The most important meal of the day: daily breakfast consumption patterns in European adolescents

By Tarun Sai LomteReviewed by Danielle Ellis, B.Sc.May 26 2023

A recent study published in Nutrients examined daily breakfast consumption (DBC) patterns in adolescents from 23 European countries.

Background

Breakfast is vital for a healthy diet. Most age groups eat regular breakfasts, except adolescents. Breakfast consumption in adolescents and children is inversely associated with body mass index. Evidence suggests that breakfast consumption reduces the intake of snacks and energy-rich foods. Despite benefits, surveys report that many adolescents and children do not regularly eat breakfast.

The health behavior in school-aged children (HBSC) survey in 2018 identified significant differences in DBC between boys and girls. Further, a 2015-18 survey in the United States (US) revealed that 14% and 27% of persons aged 6-11 and 12-18 did not eat breakfast, respectively. Other studies report increased skipping of breakfast among US adolescents over the past decades.

Breakfast consumption could be influenced by socioeconomic status, sex, family structure, and ethnicity. For example, adolescents from families with low socioeconomic status are more likely to have irregular breakfast patterns. Data on demographic and social determinants of DBC in adolescents and children can help identify those requiring interventions and to plan for initiatives promoting DBC.

About the study

In the present study, researchers identified sociodemographic determinants of DBC and explored DBC trends in adolescents from 23 countries. They collected data from five HBSC surveys from 2002 to 2018 conducted among students aged 11, 13, or 15. Students completed a standardized questionnaire. Students indicated the number of days they consumed breakfast on school days and weekends.

The family affluence scale (FAS) was used to determine the socioeconomic status of students. The FAS score was stratified into low, medium, and high affluence based on responses to four questions. Students reported the number of vehicles (car, van, or truck) and computers their families had and the frequency of vacations in the past year. They also reported if they had a separate bedroom.

Family structure was classified as living with a single parent, both parents or others. Countries were included for analysis if data were available for five survey cycles. The researchers performed multi-level logistic regression for each country, with DBC as the binary outcome variable and family structure, affluence, and survey year as independent variables.

Findings

The researchers included data on 589,737 adolescents. Most adolescents (51.2%) were girls. DBC ranged from 72% in the Netherlands to 38% in Slovenia. No Northern or Central European country had a DBC frequency below 50%. The proportion of students from high-affluence households ranged between 7.9% in Ukraine and 60% in Norway.

The proportion of those from medium-affluence households ranged between 36% in Norway and 56.6% in Spain. Similarly, the proportion of students from low-affluence families ranged between 3.5% in Norway and 44.6% in Ukraine. Students living with both parents ranged from 55.5% in Russia to 86.9% in Macedonia. For those living with a single parent, the proportion ranged between 8.6% in Macedonia and 29.4% in Scotland.

Females reported an increased skipping of breakfasts than males. DBC in the high-affluence group ranged between 37.3% in Slovenia and 72.7% in the Netherlands. DBC in the medium-affluence group ranged from around 34% in Slovenia to 65% in Portugal. For the low-affluence group, it ranged from 31.3% in Slovenia and 61% in the Netherlands.

DBC was associated with being an adolescent from high affluence families in 19 countries. There was no correlation between family affluence and DBC in Latvia and Russia. Adolescents living with both parents were more likely to have DBC than those living with a single parent. DBC for adolescents living with others ranged from 34% in Slovenia and 65% in the Netherlands.

DBC was associated with being an adolescent living with both parents. DBC was lower in 2018 than in 2002, with a significant decline in 17 countries. However, Macedonia and the Netherlands had higher DBC in 2018 compared to 2002. DBC in 2018 was similar to 2002 estimates for adolescents from four countries.

Conclusions

Taken together, the trend in DBC was downward in most countries. DBC was higher among boys compared to girls. Adolescents from high-affluence families had a higher frequency of DBC in most countries, and those living with both parents also had a higher DBC frequency in all countries. Overall, the findings highlight the need for strategies to encourage and improve DBC.