Breakfast skipping and exercising before breakfast- association with patterned hair loss

Objectives: Patterned hair loss (PHL) is a type of non-cicatricial alopecia characterized by thinning hair follicles leading progressively to a visible reduction in hair density. Numerous studies have been published showing a relationship between hormones, genetics, inflammation, micronutrients, and PHL. However, so far, no study has been conducted establishing any association between PHL and unhealthy breakfast practices. The study aims to find the prevalence and the association of PHL with unhealthy breakfast practices, including exercise before breakfast. Material and Methods: A cross-sectional study was carried out in 41 patients who complained of hair loss and showed dermoscopic features of 20% variability in hair diameter. A detailed history was obtained, including age, time of waking up, time of the first meal, the content, exercise schedules, meals before exercise, and the type of exercises. Results: Out of the 41 patients of PHL, 35 were taking breakfast after 2 hours of waking up or engaging in rigorous physical activity before a meal or having a light meal (<50 kcal) at least 10 days a month, and these were labelled as having unhealthy breakfast practices. Twenty participants engaged in physical recreational activities before the hair loss started. The metabolic equivalent-hours (MET) calculated from the time of waking to the first meal in the 35 unhealthy diet consumers during the time period starting from the onset of the unhealthy breakfast practices to the onset of hair loss showed that the patients with strong family history had MET of 3630 in comparison with the average of 10123. Limitations: Sample size is small and recall bias can be present. Conclusion: Breakfast skipping has been studied in relation to obesity, cardiovascular complications, increased stress, diabetes, etc. This is the first study to find its association with patterned hair loss.