New Delhi, Oct. 2: People who skip breakfast may be putting themselves at risk of silent coronary artery blockages and cardiovascular disease, medical researchers said today after a study corroborated earlier hints that breakfast is the most important meal of the day.

Researchers in Spain and the US who have analysed the food habits and health of more than 4,000 healthy men and women have found more frequent atherosclerosis, and at higher levels, among volunteers who skipped or ate frugal breakfasts compared to those who had hearty breakfasts.

Although several past studies had shown an association between skipping breakfast and developing coronary artery disease, the new study has been described as the first to evaluate the association between breakfast and sub-clinical atherosclerosis, or the development of arterial blockages without symptoms. The findings appeared today in the Journal of the American College of Cardiology.

"This study provides evidence that this (skipping breakfast) is one bad habit people can change to reduce their risk of heart disease," Valentin Fuster, director of the Mount Sinai Heart and editor-in-chief of the journal, said.

Estimates about the proportion of people who skip breakfast are likely to vary widely. Some public health specialists, however, believe that about 20 to 30 per cent adults skip breakfast or just drink coffee, juice, tea or other non-alcoholic beverages for breakfast.

In the new study, the researchers found that people who obtained less than five per cent of their daily energy intake through breakfast were likelier to have atherosclerosis and high blood pressure and be overweight or obese.

The study has also found that people who skip breakfast are likely to show an overall poor diet, frequent alcohol consumption and smoking.

"Aside from the direct association with cardiovascular risk factors, skipping breakfast might serve as a marker for general unhealthy diet or lifestyle, which itself is associated with the development of atherosclerosis," said Jose Penalvo, assistant professor at Tufts University in the US and senior author of the study.

Doctors have long recognised the links between a good breakfast and health.

In 2003, researchers at the Harvard Medical School who had tracked the breakfast habits and health of over 2,700 adults for eight years found that breakfast eaters were significantly less likely to be obese or to develop diabetes. The study suggested that breakfast may have beneficial effects on appetite and insulin resistance later in the day.

In 2013, researchers at the Harvard School of Public Health who had tracked over 26,900 men for 16 years found that those who had regularly skipped breakfast had a 27 per cent higher risk of heart attack or death from coronary heart disease than men who ate breakfast.

An Indian-origin doctor, Prakash Deedwania, who is now a professor of medicine at the University of California, has published an editorial comment in the journal, highlighting the significance of the new study.

"Although breakfast skippers are generally attempting to lose weight, they often end up eating more and unhealthy foods later in the day," Deedwania said.

"Skipping breakfast can cause hormonal imbalances and alter circadian rhythms.... That breakfast is the most important meal of the day has been proven right through this evidence."