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The association of skipping breakfast with cancer-related and all-cause mortality in a national cohort of United States adults



Many lifestyle and dietary factors have been recognized as risk factors for cancer morbidity and mortality. However, investigations of the association of the frequency of breakfast consumption and cancer are limited. This study aimed to examine the association of skipping breakfast with all-cause and cancer-related mortality in a national cohort of United States men and women.


Data were from 7,007 adults aged ≥ 40 years who participated in the third National Health and Nutrition Examination Survey (1988–1994) and had follow-up information on mortality up until 31 December 2015. Cox proportional hazards regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI).


The mean age of participants was 55.4 years, with 54.4% and 79% being women and non-Hispanic whites, respectively. Approximately, 16% of participants rarely consumed breakfast, 23.0% consumed breakfast some days, and 61% consumed breakfast every day. During a median follow-up of 22.2 years, 3,573 deaths occurred with 795 being related to cancer. In models adjusting for sociodemographic factors, smoking, physical activity, body mass index, hypertension, diabetes, cholesterol levels, total energy intake and diet quality, persons who rarely consumed breakfast had a higher risk of cancer-related mortality (HR = 1.52; CI:1.06–2.18) and all-cause (HR = 1.69; CI: 1.42–2.02) compared to those who took breakfast every day.


In this nationally representative sample, skipping breakfast was associated with elevated risks for all-cause and cancer-related mortality. This study provides evidence for the benefits of regular breakfast consumption in reducing the risk of all-cause and cancer mortality.

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Data availability

All data are from the National Health and Nutrition Examination Survey (NHANES) and are publicly available through the Centers for Disease Control and Prevention:

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Authors and Affiliations



Dr. Appiah had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Appiah, Helo, Appiah. Acquisition, analysis, or interpretation of data: Appiah, Helo. Drafting of the manuscript: Appiah, Helo. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: Appiah, Helo. Obtained funding: None. Administrative, technical, or material support: Appiah. Supervision: Appiah.

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Correspondence to Duke Appiah.

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The National Center for Health Statistics’ Institutional Review Board approved NHANES, and all participants provided written informed consent prior to the study.

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All participants provided written informed consent prior to the study.

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Helo, D., Appiah, L., Bhende, K.M. et al. The association of skipping breakfast with cancer-related and all-cause mortality in a national cohort of United States adults. Cancer Causes Control 32, 505–513 (2021).

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  • Breakfast
  • Diet
  • Cancer
  • Epidemiology
  • Mortality