Breakfast at 8 am and dinner at 8 pm! A tall order for those with busy work days but a mantra for staving off cardiovascular diseases, say doctors who cite a recent study to stress the importance of early, regular and well-spaced meals.

A study led by the Université Sorbonne Paris Nord in France lays out the association between meal timings and the risk of cardiovascular disease (CVD), a finding of particular interest to India.

According to the Global Burden of Disease study in 2020, India has a cardiovascular death rate of 272 per one lakh population, much higher than that of global average of 235.

CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions.

The French study, published in the journal Nature Communications, found that eating the first and last meals of the day early along with a longer period of night-time fasting could reduce the risk of cardiovascular diseases. It is the leading cause of mortality in the world with 18.6 million annual deaths in 2019, of which around 7.9 are attributable to diet.

The findings, which need to be replicated in other cohorts and through additional scientific studies with different designs, highlight a potential role for meal timing in preventing cardiovascular disease, according to the researchers. While the study wasn't conducted specifically in India, Abhinit Gupta, consultant cardiologist at Regency Hospital in Kanpur, Uttar Pradesh, said its findings may have implications for the population given the increasing burden of cardiovascular diseases in the country.

"As a doctor, I would advise people in India to be mindful of their meal timings and adopt a balanced approach to nutrition," Gupta told PTI.

"While individual dietary needs may vary, it's important to emphasise regular, well-spaced meals and avoid heavy meals close to bedtime.

“This advice aligns with established principles of maintaining a healthy lifestyle, which includes a well-balanced diet, regular physical activity, and other factors that contribute to cardiovascular well-being," he added.

Adhering to the wisdom of timely meals, especially in the evening, has now gained scientific validation for its role in preventing cardiovascular issues, said Vijay Kumar, senior consultant interventional cardiologist at Delhi’s Ujala Cygnus Group of Hospitals The French study had noted that in addition to light, the daily cycle of food intake (meals, snacks, etc.) alternating with periods of fasting synchronises the circadian rhythms of the body's various organs, influencing cardiometabolic functions such as blood pressure regulation.

Circadian rhythm is our body's internal clock that orchestrates physiological functions throughout the day.

The study used data from 103,389 (over one lakh) participants, 79 per cent of whom were women, with an average age of 42.

The results show that having the first meal later in the day, such as when skipping breakfast, is associated with a higher risk of cardiovascular disease, with a 6 per cent increase in risk per hour delay.

For example, a person who eats for the first time at 9 am is 6 per cent more likely to develop cardiovascular disease than someone who eats at 8 am, the researchers said.

Eating late (after 9 pm) is associated with a 28 per cent increase in the risk of cerebrovascular disease such as stroke compared with eating before 8 p.m., particularly in women, they said.

The study also shows that a longer duration of night-time fasting -- the time between the last meal of the day and the first meal of the following day -- is associated with a reduced risk of cerebrovascular disease, supporting the idea of eating one's first and last meals earlier in the day.

According to a 2020 report by the World Health Organisation, India accounts for one-fifth of the total 17.7 million deaths worldwide due to cardiovascular diseases, especially in the younger population.

"The latest study underscores the critical impact of diet on the development and progression of these diseases. Encouraging individuals to consume their initial and concluding meals earlier, thereby incorporating an extended period of night time fasting, emerges as a strategic approach to mitigate cardiovascular risks," Kumar told PTI.

"This practice not only promotes heart health but has also shown promise in averting heart attacks," he added.

Shedding light on the possible reasons behind this association, V Rajasekhar, senior consultant interventional cardiology and electrophysiology at Hyderabad’s Yashoda Hospitals, noted that early meals may foster improved insulin sensitivity and reduced inflammation, crucial elements in maintaining heart health.

"By regulating blood sugar levels more effectively, early eating could alleviate strain on the cardiovascular system over time," Rajasekhar told PTI.

"Beyond the biological aspects, the timing of meals may also influence sleep quality, indirectly impacting heart health," he added.

An earlier study published in the American Journal of Clinical Nutrition unveiled a compelling link between early eating habits and a diminished risk of developing cardiovascular issues.

This correlation persisted even after accounting for influential factors such as sleep duration, physical activity, and overall diet quality.

"Evidence suggests that aligning meal times with the natural rhythms could enhance the body's ability to process nutrients efficiently and manage energy, potentially reducing the risk of cardiovascular disease," Rajasekhar said.

"As dietary patterns continue to be recognised as powerful contributors to heart health, adopting these practices becomes instrumental in fostering overall well-being and longevity," Kumar added.

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