Breakfast irregularity among Brazilian adolescents: coexistence with other risk behaviors and associated factors

Abstract Objective To assess the prevalence of breakfast irregularity among Brazilian adolescents and its co-occurrence with other risk behaviors. Methods Cross-sectional study based on data from the National School Health Survey, 2019. Breakfast irregularity (≤4 days/week) was the dependent variable, whose co-occurrence with excessive screen time (>3h/day), regular consumption of sugar-rich foods (≥5 days/week), and irregular consumption of fruit, greenery, and beans (FV - ≤4 days/week) was investigated. The Chi-Square and Multiple Logistic Regression tests were used to analyze the factors associated with breakfast irregularity and its co-occurrence (p<0.05). Results Approximately 40.7% of adolescents reported breakfast irregularity. The four risk behaviors coexisted in 8.1% of students, with 86.0% higher likelihood of co-occurrence among girls. The most frequent combination of three risk behaviors included excessive screen time, irregular fruit and greenery consumption, and irregular breakfast (8.9%). Conclusion Four in every ten adolescents ate breakfast irregularly, with a marked coexistence with other risky behaviors, especially among girls. It is, therefore, essential to encourage, propose, and implement intervention strategies based on multicomponent approaches, with multi-professional and intersectoral support, to achieve greater effectiveness.