Editorial
Why are Skipping Breakfast and Skipping Staple Foods Inappropriate Dietary Patterns? The Association with Small Dense Low-Density Lipoprotein Cholesterol Levels
2023 Volume 30 Issue 10 Pages 1313-1314
Details
2023 Volume 30 Issue 10 Pages 1313-1314
See article vol. 30: 1376-1388
Eating or dietary pattern determines what to eat, when to eat, and how much to eat in daily life; it is obviously an important risk factor for atherosclerosis. A meta-analysis was conducted, and it was shown that skipping breakfast is associated with an increased risk of heart disease1). Seidelmann et al. reported a U-shaped association between the percentage of energy carbohydrate and mortality and minimal risk at 50%–55% of carbohydrate intake in the Atherosclerotic Risk in Communities study2). The Japan diet includes staple foods with main and side dishes and is fit for consuming balanced carbohydrate, protein, and fat contents.
Delayed first active-phase meal protocol was conducted as a skipping breakfast model, and the delaying circadian oscillation of lipid metabolism-related genes was observed in the liver of rat models, which indicates inducing abnormal lipid metabolism3). However, there is little evidence of the mechanism of how eating or dietary pattern affects lipid metabolism. Small dense low-density lipoprotein (sdLDL) is an LDL with small particle size; sdLDL cholesterol (sdLDL-C) has been suggested to be a more sensitive risk marker for the development of coronary heart disease than LDL cholesterol (LDL-C)4). Arimoto et al. assessed the association of eating and dietary patterns such as the skipping of breakfast and staple foods with the serum concentration of sdLDL-C and other cardiovascular disease risk factors in a cross-sectional study among 27,997 Japanese men and women who underwent medical checkup5). They defined participants who consumed breakfast less than six times a week as breakfast skippers (BS), and participants who had three meals a day but did not consume staple food at every meal as staple food skippers (SS). They found that BS had significantly higher serum levels of sdLDL-C and sdLDL-C/LDL-C ratio than breakfast eaters, and SS also had significantly higher sdLDL-C level and sdLDL-C/LDL-C ratio than staple food eaters (SE)5). The results may be confounded by other lifestyle behavior such as cigarette smoking or snack eating every day; this lifestyle may also be associated with the deterioration of lipid metabolism. Therefore, the authors performed a stratified analysis using other lifestyle factors, and similar results were obtained for both male and female participants except for female non-drinkers; however, excluding other uninvestigated lifestyle factor confounding is difficult. According to the lifestyle, the proportion of snack eating every day was significantly lower in SS than in SE. It is possible that the participants skipping staple foods intended to lose weight or not to gain weight. Not only some general population but also some medical professionals recognize that skipping breakfast or staple foods is a healthy eating pattern, which does not seem to be appropriate. What we should do is verify the cardiometabolic effect of eating or dietary pattern using an ethical scientifically validated study design. We should conduct a survey and consider the background factors of those eating or dietary pattern simultaneously, for example, whether they intend not to eat or have little appetite.
None.
None.
