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Thesis Format



Master of Science


Epidemiology and Biostatistics


Seabrook, Jamie

2nd Supervisor

Stranges, Saverio



BACKGROUND: Breakfast skipping has previously been associated with worse diet quality among adolescents, although research from Canada is relatively sparse. Additionally, many studies do not consider diet quality as a function of calories, which is problematic as skippers tend to consume less energy than consumers.

PURPOSE: This study investigated breakfast skipping habits and Healthy Eating Index-2015 scores among teens in Southwestern Ontario.

METHODS: Cross-sectional, baseline data were used from the SmartAPPetite project, which is currently ongoing. 24-hour dietary recalls and sociodemographic information were obtained from participants and parents (n=512).

RESULTS: Breakfast skippers had significantly lower diet quality, even when calories were controlled for, though the differences were relatively small. On average, both skippers and consumers had poor diet quality.

CONCLUSION: While breakfast may appear to be an attractive meal to intervene upon to improve diet quality, consumption alone is not likely to meaningfully improve diet quality among teens.

Summary for Lay Audience

Breakfast has been heralded as being the most important meal of the day, yet breakfast skipping among teens is a common phenomenon. Past research has largely found that teens who consume breakfast tend to have better diet quality, though much of this research comes from outside of Canada. Additionally, teens who eat breakfast tend to consume more calories, giving them an inherent advantage in consuming enough nutrients, when compared to skippers. This study sought to investigate the importance of breakfast among teens in Southwestern Ontario, by comparing the diet quality (on a per-calorie basis) of those who skip breakfast to those who consume breakfast.

512 teens recruited from secondary schools in Southwestern Ontario completed a 24-hour dietary recall. Teens who consumed breakfast tended to have better diet quality than those who skipped breakfast, but the difference was relatively minimal. Importantly, even among those who consumed breakfast, average diet quality was quite poor, suggesting that breakfast is likely not enough to meaningfully improve diet quality, compared to those who skipped. This study, coupled with previous literature, suggests that simply advising teens to consume breakfast is likely not a sufficient strategy to improve overall diet quality, and if breakfast is truly the most important meal of the day, then more importance should be placed on the quality of breakfast, rather than simply the consumption of it. Initiatives such as a federally funded breakfast program represent one method of accessibility of a nutritious breakfast for teens, though participation in these programs can be quite varied. As such, it is important to address barriers to nutritious breakfasts while pursuing other avenues in improving teens’ diet quality, with the eventual goal of reducing the long-term risk for chronic diseases.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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