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If you鈥檝e experienced a heart attack, don鈥檛 skip your breakfast or eat dinner near bedtime, or you鈥檒l significantly worsen your chances of dying.

A new study has found聽that people with these two eating habits had a four to five times higher likelihood of death, another heart attack or angina (chest pain) within 30 days after hospital discharge for heart attack.

That鈥檚 the finding of research published in the European Journal of Preventive Cardiology.

This was the first study to evaluate these unhealthy behaviours in patients with acute coronary syndromes. Skipping breakfast was observed in 58%, late-night dinner eating in 51% and both behaviours in 41%.

The study enrolled patients with a particularly serious form of heart attack called ST-segment elevation myocardial infarction (STEMI).

鈥淥ne in 10 patients with STEMI dies within a year, and nutrition is a relatively inexpensive and easy way to improve prognosis,鈥� said study author Dr Marcos Minicucci, of S茫o Paolo State University, Brazil.

He recommended a minimum two-hour interval between dinner and bedtime. 鈥淚t is said that the best way to live is to breakfast like a king,鈥� he added. 鈥淎 good breakfast is usually composed of dairy products (fat-free or low-fat milk, yoghurt and cheese), a carbohydrate (whole wheat bread, bagels, cereals) and whole fruits. It should have 15 to 35% of our total daily calorie intake.鈥�

The study included 113 patients with a mean age of 60, 73% of which were men. Patients were asked about eating behaviours on admission to a coronary intensive care unit.聽Skipping breakfast was defined as nothing before lunch, excluding beverages, such as coffee and water, at least three times per week. Late-night dinner eating was defined as a meal within two hours before bedtime at least three times per week.

Dr Minicucci noted that late-night dinner eating was defined by the two-hour interval between dinner and bedtime, rather than eating late at night. But nearly all participants with this habit were late eaters.

Previous studies have found that people who miss breakfast and have a late dinner are more likely to have other unhealthy habits, such as smoking and low levels of physical activity.

鈥淥ur research shows that the two eating behaviours are independently linked with poorer outcomes after a heart attack, but having a cluster of bad habits will only make things worse,鈥� said Dr Minicucci. 鈥淧eople who work late may be particularly susceptible to having a late supper and then not being hungry in the morning.

鈥淲e also think that the inflammatory response, oxidative stress and endothelial function could be involved in the association between unhealthy eating behaviours and cardiovascular outcomes,鈥� he added.

In this study, statin use before hospital admission was higher in the group with unhealthy eating habits and worse outcome. Dr Minicucci said: 鈥淭here are some controversies regarding eating habits of patients using statins. Our study suggests that patients with STEMI perceive statins as an alternative path to health benefits. But these drugs should be an addition to healthy eating habits, not a replacement.鈥�

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