Abstract
BACKGROUND: Concerns about the association between breakfast consumption, lifestyle factors and childhood obesity are increasing. Evidence suggests that regular breakfast intake may play a crucial role in weight management. The present study investigated the association between breakfast frequency, screen time, sleep duration, physical activity, and weight status in schoolchildren. METHODS: A nationwide cross-sectional study was conducted, involving a total sample of 7763 Polish schoolchildren (50.8% girls) aged 10-12 years. Dietary data were collected using the Food Frequency Consumption and Nutritional Knowledge Questionnaire (SF-FFQ4PolishChildren(®)). Trained investigators collected the anthropometric measurements, which were compared to age- and sex-adjusted reference values. Sociodemographic and lifestyle-related data were also collected. Multiple logistic regression analysis was used to examine the association between regular breakfast consumption and weight status, and the mediating effects of lifestyle-related factors confirmed path effects. RESULTS: Approximately two-thirds of the children were daily breakfast consumers (7 d/wk), 24% were breakfast skippers (0-to-3 d/wk), and 14% had irregular breakfast consumption (4-to-6 d/wk). Younger children were more likely to consume breakfast daily than older children (OR = 0.84, 95%CI: 0.74-0.95; p = 0.006). Additionally, children who ate breakfast daily were more physically active than those insufficiently active (OR = 1.16, 95%CI:1.05-1.36; p = 0.039) and had lower odds of being overweight or obese compared to those not eating breakfast daily (OR = 0.73, 95%CI: 0.64-0.83; p < 0.001). Female children were less likely to be daily breakfast eaters compared to males (OR = 0.74, 95%CI: 0,67-0.82; p < 0.001). Children with adequate sleep duration were more likely to eat breakfast daily than those with insufficient sleep (OR = 2.20, 95%CI: 1.85-2.63; p < 0.001). Moreover, children with prolonged screen time (> 4 h/day) had lower odds of regular breakfast intake compared to those with screen time of up to 2 h/day (OR = 0.72, 95%CI: 0.63-0.82; p < 0.001). CONCLUSIONS: Daily frequency of breakfast consumption was associated with more favourable anthropometric outcomes and lower odds of excessive body weight. Maintaining a healthy lifestyle - incorporating physical activity, optimal sleep duration, limited screen time, and shared meals at school and with family - plays an important role in supporting overall health and weight management in school-aged children. Educational and intervention programmes aimed at preventing or treating obesity in schoolchildren should prioritise regular breakfast consumption alongside other lifestyle-related factors.