A healthy breakfast is part of a lifestyle that decreases the risk of obesity, diabetes, heart attack and stroke Pen Waggener

Skipping the most important meal of the day has been linked to an increased risk of atherosclerosis, or a build-up of plaque in the arteries.

We have known that having breakfast is good for health for decades. Eating a morning meal is linked to lower risk of diabetes and heart disease. It is also associated with improved memory performance and weight loss.

People who do not eat breakfast are more likely to develop atherosclerosis, a study in the Journal of the American College of Cardiology has now found. Atherosclerosis is a major risk factor for heart attack and stroke.

A total of 4,052 people took part in the study. A small proportion of them – 2.9% – skipped breakfast, while 69.4% had a small, low-energy breakfast. Only 27.7% ate a proper breakfast accounting for 20% or more of their daily energy intake.

Those who pass on breakfast had the highest BMI, greatest waist circumference, highest blood pressure and highest blood lipid levels.

"People who regularly skip breakfast likely have an overall unhealthy lifestyle," said study author Valentin Fuster, director of Mount Sinai Heart. "This study provides evidence that this is one bad habit people can proactively change to reduce their risk for heart disease."

It is thought that skipping breakfast is one of a range of frequently linked habits to unhealthy life choices. People who forego breakfast are more likely to smoke, drink a lot and overeat.

"Aside from the direct association with cardiovascular risk factors, skipping breakfast might serve as a marker for a general unhealthy diet or lifestyle which in turn is associated with the development and progression of atherosclerosis," said Jose L. Peñalvo of the Friedman School of Nutrition Science and Policy at Tufts University, another author of the study.

Between 20 and 30% of adults tend to skip breakfast. Prakash Deedwania of the University of California, San Francisco, authored an editorial comment on the study.

He added: "Poor dietary choices are generally made relatively early in life and, if remained unchanged, can lead to clinical cardiovascular disease later on. Adverse effects of skipping breakfast can be seen early in childhood in the form of childhood obesity and although breakfast skippers are generally attempting to lose weight, they often end up eating more and unhealthy foods later in the day. Skipping breakfast can cause hormonal imbalances and alter circadian rhythms.

"That breakfast is the most important meal of the day has been proven right in light of this evidence."