Eating breakfast is linked with better grades, cognitive performance and diet quality in students; skipping it has been linked with poor mental health — depression, stress, psychological distress and anxiety. Daily breakfast among adolescents has been declining since 2009, according to earlier Youth Risk Behavior Survey (YRBS) analyses. And at the start of the 2022–23 school year, school leaders were under pressure to deal with declining student mental health and to speed learning recovery after the pandemic.
CDC used the 2023 YRBS to ask: how often do high school students eat breakfast, and is skipping it every day linked with persistent sadness or hopelessness, school connectedness and grades? School connectedness had never been studied alongside breakfast before.
The survey
- 20,103 students in grades 9–12, a nationally representative sample from public and private schools in the 50 states and D.C. (the YRBS has run every two years since 1991).
- Skipping breakfast: eating breakfast on 0 of the past 7 days.
- Persistent sadness or hopelessness: in the past 12 months, feeling so sad or hopeless almost every day for 2 weeks or more that they stopped some usual activities.
- School connectedness: agreeing that they feel close to people at school.
- Grades: mostly As or Bs in the past 12 months.
Results were adjusted for sex, race and ethnicity, sexual identity and grade.
How often students ate breakfast
- 27.4% ate breakfast every day of the past week.
- 72.6% missed it at least once; 51.8% ate it on 3 or fewer days.
- 17.9% — about one in six — never ate breakfast that week.
Who skipped it every day:
| Group | Skipped breakfast all 7 days |
|---|---|
| Female | 19.7% |
| Male | 16.2% |
| Hispanic | 20.0% |
| Black | 18.4% |
| Multiracial | 17.9% |
| White | 16.2% |
| Asian | 15.8% |
| American Indian or Alaska Native | 11.1% |
| Bisexual | 25.0% |
| Gay or lesbian | 23.3% |
| Questioning | 20.7% |
| Another identity | 19.1% |
| Heterosexual | 15.8% |
| Grades 9–10 / 11–12 | 17.7% / 17.9% |
Females skipped more than males; Hispanic students more than White or American Indian or Alaska Native students; and gay or lesbian, bisexual and questioning students more than heterosexual students. This is the first nationally representative look at breakfast skipping by sexual identity.
What went with skipping
Compared with students without each characteristic, as adjusted prevalence ratios (above 1: more likely to skip breakfast every day; below 1: less likely):
| Characteristic | Overall | Females | Males |
|---|---|---|---|
| Persistent sadness or hopelessness | 1.51 | 1.64 (64% more likely) | 1.37 (37% more likely) |
| Feeling connected to school | 0.73 (27% less likely) | 0.72 | 0.74 |
| Mostly As or Bs | 0.65 | 0.67 (33% less likely) | 0.63 (37% less likely) |
- Sadness: the link held for most racial and ethnic groups — Asian, Black, White and Hispanic students — but not for American Indian or Alaska Native or multiracial students.
- Connectedness: significant for American Indian or Alaska Native students (86% less likely, ratio 0.14), Black students (0.63) and White students (23% less likely, 0.77).
- Grades: significant for Asian, multiracial and White students, not for Black or Hispanic students.
- Estimates for Native Hawaiian or other Pacific Islander students were too unreliable to report by these measures.
This is also the first national YRBS analysis of school connectedness and a dietary behavior.
Why it matters
Breakfast and poor mental health go together in many adolescents, and together may undermine readiness to learn. The survey cannot tell which drives which — but students struggling with their mental health should be prioritized in efforts to reduce breakfast skipping. The U.S. Surgeon General has also elevated social and school connectedness as ways to improve physical and emotional well-being.
Connectedness could work either way. Feeling connected may bring students to school — and to school breakfast — more often; a welcoming breakfast program that fosters belonging may itself build connectedness. A Canadian study (COMPASS) likewise found that students with higher school connectedness used school breakfast programs more often. Connected students may also differ in other ways, such as playing sports or having better mental health.
What schools can do
At home, breakfast depends on things hard to change — food availability, household income, parents' education, two-parent households and whether parents eat breakfast. Schools are easier to reach: about 90,000 schools and institutions already take part in the U.S. Department of Agriculture's School Breakfast Program (SBP), which serves breakfast at paid, reduced or free prices depending on household income.
- Teach it: standards-based health education on the benefits of daily breakfast — for example, the Food and Nutrition module of CDC's Health Education Curriculum Analysis Tool — while giving students the chance to act on it.
- Offer it: the SBP can help students overcome rushed mornings, low income and food insecurity, with a balanced meal that meets nutrition standards.
- Make it free for all: the Community Preventive Services Task Force recommends Healthy School Meals for All — meals at no cost to every student in a qualifying school, with no application, as a way to advance health equity. Such universal meals were common during the pandemic emergency but became less common when the federal waivers expired in 2022–23, the year these data were collected. That year school breakfast participation fell, and the gap between breakfast and lunch widened, except in states that had adopted Healthy School Meals for All or made wide use of the Community Eligibility Provision (which lets higher-poverty districts or schools offer them). Universal meals are linked with higher breakfast participation and attendance — which matters because students in higher-poverty districts lost more reading and math achievement during the pandemic.
- Change how it is served: breakfast in the classroom or grab-and-go breakfasts have raised participation in high schools. Students can eat after the school day starts, without arriving early, without the stigma of the cafeteria, and with little lost learning time. In the few U.S. high school studies, attendance improved significantly.
Families shape breakfast at home by providing it and eating it themselves, though that is not always logistically or economically possible.
Limitations
- Cross-sectional data cannot show which way the associations run.
- The measures cover different periods (past 7 days, past 12 months) and may be recalled differently.
- School connectedness was measured by one question; some studies treat it as multidimensional.
- Household income could affect breakfast, grades and diet but could not be adjusted for.
- Self-reported grades are a limited measure of academic performance.
- Only how often students ate breakfast was asked — not where (home or school) or what.
Sources
Based on Sliwa SA, Merlo CL, McKinnon II, Self JL, Kissler CJ, Saelee R, Rasberry CN, "Skipping Breakfast and Academic Grades, Persistent Feelings of Sadness or Hopelessness, and School Connectedness Among High School Students — Youth Risk Behavior Survey, United States, 2023," MMWR Supplements, volume 73, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The report's abstract rounds the school-connectedness result to "approximately 30%"; its results give 27%, used here. Its bar chart of breakfast days draws the daily and every-day-skipped bars below the report's stated 27.4% and 17.9%, so it is not reproduced.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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