.

Study findings

The current study included 383 obese or overweight older adults with metabolic syndrome and high cardiovascular risk factors. No significant differences in baseline characteristics were identified between groups categorized by breakfast energy intake or quality.

In terms of association with adiposity, study participants with low or high breakfast energy intake exhibited greater BMI and waist circumference (WC) over time compared to the reference group. Both low and high breakfast energy intake was associated with higher triglyceride and lower HDL cholesterol levels, with the high-energy group experiencing more pronounced effects. Study participants with low breakfast quality also experienced a rebound in triglycerides and lower HDL levels.

No significant systolic or diastolic blood pressure changes were observed based on breakfast energy intake. However, slightly higher blood pressure levels were observed in those with low breakfast quality.

Likewise, no significant differences in glucose or glycated hemoglobin levels were reported among the breakfast groups; however, study participants with low breakfast quality had slightly higher levels. Furthermore, the estimated glomerular filtration rate (eGFR), an indicator of kidney function, was somewhat lower in participants with low breakfast quality.

Conclusions

Both energy intake and breakfast quality independently influence health outcomes; however, no significant interaction was observed between these two factors on cardiometabolic risk markers.

The current study found that consuming insufficient energy at breakfast correlates with greater adiposity, which supports previous research. However, a higher breakfast energy intake of over 30% also correlated with greater adiposity, which is a novel finding.

Participants who consumed 20-30% of their daily calories at breakfast experienced improvements in lipid profiles, with lower triglycerides and higher HDL cholesterol levels. A high-quality breakfast rich in nutrients like protein and carbohydrates was associated with lower waist circumference, higher HDL cholesterol, and better kidney function.

These findings indicate that breakfast quantity and quality are important for maintaining cardiovascular and metabolic health, especially in high-risk individuals.