Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional control

IntroductionBreakfast skipping is common among young people, although previous work has suggested its negative influences on cognitive and executive functions and mental health outcomes. Whether reduced impulse control, particularly in the cognitive domain, would be a mechanism that links breakfast...

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Main Authors: Stephanie Ming Yin Wong, Olivia Choi, Yi Nam Suen, Christy Lai Ming Hui, Edwin Ho Ming Lee, Sherry Kit Wa Chan, Eric Yu Hai Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1574119/full
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author Stephanie Ming Yin Wong
Olivia Choi
Yi Nam Suen
Christy Lai Ming Hui
Edwin Ho Ming Lee
Sherry Kit Wa Chan
Sherry Kit Wa Chan
Eric Yu Hai Chen
Eric Yu Hai Chen
Eric Yu Hai Chen
author_facet Stephanie Ming Yin Wong
Olivia Choi
Yi Nam Suen
Christy Lai Ming Hui
Edwin Ho Ming Lee
Sherry Kit Wa Chan
Sherry Kit Wa Chan
Eric Yu Hai Chen
Eric Yu Hai Chen
Eric Yu Hai Chen
author_sort Stephanie Ming Yin Wong
collection DOAJ
description IntroductionBreakfast skipping is common among young people, although previous work has suggested its negative influences on cognitive and executive functions and mental health outcomes. Whether reduced impulse control, particularly in the cognitive domain, would be a mechanism that links breakfast skipping to elevated psychiatric symptoms remains to be investigated.MethodsWe used data from 3154 young people (aged 15–25 years) in the Hong Kong Youth Epidemiological Study of Mental Health 2019–2022. Participants were asked about their general breakfast consumption habits, impulsivity (overall and its subdomains, using the Barratt Impulsiveness Scale–11), depressive symptoms (Patient Health Questionnaire–9), anxiety symptoms (Generalized Anxiety Disorder Scale–7), and functioning (reduced and lost productivity due to mental health problems, and the observer-rated Social and Occupational Functioning Assessment Scale). Impulsivity and its subdomains were tested for their potential mediating influences between breakfast skipping frequency and symptom outcomes. Sociodemographic variables, psychiatric history, and eating disorder symptoms were adjusted for in all mediation models.ResultsThe weighted prevalence of daily breakfast consumption and breakfast skipping (defined as no breakfast consumption at all) was 33% and 14.2%, respectively. More frequent breakfast skipping was associated with higher levels of impulsivity, specifically in terms of attentional control (r=0.14) and self-control (r=0.13), and depressive symptoms (r=0.14), all p<0.001. Breakfast skipping frequency also showed significant associations with anxiety symptoms and poorer functioning, although their relationships were weak (r range=0.04–0.08). In a parallel mediation model, attentional impulsivity (B=0.21, SE=0.03, CI=0.15–0.27), but not self-control impulsivity (B=0.01, SE=0.01, CI=-0.02–0.03), significantly mediated the relationship between breakfast skipping and depressive symptoms and explained 34.2% of the total effect. All findings remained unchanged even when excluding those who reported rising at 12 pm or after.ConclusionBreakfast skipping is associated with elevated depressive symptoms in young people, with impaired attentional control being an important mechanism in this relationship. Encouraging young people to build regular breakfast habits may be incorporated as part of future lifestyle interventions for mental disorders and be further emphasised in public health policies.
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spelling doaj-art-4cc2ee73233e4d50bfddf7cf2d7e4a722025-08-20T03:53:51ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-05-011610.3389/fpsyt.2025.15741191574119Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional controlStephanie Ming Yin Wong0Olivia Choi1Yi Nam Suen2Christy Lai Ming Hui3Edwin Ho Ming Lee4Sherry Kit Wa Chan5Sherry Kit Wa Chan6Eric Yu Hai Chen7Eric Yu Hai Chen8Eric Yu Hai Chen9Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaSchool of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaThe State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, ChinaDepartment of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, ChinaCentre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, AustraliaOrygen Youth Health, Parkville, VIC, AustraliaIntroductionBreakfast skipping is common among young people, although previous work has suggested its negative influences on cognitive and executive functions and mental health outcomes. Whether reduced impulse control, particularly in the cognitive domain, would be a mechanism that links breakfast skipping to elevated psychiatric symptoms remains to be investigated.MethodsWe used data from 3154 young people (aged 15–25 years) in the Hong Kong Youth Epidemiological Study of Mental Health 2019–2022. Participants were asked about their general breakfast consumption habits, impulsivity (overall and its subdomains, using the Barratt Impulsiveness Scale–11), depressive symptoms (Patient Health Questionnaire–9), anxiety symptoms (Generalized Anxiety Disorder Scale–7), and functioning (reduced and lost productivity due to mental health problems, and the observer-rated Social and Occupational Functioning Assessment Scale). Impulsivity and its subdomains were tested for their potential mediating influences between breakfast skipping frequency and symptom outcomes. Sociodemographic variables, psychiatric history, and eating disorder symptoms were adjusted for in all mediation models.ResultsThe weighted prevalence of daily breakfast consumption and breakfast skipping (defined as no breakfast consumption at all) was 33% and 14.2%, respectively. More frequent breakfast skipping was associated with higher levels of impulsivity, specifically in terms of attentional control (r=0.14) and self-control (r=0.13), and depressive symptoms (r=0.14), all p<0.001. Breakfast skipping frequency also showed significant associations with anxiety symptoms and poorer functioning, although their relationships were weak (r range=0.04–0.08). In a parallel mediation model, attentional impulsivity (B=0.21, SE=0.03, CI=0.15–0.27), but not self-control impulsivity (B=0.01, SE=0.01, CI=-0.02–0.03), significantly mediated the relationship between breakfast skipping and depressive symptoms and explained 34.2% of the total effect. All findings remained unchanged even when excluding those who reported rising at 12 pm or after.ConclusionBreakfast skipping is associated with elevated depressive symptoms in young people, with impaired attentional control being an important mechanism in this relationship. Encouraging young people to build regular breakfast habits may be incorporated as part of future lifestyle interventions for mental disorders and be further emphasised in public health policies.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1574119/fullbreakfast skippingdepressive symptomsanxiety symptomsattentional impulsivityattentional controlyouth mental health
spellingShingle Stephanie Ming Yin Wong
Olivia Choi
Yi Nam Suen
Christy Lai Ming Hui
Edwin Ho Ming Lee
Sherry Kit Wa Chan
Sherry Kit Wa Chan
Eric Yu Hai Chen
Eric Yu Hai Chen
Eric Yu Hai Chen
Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional control
Frontiers in Psychiatry
breakfast skipping
depressive symptoms
anxiety symptoms
attentional impulsivity
attentional control
youth mental health
title Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional control
title_full Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional control
title_fullStr Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional control
title_full_unstemmed Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional control
title_short Breakfast skipping and depressive symptoms in an epidemiological youth sample in Hong Kong: the mediating role of reduced attentional control
title_sort breakfast skipping and depressive symptoms in an epidemiological youth sample in hong kong the mediating role of reduced attentional control
topic breakfast skipping
depressive symptoms
anxiety symptoms
attentional impulsivity
attentional control
youth mental health
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1574119/full
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