Intermittent fasting, a popular weight loss technique, has helped many lose weight and keep off extra pounds long term. However, a recent study has found that skipping breakfast correlates to a higher risk of dying from cardiovascular disease.

The study was published in the journal of the Academy of Nutrition and Dietetics and used a sample size of 24,000 adults over the age of 40 who logged daily the time of their meals since 2015. If the subject passed away, researchers would log the reason for their death.

Of those studied, 4,175 passed on within the seven-year time frame. Researchers found those who skipped breakfast were more likely to develop fatal cardiovascular disease. At the same time, those who skipped lunch or dinner had a heightened risk of dying from all causes.

Those who ate only one meal a day had a 30% higher mortality rate than those who ate three meals a day.

The study’s researchers suggest that a possible reason for increased mortality rates may be that when a person eats after fasting, they are more likely to consume more calories in a short amount of time. As a result, the person will increase their blood sugar rapidly and release higher levels of insulin.

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Dr. Yangbo Sun, the study’s lead author and researcher at the department of preventative medicine at the University of Tennessee Health Science Center in Memphis, said that the research is especially pertinent to Americans given the popularity of intermittent fasting.

“At a time when intermittent fasting is widely touted as a solution for weight loss, metabolic health and disease prevention, our study is important for the large segment of American adults who eat fewer than three meals each day,” said Dr. Sun.

On the other hand, intermittent fasting has worked for many struggling to lose weight. Among them is Dallas physician Samuel Tyuluman who lost a total of 45 pounds on a 5:2 schedule (Tyuluman eats for 5 days and fasts for two).

“When your stomach is empty, it is sending signals to your brain, ‘eat or you’re going to die,'” Tyuluman explained to Dallas Morning News. “If you resist the urge for a few hours, all of a sudden, the hunger disappears. What you’ve done is mobilize a half pound of white fat, which is the product of excess sugar eaten, to become sugar you can use.”

“It’s like metabolic liposuction. It works very nicely,” he continued.

While the study draws several lines between increased fatality and intermittent fasting practices, the study’s authors stress that correlation does not necessarily mean causation. Other factors may influence results. For instance, according to Dr. Sun, many who skipped meals also tended to smoke or drink alcohol regularly.

Nonetheless, Dr. Wei Bao, the study’s senior investigator and researcher at the epidemiology department in the College of Public Health at the University of Iowa, urged Americans to use caution.

“[Mortality rates] are significant even after adjustments for dietary and lifestyle factors such as smoking, alcohol use, physical activity levels, energy intake, and diet quality and food insecurity.”

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