Think twice before running out the door on an empty stomach, says a study of more than 6,500 U.S. adults. The study's findings, recently published in the Journal of the American College of Cardiology, highlight the importance of a well-balanced diet—complete with breakfast—to protect heart health.

Using data from the National Health and Nutrition Examination Survey (NHANES), researchers explored survival rates associated with breakfast consumption. A number of studies suggest that skipping breakfast is associated with conditions like obesity, high cholesterol, diabetes and heart disease. However, evidence is limited especially when it comes to long-term outcomes in the general US population.

To learn more, researchers analyzed data from NHANES—the longest running study on health and lifestyle in the US. The survey study started in the 1970s and now includes a combination of self-reported data and physical examinations.

The recent analysis involved data from 6,550 adults who completed in-person interviews between 1988 and 1994. Interviews included questions about diet and lifestyle, including frequency of breakfast consumption.

Participants were 53 years old on average and were followed through 2011.

Based on interviews, 59% of adults had breakfast every day, while 25% consumed breakfast some days of the week, and 11% rarely ate breakfast. The remaining 5% of participants reported never eating breakfast.

Over the 23-year study period, there were 2,318 deaths—619 of which were from heart disease. Analysis showed that adults who never ate breakfast had 87% greater risk of heart-related death and 19% greater risk of death from any cause compared to those who always consumed breakfast.

According to the authors, findings confirm the link between breakfast consumption and heart health. In this study, skipping breakfast was associated with significantly greater risk of death. This association held true after taking into account factors like physical activity and overall health.

According to authors, findings can’t prove cause and effect. However, it’s possible that eating breakfast could reduce risk of death in US adults. Experts encourage further research to understand the impact of breakfast on cardiovascular health.

It’s estimated that as many as 24% of Americans skip breakfast, despite its reputation as being the most important meal of the day. Experts hope these findings will encourage Americans to make breakfast a priority as part of an overall heart-healthy diet.