Public Health Nutrition

Assessment and methodology

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

Celia Monteagudoa1, Alba Palacín-Arcea1, Maria del Mar Bibilonia2, Antoni Ponsa2, Josep A Tura2, Fatima Olea-Serranoa1 c1 and Miguel Mariscal-Arcasa1

a1 Department of Nutrition and Food Science, University of Granada, Campus de Cartuja s/n, E-18071 Granada, Spain

a2 Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands, Palma de Mallorca, Spain


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.

(Received January 02 2012)

(Revised May 02 2012)

(Accepted May 15 2012)

(Online publication July 05 2012)


  • Breakfast;
  • Breakfast Quality Index (BQI);
  • Children;
  • Adolescents


c1 Corresponding author: Email