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Nutrition and Health (including climate and ecological aspects)

Weekday sleep duration and morning tiredness are independent covariates of breakfast skipping in adolescents



Although regular breakfast consumption is associated with various health benefits, many adolescents skip this meal, particularly those with shorter sleep durations. In order to better understand the association between sleep duration and breakfast consumption among youth, we analyzed the association between weekday morning tiredness and daily breakfast consumption in adolescents, and explored the mediating role of morning tiredness in the association between sleep duration and daily breakfast consumption on weekdays.


The “Health Behaviour in School-aged Children” survey conducted in 2018 in French-speaking Belgian schools provided data (n = 8444 11–20-year-old adolescents) on bed- and wake-up times, and on the frequency of breakfast consumption and morning tiredness on weekdays. Multivariable logistic regressions and mediation analyses assessed the association, on weekdays, of morning tiredness (≥4 school mornings a week vs. less) and sleep duration (hours), with daily breakfast consumption, and the mediating role of morning tiredness.


Feeling tired ≥4 school mornings a week was associated with lower odds of daily breakfast consumption on weekdays (aOR = 0.77 (95% CI 0.69–0.86)). In turn, on weekdays, sleep duration was positively associated with daily breakfast consumption (aOR = 1.29 (95% CI 1.23–1.36)), even after adjustment for morning tiredness (aOR = 1.28 (95% CI 1.21–1.35)). Morning tiredness only explained 4.9% of the association between sleep duration and daily breakfast consumption.


Our findings suggest that in adolescents, sleep duration and morning tiredness are independent correlates of daily breakfast consumption on weekdays.

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Fig. 1: Flow chart of inclusion in analyses.
Fig. 2: Mediation model with weekday morning tiredness as a mediator of the relationship between sleep duration and breakfast consumption on weekdays.

Data availability

Data and code used in this study are available on request to the principal investigators.


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The authors thank the schools and students for their participation in the French-speaking Belgian Health Behaviour in School-aged Children (HBSC) survey. They also thank the HBSC international coordination center (University of St Andrews, United Kingdom) and the HBSC data management center (University of Bergen, Norway) for their scientific support, as well as Amélie Bellanger, Omer Cimpaye, Véronique Desnouck, Morgane Eggen, Estelle Méroc and Nathalie Moreau (SIPES, Université libre de Bruxelles, Belgium) for their collaboration in data collection, cleaning and management.


This research was funded by the Birth and Children Office (ONE), the Walloon Region, and the French Community Commission.

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Authors and Affiliations



TL contributed to the data collection, conceptualized the study, determined the methodology used, conducted the analyses and wrote the original draft. KC conceptualized the study, validated the methodology used, reviewed and edited the draft. CP and MD contributed to the data collection, reviewed and edited the draft. EH reviewed and edited the draft. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Thérésa Lebacq.

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The authors declare no competing interests.

Ethical approval

The 2018 HBSC survey was approved by the Ethics Review Committee of the Faculty of Psychology (Université libre de Bruxelles, ULB) and the regional education boards of the school networks. The adolescents and their parents were fully informed about the study requirements. Students could refuse to complete the questionnaire without any formal procedure. Parents could refuse their child’s participation by filling in a form provided together with the information documents.

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Lebacq, T., Holmberg, E., Pedroni, C. et al. Weekday sleep duration and morning tiredness are independent covariates of breakfast skipping in adolescents. Eur J Clin Nutr (2022).

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