Breakfast frequency and timing were not associated with incident myocardial infarction (MI) or coronary artery disease (CAD) in older adults in a long-term prospective cohort analysis. This prospective cohort study, published in The Journal of Nutrition, Health & Aging, assessed whether breakfast frequency and timing were associated with incident myocardial infarction (MI) and coronary artery disease (CAD) among older adults and whether these associations varied by sex or cardiometabolic risk factors.

A total of 4,070 adults aged ≥65 years from the Cardiovascular Health Study were included and followed for up to 26 years. Breakfast frequency per week and usual breakfast timing were obtained through questionnaires. Cause-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using multivariable-adjusted Cox proportional hazards models.

During follow-up, 1,617 CAD cases were identified, including 795 MI events. Regular breakfast consumption (7 days/week; 85.3%) and eating between 07:00 and 09:00 (72.6%) were associated with favorable sociodemographic and lifestyle characteristics, including higher education, non-smoking status, and healthier dietary patterns. However, neither breakfast frequency nor timing was associated with risk of CAD or MI across the overall cohort or when stratified by sex.

In pre-specified analyses, compared with daily breakfast consumption, non-daily intake showed an HR for MI of 0.66 (95% CI: 0.43, 1.02) in individuals with body mass index (BMI) ≥30 kg/m² and 1.17 (95% CI: 0.91, 1.51) in those with BMI <30 kg/m² (interaction p=0.02). Compared with breakfast between 07:00 and 09:00, earlier timing (<07:00) showed an HR for CAD of 1.40 (95% CI: 1.02, 1.93) in participants with type 2 diabetes and 1.19 (95% CI: 1.03, 1.38) in those with elevated fasting insulin.

Breakfast frequency and timing were not associated with MI or CAD risk overall in older adults. These findings require confirmation in larger studies.