Turning off your TV and eating energy-rich breakfast could lead to a healthy heart
Mar 19, 2019
The small lifestyle choices we make each day add up when it comes to heart
health. In a new twopronged study being presented at the American College
of Cardiology's 68th Annual Scientific Session, people who spent less time
watching TV and regularly ate an energyrich breakfast showed significantly
less plaque and stiffness in their arteries, indicating a lower chance of
developing heart disease or suffering a stroke.
"Environmental and lifestyle factors are important but underestimated risk
factors for cardiovascular diseases," said Sotirios Tsalamandris, MD, a
cardiologist at the First Cardiology Clinic at National and Kapodistrian
University of Athens, Greece, and the study's lead author. "These two studies
emphasize the many factors that impact heart disease and the need for
holistic preventive approaches."
Researchers assessed markers of heart health along with a variety of
environmental exposures and lifestyle factors in 2,000 people living in
Corinthia, Greece. Participants represented a broad spectrum of the general
public, including healthy people as well as those with cardiovascular risk
factors and established heart disease. They ranged in age from 40 to 99
years, with an average age of 63 years old.
Detailed questionnaires were used to assess participants' physical activity
levels and eating habits, while two noninvasive tests were used to assess the
condition of participants' arteries. The first test, carotid femoral pulse wave
velocity, measured the speed of pressure waves that move along the arteries
to detect stiffening of the arteries, or atherosclerosis. The second test used
ultrasound imaging to measure the thickness of the inner part of the arterial
wall. Thickening of the arterial walls reflects plaque buildup and is associated
with an increased risk of stroke.
Downsides of Too Much TV
For the first prong of the study, researchers divided participants into three
groups according to the number of hours spent watching television or videos
each week: a low amount (seven hours or fewer), a moderate amount (seven
to 21 hours) or a high amount (more than 21 hours).
After accounting for cardiovascular risk factors and heart disease status,
researchers found those watching the most TV per week were almost twice as
likely to have plaque buildup in the arteries compared with those watching
"Our results emphasize the importance of avoiding prolonged periods of
sedentary behavior," Tsalamandris said. "These findings suggest a clear
message to hit the 'off' button on your TV and abandon your sofa. Even
activities of low energy expenditure, such as socializing with friends or
housekeeping activities, may have a substantial benefit to your health
compared to time spent sitting and watching TV."
The study also found that watching more TV was associated with an increased
risk of other cardiovascular risk factors, including high blood pressure and
diabetes. Compared to those watching less than seven hours of TV per week,
those watching more than 21 hours per week were 68 percent more likely to
have high blood pressure and 50 percent more likely to have diabetes.
"Since our results emphasize the clinical benefit of low energy expenditure
activities, performing recreational activities, weight lifting, stretching bands
treadmill exercise while watching TV may be a healthy alternative,"
Benefits of a HighEnergy Breakfast
In the second part of the study, participants were divided into three groups
based on how much of their daily caloric intake came from breakfast:
highenergy (breakfast contributing more than 20 percent of daily calories),
lowenergy (520 percent of daily calories) or skipped breakfast (less than 5
percent of daily calories). In total, about 240 people reported a highenergy
breakfast, nearly 900 ate a lowenergy breakfast and about 680 skipped
Breakfast foods commonly eaten by those in the highenergy group included
milk, cheese, cereals, bread and honey. Breakfast for those in the lowenergy
group typically included coffee or lowfat milk along with bread with butter,
honey, olives or fruit.
The researchers found those who ate a highenergy breakfast tended to have
significantly healthier arteries than those who ate little or no breakfast. Even
after accounting for cardiovascular risk factors, both pulse wave velocity and
arterial thickness were, on average, highest in those skipping breakfast and
lowest in those eating a highenergy breakfast.
Specifically, arterial stiffness was abnormal in 15 percent of those skipping
breakfast, 9.5 percent of those consuming a lowenergy breakfast and 8.7
percent of those consuming a highenergy breakfast. Similarly, more plaque
was found in in the carotid arteries of 28 percent of people skipping
breakfast, 26 percent of those consuming a lowenergy breakfast and 18
percent of those consuming a highenergy breakfast.
"A highenergy breakfast should be part of a healthy lifestyle," Tsalamandris
said. "Eating a breakfast constituting more than 20 percent of the total daily
caloric intake may be of equal or even greater importance than a person's
specific dietary pattern, such as whether they follow the Mediterranean diet, a
lowfat diet or other dietary pattern."
However, Tsalamandris also indicated that because most study participants
followed a Mediterranean diet overall, it is unknown how the study findings
translate to people following different dietary patterns.
Since the research was observational, the study does not prove cause and
effect, and the reason for the association between a highenergy breakfast
and better heart health is not known. Based on previous studies, the
researchers offered two possible explanations. One is that people who eat
breakfast tend to eat healthier food overall and have fewer unhealthy lifestyle
patterns such as smoking and sedentary behavior than those who skip
breakfast. Another is that the specific breakfast foods consumed in the
highenergy group, such as dairy products, may benefit heart health.
The researchers plan to continue to track health outcomes in the study
participants for at least 10 years, with a primary focus on assessing potential
impacts of environmental exposures.