Current status and related factors of breakfast skipping among adolescents aged 12–15 years in Shandong Province, China: a cross-sectional study

BACKGROUND: Regular breakfast consumption is essential for adolescent health, providing critical nutrients for growth, development, and cognitive performance. However, breakfast skipping remains prevalent among adolescents globally and has been associated with multiple adverse health and behavioral outcomes. METHODS: A large-scale cross-sectional study was conducted between February and June 2025 using stratified random cluster sampling. A total of 58,762 valid questionnaires were collected from students across 116 primary schools. Data were gathered through structured, anonymous questionnaires addressing breakfast frequency, demographic characteristics, parental factors, and health-related behaviors. Breakfast skipping was defined as eating breakfast fewer than five days per week. Univariable chi-squared tests and multivariable logistic regression analyses were employed to identify significant predictors. RESULTS: Breakfast skipping was significantly associated with six variables. Multivariable logistic regression showed that females had higher odds of skipping breakfast than males (OR = 1.661, 95% CI: 1.527 ~ 1.807). Adolescents living with only one parent (OR = 1.216, 95% CI: 1.131 ~ 1.306) or with neither parent (OR = 1.273, 95% CI: 1.183 ~ 1.371) were also more likely to skip breakfast compared with those living with both parents. In addition, parental breakfast skipping was associated with increased odds of adolescent breakfast skipping (OR = 1.137, 95% CI: 1.067 ~ 1.212). In contrast, higher parental education was associated with lower odds of breakfast skipping (OR = 0.669, 95% CI: 0.613 ~ 0.730). More than five exercise sessions per week (OR = 0.884, 95% CI: 0.786 ~ 0.995) and exercise duration exceeding one hour per session (OR = 0.835, 95% CI: 0.749 ~ 0.931) were similarly protective. CONCLUSION: Breakfast skipping among adolescents in Shandong Province may be influenced by gender, parental behaviors, living arrangements, and physical activity levels. These findings highlight the need for family-centered and gender-sensitive interventions that promote regular breakfast consumption and active lifestyles in youth. Future studies should adopt longitudinal designs to better understand causal relationships.