Associations of breakfast habits and breakfast quality with depression symptoms: A cross-sectional study based on NHANES 2007-2018

Abstract

Background: Breakfast, often considered the most important meal of the day, affects both physical and mental health. While most studies focused on the effects of skipping breakfast on depression, few explored the roles of breakfast quality and breakfast time. The study aimed to investigate the association of breakfast habits and breakfast quality with depression symptoms.

Methods: This study included 23,839 participants aged 20 and older from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Breakfast habits were assessed using two 24-h dietary recalls, capturing both whether and when breakfast was consumed. Breakfast quality was assessed by calculating the Breakfast Quality Score (BQS). Depression symptoms was diagnosed using the Patient Health Questionnaire (PHQ-9). Binary logistic regression was used to explore the associations.

Results: Compared to participants who did not report breakfast, the ORs of participants who reported breakfast on both one recall and both recalls were 0.737(0.591,0.919) and 0.766(0.624,0.939) for depression symptoms. Compared to participants in the BQS T₁ subgroup, the ORs of participants in the T₂ subgroup and T₃ subgroup were 0.895(0.723,1.108) and 0.716(0.564,0.908) for depression symptoms (P for trend = 0.013). Compared to participants who had breakfast before 8:00 AM, the ORs for depression symptoms were 1.104 (95 % CI: 0.888, 1.371) for those who had breakfast between 8:00-9:00 AM and 1.278 (95 % CI: 1.030, 1.587) for those who had breakfast after 9:00 AM.

Conclusions: Skipping breakfast, low breakfast quality, and late breakfast are independently associated with depression symptoms.

Keywords: Breakfast habits; Breakfast quality; Breakfast time; Depression.