Association Between Breakfast Frequency, Forced Vital Capacity, and Psychological Symptoms: A Cross-Sectional Study of Chinese Adolescents

Abstract This cross-sectional study examined the independent and combined associations of breakfast frequency, forced vital capacity (FVC) and psychological symptoms among Chinese adolescents. A total of 2776 adolescents aged 12-17 years were recruited from three regions of Anhui Province using stratified cluster random sampling. Breakfast frequency was self-reported as days per week over the past month and categorised as low, medium or high. FVC was measured with a standardised electronic spirometer (CSTF-FH) following CNSSCH protocols. Psychological symptoms were assessed using the Multidimensional Subhealth Assessment Questionnaire for Adolescents (MSQA) and dichotomised according to established cut-offs. Covariates included age, height, weight, grip strength, standing long jump, sleep duration and parental education. Binary logistic regression was used, building three models. The overall prevalence of psychological symptoms was 14%. Breakfast frequency was inversely correlated with psychological symptoms ( P < 0.001). Low breakfast frequency (1-2 d/week) was associated with a higher symptom rate (31%) than high frequency (5-7 d/week, 12%) and increased odds of symptoms ( OR = 3.34, 95% CI 2.04–5.60). No independent association was found between FVC and psychological symptoms. However, adolescents with both low breakfast frequency and low FVC had 4.10 times higher odds of psychological symptoms ( 95% CI 1.83–9.21, P < 0.001) than those with high breakfast frequency and high FVC. These findings suggest that low breakfast frequency is a robust correlate of psychological symptoms in adolescents, and that the combination of low breakfast frequency with low FVC identifies a particularly high-risk group.