Proposal for a Breakfast Quality Index (BQI) for children and adolescents

Objective: To propose and apply an instrument to assess the breakfast quality of children and adolescents in the Mediterranean area. Design: Randomized, cross-sectional survey of breakfast consumption using a validated semi-quantitative FFQ administered at school by trained dietitians between Tuesday and Friday. A Breakfast Quality Index (BQI) score was developed, assigning a positive value to the consumption of cereals, fruit, vegetables, dairy products, MUFA, Ca and compliance with energy recommendations, and to the absence of SFA and trans-rich fats. Data were analysed by Student's t test and ANOVA. Setting: Schools in Granada and Balearic Islands (Spain). Subjects: All schoolchildren (n 4332) aged 8-17 years at randomly selected and representative schools between 2006 and 2008, stratified by age and sex. Results: Breakfast was not consumed by 6.5% of participants. BQI score was highest for children aged 7-9 years and decreased with age (P = 0.001). Females scored higher in all age groups. The lowest score was in males aged 14-17 years and the highest in females aged 7-9 years (P = 0.006). Conclusions: The proposed BQI appears useful to estimate the breakfast quality of schoolchildren and to form a basis for nutrition education.