Skipping breakfast may be bad for your heart, doctors say

Planning meals and snacks in advance and eating breakfast every day may help lower the risk of cardiovascular disease, new guidelines from U.S. doctors say.

Eating more calories earlier in the day and consuming less food at night may also reduce the odds of a heart attack, stroke or other cardiac or blood vessel diseases, according to the scientific statement from the American Heart Association.

"When we eat may be important to consider, in addition to what we eat," said Marie-Pierre St-Onge, chair of the group that wrote the guidelines and a nutrition researcher at Columbia University Medical Center in New York.

As many as 30 percent of U.S. adults may routinely skip breakfast, a habit that has become more common in recent years as more people snack throughout the day instead of sitting down for three traditional meals, St-Onge and colleagues note in the journal Circulation.

When people do eat breakfast daily, they're less likely to have risk factors for cardiovascular disease like high cholesterol and elevated blood pressure. And people who skip this morning meal are more likely to have risk factors like obesity, poor nutrition and diabetes or high blood sugar.

That's because meal timing may affect health by impacting the body's internal clock. We may not process sugars as well at night as we do during the day, and studies of shift workers have linked this schedule with a greater risk of obesity and heart disease than a typical day job, St-Onge said by email.

"We know from population studies that eating breakfast is related to lower weight and healthier diet, along with lower risk of cardiovascular disease," St-Onge said.

"However, interventions to increase breakfast consumption in those who typically skip breakfast do not support a strong causal role of this meal for weight management, in particular," St-Onge cautioned. "Adding breakfast, for some, leads to an additional meal and weight gain."

It's possible that some people who add breakfast aren't eating the right things or cutting back on what they eat later in the day, resulting in more calories but not necessarily good nutrition.

A healthy diet is heavy on fruits and vegetables, whole grains, low-fat dairy, poultry and fish, according to the guidelines. Eating well also means limiting red meat, salt and foods high in added sugars.

Plotting out what to eat ahead of time, especially for busy people who eat on the go, can help create a diet that's better for heart health, St-Onge said.

"Planning ahead and making healthy, carry-on foods is important," St-Onge suggested. "This could be a homemade smoothie or whole grain muffin or cereal bar for breakfast; packing a sandwich or leftovers for those times when time is tight."

Advance thought can also help people eat the right amount of food throughout the day and eat at the right time, said Samantha Heller, a nutritionist at New York University Langone Medical Center who wasn’t involved in the guidelines.

"The 'eating several small meals' during the day advice that we commonly hear is unrealistic for most people because the 'small' meals often turn into meal-sized meals and weight gain is inevitable," Heller said by email.

"Another booby trap for overeating is after dinner," Heller added. "Night time eating is quite common and an easy way to add unnecessary calories and pack on the pounds over time because people snack when in front of TV, computer and tablet screens."

Heller’s advice: "Once dinner is finished, the kitchen should be closed. If your schedule is crazy and you cannot get to dinner until later in the evening, then eat light at night."

SOURCE: bit.ly/2jznKZG Circulation, online January 30, 2017.

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Cardiac arrest or heart attack: Know the difference

MANILA - Many get confused with cardiac arrest and heart attack, with most thinking that the two are just the same condition.

In an interview on DZMM's "Magandang Gabi Dok," Dr. John David Tan, a cardiologist, explained that cardiac arrest is often an effect of a heart attack.

"By the name itself (cardiac arrest), hindi na po tumitibok ang puso. Either the heart does not pump anymore, because of that, hindi na po efficient ang daloy ng dugo sa utak. That's why yung pinaka-common manifestation of sudden cardiac death is loss of consciousness, nawawalan ng malay po ang tao," he said.

"The most common cause of sudden cardiac death is heart attack. I think that was the case nung nangyari kay Direk Wenn (Deramas), sudden cardiac death due to massive heart attack," Tan added.

Heart attack is often caused by a blockage in the veins, making it difficult for blood to circulate the body.

For Tan, it is important for a heart attack patient to undergo cardio pulmonary resuscitation (CPR) as soon as possible.

"Kapag hindi na-CPR within a minute, there is a higher chance of dying every minute," he added.

Upon diagnosis of the cause of the heart attack, a person may undergo emergency angioplasty to remove the blockage.

"Binubuka po 'yung 100 percent blockage na nag-cause ng heart attack," Tan said.

Aside from giving of first aid, patients should also be aware of symptoms of heart attack, which includes chest pains, difficulty in breathing, and breaking into a cold sweat.

Deramas passed away Monday of cardiac arrest due to a heart attack.

Deramas was in a hospital to see his sister who also earlier succumbed to a heart attack.


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Divorce tied to increased heart attack risk

Women who have been divorced once, or men who have been divorced at least twice, are more likely to have a heart attack than people who get and stay married, according to a new study.

“The negative health consequences of divorce have been known for some time,” said lead author Matthew E. Dupre of Duke Clinical Research Institute in Durham, North Carolina.

Remarriage only reverses the risk for men, the researchers also found. And for women divorced at least twice, the heart attack risk was comparable to that of having diabetes or high blood pressure.

The researchers analyzed data on more than 15,000 adults ages 45 to 80 at the beginning of the study period, who had been married at least once and were followed from 1992 to 2010.

At the outset, 14% of men and 19% of women were divorced. By the end of the study, more than a third of people had gone through at least one divorce.

Over the 18-year study period, 1211 people suffered a heart attack, and this was more likely to happen to those who had been divorced, according to the April 14 online paper in Circulation: Cardiovascular Quality and Outcomes. The authors accounted for age, socioeconomic, behavioral and health factors.

Women who had one divorce were 24% more likely to have a heart attack than women who were continuously married, and those who had been divorced at least twice were 77% more likely to have one.

Remarried women were 35% more likely than women who were continuously married to have a heart attack.

For men, risk only increased for those who had been divorced twice or more. They were 30% more likely to have a heart attack than men who remained married or who remarried.

“Earlier studies have suggested that marital loss has a greater impact on the health of women than men,” Dupre told Reuters Health by email. “The reasons for these differences are not entirely known; however, the prevailing view is that divorced women suffer greater economic losses and emotional distress than divorced men.”

“Men are also much more likely to remarry after divorce than women, and among those who remarry, men remarry sooner than women,” he said.

Though the results offer strong evidence that divorce increases heart attack risk, the authors were not able to account for other potentially important factors like elevated stress, anxiety and the loss of social support or changes in medication adherence, Dupre said.

They also were not able to account for whether the risk rises or falls over time following divorce, he said.

“There's already a substantial literature linking changes in marital status to physical health,” said David A. Sbarra of the psychology department at the University of Arizona in Tucson. “I would have predicted men to be at increased risk following divorce, but this is not what the paper reports.”

The immediate emotional shock of ending a relationship may lead to cardiovascular changes, or people who get a divorce may change their behavior, may start smoking to manage the stress of separation, for example, he told Reuters Health by email.

“The difficult spot all of us are in when working on this topic is that you cannot randomly assign people to divorce,” Sbarra said.

Divorce may be a proxy for other variables, like hostility, which lead people to end marriages and also convey heart attack risk, he said.

“If you feel your divorce was done for good reasons, you've coped well with the transition (after a period of grief, you've got most of your life back together . . . or, at least, you feel headed in the right direction), these results may not apply,” he said.

The study only involved people who had ever married, which includes 95% of the older adult population, but not those who remained single, Dupre said.

People cannot change their marital history in order to reduce their heart attack risk, but recognizing an increased risk may improve doctors’ decision making or screening for divorced people, he said.

“A greater recognition of social stressors will help physicians identify and treat adults at potentially high risk of having a heart attack, as well as provide patients a new (or heightened) awareness of how the social world can get under our skin and damage our heart,” he said.

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Daylight Saving Time linked to heart attacks: study

WASHINGTON -- Switching over to daylight saving time, and losing one hour of sleep, raised the risk of having a heart attack the following Monday by 25 percent, compared to other Mondays during the year, according to a new U.S. study released on Saturday.

By contrast, heart attack risk fell 21 percent later in the year, on the Tuesday after the clock was returned to standard time, and people got an extra hour's sleep.

The not-so-subtle impact of moving the clock forward and backward was seen in a comparison of hospital admissions from a database of non-federal Michigan hospitals. It examined admissions before the start of daylight saving time and the Monday immediately after, for four consecutive years.

In general, heart attacks historically occur most often on Monday mornings, maybe due to the stress of starting a new work week and inherent changes in our sleep-wake cycle, said Dr. Amneet Sandhu, a cardiology fellow at the University of Colorado in Denver who led the study.

"With daylight saving time, all of this is compounded by one less hour of sleep," said Sandhu, who presented his findings at the annual scientific sessions of the American College of Cardiology in Washington.

A link between lack of sleep and heart attacks has been seen in previous studies. But Sandhu said experts still don't have a clear understanding of why people are so sensitive to sleep-wake cycles.

"Our study suggests that sudden, even small changes in sleep could have detrimental effects," he said.

Sandhu examined about 42,000 hospital admissions in Michigan, and found that an average of 32 patients had heart attacks on any given Monday. But on the Monday immediately after springing the clock forward, there were an average of eight additional heart attacks, he said.

The overall number of heart attacks for the full week after daylight saving time didn't change, just the number on that first Monday. The number then dropped off the other days of the week.

People who are already vulnerable to heart disease may be at greater risk right after sudden time changes, said Sandhu, who added that hospital staffing should perhaps be increased on the Monday after clocks are set forward.

"If we can identify days when there may be surges in heart attacks, we can be ready to better care for our patients," he said.

The clock typically moves ahead in the spring, so that evenings have more daylight and mornings have less, and returns to standard time in the fall. Daylight saving time was widely adopted during World War I to save energy, but some critics have questioned whether it really does so and whether it is still needed.

Researchers cited limitations to the study, noting it was restricted to one state and heart attacks that required artery-opening procedures, such as stents. The study therefore excluded patients who died prior to hospital admission or intervention.

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