Association of Breakfast Consumption Frequency with Depression and Anxiety Symptoms Among School Students: A Cross-Sectional Study in Eastern China

<b>Objective</b>: This study aimed to explore the relationship between breakfast consumption frequency and both depression and anxiety symptoms among middle and high school students in Eastern China. <b>Methods</b>: In this school-based cross-sectional study, 27,001 middle and high school students were investigated in 2022. Multivariable logistic regression models were used to examine the relationship between breakfast consumption frequency and both depression and anxiety symptoms. <b>Results</b>: The percentages of students who consumed breakfast daily, 6 days/week, 4-5 days/week, and ≤3 days/week were 71.0% (95%CI: 69.9-72.2), 8.3% (95%CI: 7.8-8.6), 11.9% (95%CI: 11.2-12.6), and 8.8% (95%CI: 8.2-9.5), respectively. After adjusting for socio-demographic and lifestyle factors, academic performance, self-reported health, and bullying victimization, compared to those consuming breakfast daily, the odds ratios (95%CI) for depression symptoms were 1.32 (1.15-1.52) for those consuming breakfast 6 days/week, 1.66 (1.49-1.84) for those consuming breakfast 4-5 days/week, and 1.74 (1.54-1.97) for those consuming breakfast ≤3 days/week, respectively (<i>p</i> < 0.001). The corresponding figures for anxiety symptoms were 1.31 (1.14-1.51), 1.35 (1.20-1.52), and 1.43 (1.23-1.66), respectively (<i>p</i> < 0.001). <b>Conclusions</b>: Breakfast skipping is common among middle and high school students in Eastern China. The frequency of breakfast consumption is inversely associated with both depression symptoms and anxiety symptoms among adolescents.