@article{2987691,
    title = "Breakfast association with arterial stiffness and carotid atherosclerotic burden. Insights from the ‘Corinthia’ study",
    author = "Oikonomou, E. and Lazaros, G. and Christoforatou, E. and Chasikidis, C. and Vavouranaki, G. and Vogiatzi, G. and Papamikroulis, G.A. and Tsalamandris, S. and Gergiopoulos, G. and Mazaris, S. and Theofilis, P. and Anastasiou, M. and Galiatsatos, N. and Tousoulis, D.",
    journal = "Nutrition, Metabolism and Cardiovascular Diseases",
    year = "2019",
    volume = "29",
    number = "7",
    pages = "744-750",
    publisher = "Elsevier B.V.",
    issn = "0939-4753",
    doi = "10.1016/j.numecd.2019.04.008",
    keywords = "cholesterol;  high density lipoprotein cholesterol;  low density lipoprotein cholesterol;  triacylglycerol, adult;  arterial pressure;  arterial stiffness;  arterial wall thickness;  Article;  body mass;  breakfast skipping;  caloric intake;  cardiovascular disease;  cardiovascular risk;  carotid atherosclerosis;  chromatography;  cross-sectional study;  diastolic blood pressure;  diet;  female;  femoral artery;  food frequency questionnaire;  food intake;  human;  hypercholesterolemia;  hypertension;  major clinical study;  male;  meal;  non insulin dependent diabetes mellitus;  priority journal;  pulse wave;  smoking;  sphygmomanometry;  systolic blood pressure;  ultrasound;  aged;  carotid artery disease;  feeding behavior;  Greece;  middle aged;  nutritional value;  pathophysiology;  protection;  risk assessment;  risk factor, Aged;  Breakfast;  Carotid Artery Diseases;  Carotid Intima-Media Thickness;  Cross-Sectional Studies;  Energy Intake;  Feeding Behavior;  Female;  Greece;  Humans;  Male;  Middle Aged;  Nutritive Value;  Protective Factors;  Pulse Wave Analysis;  Risk Assessment;  Risk Factors;  Vascular Stiffness",
    abstract = "Background and aims: The role of dietary patterns, in cardiovascular diseases has been challenged. The role of breakfast as an element of balance energy intake has gained research interest. However, the effects of dietary patterns related to breakfast consumption on vascular function are unknown. We explored the association of breakfast consumption habits with arterial wall elastic properties and carotid atherosclerosis. Methods and results: In this cross-sectional study we enrolled 2043 inhabitants of the Corinthia region in Greece. Carotid-femoral pulse wave velocity (cf-PWV) was used to assess arterial stiffness. Carotid intima-media thickness (cIMT) was measured and the mean and the maximum cIMT were calculated. According to food frequency questionnaires, breakfast contribution in total daily energy intake (>20%; 5–20% and <5%) was estimated. Subjects were categorized as high-energy breakfast consumers (HeBC), low-energy breakfast consumers (LeBC) and those skipping breakfast (SBf) respectively. From the study population 240 subjects were categorized as HeBC, 897 as LeBC, and 681 as SBf. The mean cf-PWV was significantly higher in subjects SBf compared to LeBC and HeBC (9.35 ± 2.82 m/s vs. 9.09 ± 2.77 m/s vs. 8.76 ± 2.69 m/s, p = 0.02). The mean cIMT was significantly higher in subjects SBf compared to LeBC and HeBC (1.04 ± 0.46 mm vs. 0.99 ± 0.43 mm vs. 0.92 ± 0.39 mm, p = 0.01). Even after adjustment for potential confounders and cardiovascular risk factors SBf subjects have significantly increased mean cIMT and cf-PWV. Conclusion: Skipping breakfast has an adverse effect on arterial stiffness and carotid atheromatic burden. Increased breakfast total energy intake may act protectively against atherosclerosis, a finding worth of further pathophysiologic exploration with potential clinical implications. © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University"
}