title: Association of Breakfast Intake With Incident Stroke and Coronary Heart Disease: The Japan Public Health Center-Based Study.
abstract: OBJECTIVE
  The association between breakfast intake and the risk of cardiovascular disease, including stroke, among Asian people remains unknown. We sought to prospectively investigate whether the omission of breakfast is related to increased risks of stroke and coronary heart disease in general Japanese populations.
  
  
  METHODS
  A total of 82,772 participants (38,676 men and 44,096 women) aged 45 to 74 years without histories of cardiovascular disease or cancer were followed up from 1995 to 2010. Participants were classified as having breakfast 0 to 2, 3 to 4, 5 to 6, or 7 times/wk. The hazard ratios of cardiovascular disease were estimated using Cox proportional hazards models.
  
  
  RESULTS
  During the 1 050 030 person-years of follow-up, we documented a total of 4642 incident cases, 3772 strokes (1051 cerebral hemorrhages, 417 subarachnoid hemorrhages, and 2286 cerebral infarctions), and 870 coronary heart disease. Multivariable analysis showed that those consuming no breakfast per week compared with those consuming breakfast everyday had hazard ratios (95% confidence interval; P for trend) of 1.14 (1.01-1.27; 0.013) for total cardiovascular disease, 1.18 (1.04-1.34; 0.007) for total stroke, and 1.36 (1.10-1.70; 0.004) for cerebral hemorrhage. Similar results were observed even after exclusion of early cardiovascular events. No significant association between the frequency of breakfast intake and the risk of coronary heart disease was observed.
  
  
  CONCLUSIONS
  The frequency of breakfast intake was inversely associated with the risk of stroke, especially cerebral hemorrhage in Japanese, suggesting that eating breakfast everyday may be beneficial for the prevention of stroke.
authors.affiliation: From the Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (Y.K., H.I.); and Epidemiology and Prevention Division, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan (N.S., S.T.).
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kubota
authors.affiliation: From the Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (Y.K., H.I.); and Epidemiology and Prevention Division, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan (N.S., S.T.). iso@pbhel.med.osaka-u.ac.jp.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.affiliation: From the Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (Y.K., H.I.); and Epidemiology and Prevention Division, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan (N.S., S.T.).
authors.forename: Norie
authors.initials: N
authors.lastname: Sawada
authors.affiliation: From the Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan (Y.K., H.I.); and Epidemiology and Prevention Division, Research Centre for Cancer Prevention and Screening, National Cancer Centre, Tokyo, Japan (N.S., S.T.).
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Tsugane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D062408:Breakfast; D002543:Cerebral Hemorrhage / Q000453:epidemiology*; D002544:Cerebral Infarction / Q000453:epidemiology*; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D004032:Diet / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D065840:Protective Factors; D020521:Stroke / Q000453:epidemiology; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology*
keywords: breakfast; cardiovascular diseases; coronary heart disease; prevention & control; stroke