British Journal of Nutrition

Dietary Surveys and Nutritional Epidemiology

Breakfast frequency inversely associated with BMI and body fatness in Hong Kong Chinese children aged 9–18 years

H. K. Soa1, E. A. S. Nelsona1 c1, Albert M. Lia1, G. S. Guldana2, J. Yina1, P. C. Nga1 and R. Y. T. Sunga1

a1 Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China

a2 Department of Biochemistry and Food and Nutritional Sciences Programme, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, People's Republic of China


The present study assessed the relationship between breakfast frequency and measures of obesity in Hong Kong Chinese children aged 9–18 years. A total of 11 570 children (50 % boys) underwent anthropometric measurements and completed a simple self-administered dietary behaviour questionnaire. Their parents completed a questionnaire providing demographic information. Breakfast frequency was assessed by a single question, ‘How many days over the past week did you have breakfast?’ Children were categorised into three groups: skippers (ate breakfast 0–2 times/week); semi-skippers (ate breakfast 3–4 times/week); non-skippers (ate breakfast 5–7 times/week), to assess all associated characteristics. Of the 3644 primary and 7926 secondary school students, 8 % (8·7 % of boys and 6·9 % of girls) and 14 % (14 % of boys and 15 % of girls), respectively, were breakfast skippers. The prevalence of obesity among breakfast skippers, semi-skippers and non-skippers was, respectively, 9·8, 10·6 and 3·8 % (P < 0·001) for primary school students and 3·9, 3·1 and 2·4 % (P < 0·001) for secondary school students. The 12 % of Hong Kong children aged 9–18 years who skipped breakfast had higher BMI, BMI z-scores and percentage of body fat (PBF) than their counterparts. The dose effects of breakfast frequency (unstandardised regression coefficient, P < 0·001) on BMI and PBF were, respectively, − 0·125 kg/m2 and − 0·219 % for boys and − 0·165 kg/m2 and − 0·353 % for girls, adjusting for physical activity per additional breakfast meal per week. Further study is recommended to elucidate whether regular breakfast consumption may have a role in the prevention of childhood obesity.

(Received June 01 2010)

(Revised January 27 2011)

(Accepted January 27 2011)

(Online publication May 03 2011)


c1 Corresponding author: Professor E. A. S. Nelson, fax +852 26360020, email


Abbreviations: PBF, percentage of body fat