Doctors should eat breakfast to prevent heart disease

Men who skipped breakfast had a higher risk of coronary heart disease (CHD) compared with men who did not; in addition, compared with men who did not eat late at night, those who ate late at night had a higher CHD risk.

However, these associations appeared to be mediated by body mass index, hypertension, hypercholesterolemia, and diabetes.

Men in middle age and beyond who skip breakfast or eat late at night may be at greater risk of developing coronary heart disease, researchers found.

Male health professionals who said they regularly skipped breakfast were 27% more likely to die during 16 years of follow-up, according to Leah Cahill, PhD, of the Harvard School of Public Health in Boston, and colleagues, who adjusted for diet, demographics, physical activity, television watching, and amount of sleep, reports MedPage. And those who said they ate late at night were 55% more likely to die.

Both relationships, however, fell shy of statistical significance after further adjustment for body mass index, hypertension, hypercholesterolemia, and diabetes, "suggesting that eating habits may affect risk of coronary heart disease through pathways associated with these traditional risk factors," they reported online in Circulation: Journal of the American Heart Association.

The present study provides evidence to support a recommendation of daily breakfast eating by clinicians and health authorities to prevent coronary heart disease.

Previous studies have demonstrated associations between skipping meals and excess weight, dyslipidemia, hypertension, insulin resistance and diabetes, but a possible association with coronary heart disease had not been explored.

Cahill and colleagues examined the relationship between coronary heart disease risk and skipping breakfast and other eating habits using data from the Health Professionals Follow-Up Study (HPFS), an ongoing investigation of male health professionals.

The current analysis included 26,902 men ages 45 to 82 who were free from cardiovascular disease and cancer in 1992, which served as baseline. At that point, 13% reported not eating breakfast and 0.2% said they ate late at night. Through follow-up, there were 1,527 incident cases of coronary heart disease, defined as nonfatal MI or fatal coronary heart disease.

 The number of times the men ate per day was not associated with the risk of coronary heart disease, even though previous analyses of this cohort have shown relationships between eating frequency and weight gain and type 2 diabetes.

Emedinews:Insights on Medicolegal Issues: What is conduct money for doctors?

In criminal cases, no fee is paid to any witness, including the doctor, at the time of serving the summons. The summoned doctor must attend the Court and give evidence because of the interest of the State in securing truth/justice; otherwise the doctor will be charged with contempt of Court. However, in criminal cases, conveyance charges and daily allowance can be claimed by the doctor according to Government rules.

Emedinews:Insights on Medicolegal Issues:Doctors should avoid special efforts to “cover up” any medical fact

The media and general public are vastly becoming informed and law conscious. There is awareness of modern diagnostic/therapeutic methods. The standard of doctors/hospital, its opinion and method of medical/surgical interventions are being scrutinized from time to time in public as well as Court of law and media. The doctor should not avoid talking to the media but definitely not too much and too soon. Prejudicial and sensational statements should not be made by doctor prior to trial. It is incumbent upon doctors to have good knowledge of the law governing their profession, in order not to transgress the law. • Doctors should totally avoid special efforts to “cover up” alleged medical negligence or unintentional wrong doing or inevitable medical accident. • It is a standard accepted universal fact that “Medicine is not mathematics but is a science of uncertainty and an art of probability. One thing that makes medicine so difficult is that there is no such thing as the average man can understand the intricacies. We can only say the reading is ‘within the range of normal’. Medicine is a biological science with the variability inherent in body physiology with the variability inherent in biological matters. • Forensic medicine is not an exact science as a mathematical calculation hence while making a forensic opinion it is required to deliberate that unexpected results are produced due to biological variations in case to case, there is an element of uncertainty and absolute proof is a rarity in any medical care delivery. • Doctors should bear in mind the essential difference between probability and proof. They should be reasonable in their opinions and should not overstate the likelihood of a relationship between cause and effect. • The doctor should be ready to defend every finding and conclusion on the report on clinical and scientific grounds in the court of law. He should be aware of professional and scientific viewpoints which might differ from his, and should be familiar with the latest scientific literature in relation to the subject involved. • The doctor in the Court of law may clarifying his testimony by means of photographs, maps, diagrams, charts, X-rays, skeletons, models, slides, films, tapes, etc., when they are properly verified.