Abstract
Background: Skipping breakfast, a prevalent issue among children and adolescents, has been reported to be associated with academic performance and long-term health. However, less attention has been given to the types of breakfast foods consumed. Therefore, our study aims to investigate the association between breakfast variety and dietary knowledge, attitude, and practice (KAP) among preadolescents. Methods: The study included 1449 students in grades 4-6 from Zhongshan city, Guangdong province. Data were collected through face-to-face field investigation using a validated questionnaire. The questionnaire encompassed sociodemographic characteristics, as well as dietary KAP. Results: Among all participants, 1315 reported consuming breakfast daily. Dietary diversity varied significantly: 8.8% consumed only 1 type of food, 52.9% consumed 2-4 types, and 38.3% consumed ≥5 types. Students who consumed a greater variety of breakfast foods exhibited more favorable dietary and lifestyle patterns. Specifically, those who consumed ≥5 types of food showed statistically significant associations with healthier practices, including reduced intake of sugary beverages and night snacks, stronger adherence to dietary guidelines, more positive attitudes toward improving eating habits, longer sleep durations, increased participation in meal preparation, greater dish variety in meals, and higher engagement in daily physical activity. Conclusions: Breakfast variety was associated with KAP, particularly when breakfast types ≥ 5, providing more sufficient and favorable evidence for breakfast consumption.