Breakfast skipping in Greek schoolchildren connected to an unhealthy lifestyle profile. Results from the National Action for Children's Health program

Aim The aim of the present study was to examine prevalence and correlates of skipping breakfast in a representative sample of children and adolescents. Methods Cross-sectional, observational study. Population data derived from a school-based health survey carried out in 2015 on 177 091 Greek children aged 8-17 years. Trained investigators performed all anthropometric evaluations. Breakfast skipping and adherence to the Mediterranean diet (MD) was assessed through the Mediterranean Diet Quality Index for children and adolescents. Physical activity status, sedentary activities and sleeping hours were assessed through self-completed questionnaires. Results Almost one in four (22.4% of boys, 23.1% of girls) schoolchildren skipped breakfast. Participants' characteristics associated with skipping breakfast were being female, being older, being overweight/obese, poorer diet, inadequate physical activity levels, insufficient sleep and increased screen time. Regression models adjusted for several potential confounders demonstrated that poor dietary habits, insufficient sleeping status (<8-9 hours per day), and increased screen time (>2 hours per day), increased the odds for skipping breakfast by almost 80% (95% CI: 1.78-1.82), 23% (95% CI: 1.20-1.26) and 22.5% (95% CI: 1.19-1.26), respectively. Conclusions Skipping breakfast was common among schoolchildren. Participants who skipped breakfast tended to have an unhealthy lifestyle profile. Policies designed to increase breakfast consumption should target schoolchildren with unhealthy lifestyle profiles.