title: Skipping Breakfast and Risk of Mortality from Cancer, Circulatory Diseases and All Causes: Findings from the Japan Collaborative Cohort Study.
abstract: BACKGROUND
  Breakfast eating habits are a dietary pattern marker and appear to be a useful predictor of a healthy lifestyle. Many studies have reported the unhealthy effects of skipping breakfast. However, there are few studies on the association between skipping breakfast and mortality. In the present study, we examined the association between skipping breakfast and mortality from cancer, circulatory diseases and all causes using data from a large-scale cohort study, the Japan Collaborative Cohort Study (JACC) Study.
  
  
  METHODS
  A cohort study of 34,128 men and 49,282 women aged 40-79 years was conducted, to explore the association between lifestyle and cancer in Japan. Participants completed a baseline survey during 1988 to 1990 and were followed until the end of 2009. We classified participants into two groups according to dietary habits with respect to eating or skipping breakfast and carried out intergroup comparisons of lifestyle. Multivariate analysis was performed using the Cox proportional hazard regression model.
  
  
  RESULTS
  There were 5,768 deaths from cancer and 5,133 cases of death owing to circulatory diseases and 17,112 cases for all causes of mortality during the median 19.4 years follow-up. Skipping breakfast was related to unhealthy lifestyle habits. After adjusting for confounding factors, skipping breakfast significantly increased the risk of mortality from circulatory diseases [hazard ratio (HR) = 1.42] and all causes (HR = 1.43) in men and all causes mortality (HR = 1.34) in women.
  
  
  CONCLUSIONS
  Our findings showed that skipping breakfast is associated with increasing risk of mortality from circulatory diseases and all causes among men and all causes mortality among women in Japan.
authors.affiliation: Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan; †Tottori College, Kurayoshi 682-8555, Japan.
authors.forename: Yae
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Onishi
authors.affiliation: ‡Tottori College of Nursing, Kurayoshi 682-8555, Japan.
authors.forename: Takenobu
authors.initials: T
authors.lastname: Hosoda
authors.affiliation: Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Amano
authors.affiliation: §International Platform for Dryland Research and Education, Tottori University, Tottori 680-0001, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Otani
authors.affiliation: Division of Health Administration and Promotion, Department of Social Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kurozawa
authors.affiliation: ||Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
keywords: cancer; circulatory diseases; mortality; prospective study; skipping breakfast