Skip to main content Accessibility help

An eating pattern characterised by skipped or delayed breakfast is associated with mood disorders among an Australian adult cohort

  • J. E. Wilson (a1), L. Blizzard (a1), S. L. Gall (a1), C. G. Magnussen (a1) (a2), W. H. Oddy (a1), T. Dwyer (a3), K. Sanderson (a1) (a4), A. J. Venn (a1) and K. J. Smith (a1)...



Meal timing may influence food choices, neurobiology and psychological states. Our exploratory study examined if time-of-day eating patterns were associated with mood disorders among adults.


During 2004–2006 (age 26–36 years) and 2009–2011 (follow-up, age 31–41 years), N = 1304 participants reported 24-h food and beverage intake. Time-of-day eating patterns were derived by principal components analysis. At follow-up, the Composite International Diagnostic Interview measured lifetime mood disorder. Log binomial and adjacent categories log-link regression were used to examine bidirectional associations between eating patterns and mood disorder. Covariates included sex, age, marital status, social support, education, work schedule, body mass index and smoking.


Three patterns were derived at each time-point: Grazing (intake spread across the day), Traditional (highest intakes reflected breakfast, lunch and dinner), and Late (skipped/delayed breakfast with higher evening intakes). Compared to those in the lowest third of the respective pattern at baseline and follow-up, during the 5-year follow-up, those in the highest third of the Late pattern at both time-points had a higher prevalence of mood disorder [prevalence ratio (PR) = 2.04; 95% confidence interval (CI) 1.20–3.48], and those in the highest third of the Traditional pattern at both time-points had a lower prevalence of first onset mood disorder (PR = 0.31; 95% CI 0.11–0.87). Participants who experienced a mood disorder during follow-up had a 1.07 higher relative risk of being in a higher Late pattern score category at follow-up than those without mood disorder (95% CI 1.00–1.14).


Non-traditional eating patterns, particularly skipped or delayed breakfast, may be associated with mood disorders.


Corresponding author

Author for correspondence: K. J. Smith, E-mail:


Hide All
Allison, KC, Ahima, RS, O'Reardon, JP, Dinges, DF, Sharma, V, Cummings, DE, Heo, M, Martino, NS and Stunkard, AJ (2005) Neuroendocrine profiles associated with energy intake, sleep, and stress in the night eating syndrome. The Journal of Clinical Endocrinology & Metabolism 90, 62146217.
American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th Edn, text rev. Washington: American Psychiatric Association.
Antypa, N, Vogelzangs, N, Meesters, Y, Schoevers, R and Penninx, BW (2016) Chronotype associations with depression and anxiety disorders in a large cohort study. Depression and Anxiety 33, 7583.
Asher, G and Sassone-Corsi, P (2015) Time for food: the intimate interplay between nutrition, metabolism, and the circadian clock. Cell 161, 8492.
Au, J and Reece, J (2017) The relationship between chronotype and depressive symptoms: a meta-analysis. Journal of Affective Disorders 218, 93104.
Begdache, L, Chaar, M, Sabounchi, N and Kianmehr, H (2017) Assessment of dietary factors, dietary practices and exercise on mental distress in young adults versus matured adults: a cross-sectional study. Nutritional Neuroscience. Available at (Accessed 10 January 2019).
Blizzard, CL, Quinn, SJ, Canary, JD and Hosmer, DW (2013) Log-link regression models for ordinal responses. Open Journal of Statistics 3, 1625.
Cardi, V, Leppanen, J and Treasure, J (2015) The effects of negative and positive mood induction on eating behaviour: a meta-analysis of laboratory studies in the healthy population and eating and weight disorders. Neuroscience and Biobehavioral Reviews 57, 299309.
Craig, CL, Marshall, AL, Sjöström, M, Bauman, AE, Booth, ML, Ainsworth, BE, Pratt, M, Ekelund, U, Yngve, A and Sallis, JF (2003) International physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports and Exercise 35, 13811395.
Drennan, MD, Klauber, MR, Kripke, DF and Goyette, LM (1991) The effects of depression and age on the Horne-Ostberg morningness-eveningness score. Journal of Affective Disorders 23, 9398.
Farhangi, MA, Dehghan, P and Jahangiry, L (2018) Mental health problems in relation to eating behavior patterns, nutrient intakes and health related quality of life among Iranian female adolescents. PLoS ONE 13, e0195669.
Fulkerson, JA, Sherwood, NE, Perry, CL, Neumark-Sztainer, D and Story, M (2004) Depressive symptoms and adolescent eating and health behaviors: a multifaceted view in a population-based sample. Preventive Medicine 38, 865875.
Furihata, R, Konno, C, Suzuki, M, Takahashi, S, Kaneita, Y, Ohida, T and Uchiyama, M (2018) Unhealthy lifestyle factors and depressive symptoms: a Japanese general adult population survey. Journal of Affective Disorders 234, 156161.
Gall, SL, Jose, K, Smith, K, Dwyer, T and Venn, A (2009) The Childhood Determinants of Adult Health Study: a profile of a cohort study to examine the childhood influences on adult cardiovascular health. Australasian Epidemiologist 16, 3539.
Gall, SL, Sanderson, K, Smith, KJ, Patton, G, Dwyer, T and Venn, A (2016) Bi-directional associations between healthy lifestyles and mood disorders in young adults: the Childhood Determinants of Adult Health Study. Psychological Medicine 46, 25352548.
Gill, S and Panda, S (2015) A smartphone app reveals erratic diurnal eating patterns in humans that can be modulated for health benefits. Cell Metabolism 22, 789798.
Greenland, S (1989) Modeling and variable selection in epidemiologic analysis. American Journal of Public Health 79, 340349.
Henderson, S, Duncan-Jones, P, McAuley, H and Ritchie, K (1978) The patient's primary group. The British Journal of Psychiatry 132, 7486.
Hidalgo, MP, Caumo, W, Posser, M, Coccaro, SB, Camozzato, AL and Chaves, MLF (2009) Relationship between depressive mood and chronotype in healthy subjects. Psychiatry and Clinical Neurosciences 63, 283290.
Hodge, A, Patterson, AJ, Brown, WJ, Ireland, P and Giles, G (2000) The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation. Australian and New Zealand Journal of Public Health 24, 576583.
Horikawa, C, Kodama, S, Yachi, Y, Heianza, Y, Hirasawa, R, Ibe, Y, Saito, K, Shimano, H, Yamada, N and Sone, H (2011) Skipping breakfast and prevalence of overweight and obesity in Asian and Pacific regions: a meta-analysis. Preventive Medicine 53, 260267.
Huang, C, Momma, H, Cui, Y, Chujo, M, Otomo, A, Sugiyama, S, Ren, Z, Niu, K and Nagatomi, R (2017) Independent and combined relationship of habitual unhealthy eating behaviors with depressive symptoms: a prospective study. Journal of Epidemiology 27, 4247.
Kim, S, DeRoo, LA and Sandler, DP (2011) Eating patterns and nutritional characteristics associated with sleep duration. Public Health Nutrition 14, 889895.
Kluge, M, Schüssler, P, Dresler, M, Schmidt, D, Yassouridis, A, Uhr, M and Steiger, A (2011) Effects of ghrelin on psychopathology, sleep and secretion of cortisol and growth hormone in patients with major depression. Journal of Psychiatric Research 45, 421426.
Kwak, Y and Kim, Y (2018) Association between mental health and meal patterns among elderly Koreans. Geriatrics and Gerontology International 18, 161168.
Landis, JR and Koch, GG (1977) The measurement of observer agreement for categorical data. Biometrics 33, 159174.
Lang, UE, Beglinger, C, Schweinfurth, N, Walter, M and Borgwardt, S (2015) Nutritional aspects of depression. Cellular Physiology and Biochemistry 37, 10291043.
Lee, G, Han, K and Kim, H (2017a) Risk of mental health problems in adolescents skipping meals: the Korean National Health and Nutrition Examination Survey 2010 to 2012. Nursing Outlook 65, 411419.
Lee, SA, Park, EC, Ju, YJ, Lee, TH, Han, E and Kim, TH (2017b) Breakfast consumption and depressive mood: a focus on socioeconomic status. Appetite 114, 313319.
Leech, RM, Worsley, A, Timperio, A and McNaughton, SA (2015) Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality. Nutrition Research Reviews 28, 121.
Leech, RM, Timperio, A, Worsley, A and McNaughton, SA (2019) Eating patterns of Australian adults: associations with blood pressure and hypertension prevalence. European Journal of Nutrition 58, 18991909.
Levandovski, R, Dantas, G, Fernandes, LC, Caumo, W, Torres, I, Roenneberg, T, Hidalgo, MPL and Allebrandt, KV (2011) Depression scores associate with chronotype and social jetlag in a rural population. Chronobiology International 28, 771778.
Lien, L (2007) Is breakfast consumption related to mental distress and academic performance in adolescents? Public Health Nutrition 10, 422428.
Lopresti, AL, Hood, SD and Drummond, PD (2013) A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. Journal of Affective Disorders 148, 1227.
Lowden, A, Moreno, C, Holmbäck, U, Lennernäs, M and Tucker, P (2010) Eating and shift work – effects on habits, metabolism, and performance. Scandinavian Journal of Work, Environment and Health 36, 150162.
Lutter, M, Sakata, I, Osborne-Lawrence, S, Rovinsky, SA, Anderson, JG, Jung, S, Birnbaum, S, Yanagisawa, M, Elmquist, JK, Nestler, EJ and Zigman, JM (2008) The orexigenic hormone ghrelin defends against depressive symptoms of chronic stress. Nature Neuroscience 11, 752.
Mattson, MP (2005) Energy intake, meal frequency, and health: a neurobiological perspective*. Annual Review of Nutrition 25, 237260.
McLennan, W and Podger, AS (1998) National Nutrition Survey Users’ Guide, 1995. Canberra: Australian Bureau of Statistics.
Meule, A, Roeser, K, Randler, C and Kübler, A (2012) Skipping breakfast: morningness-eveningness preference is differentially related to state and trait food cravings. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity 17, e304e308.
O'Sullivan, TA, Robinson, M, Kendall, GE, Miller, M, Jacoby, P, Silburn, SR and Oddy, WH (2009) A good-quality breakfast is associated with better mental health in adolescence. Public Health Nutrition 12, 249258.
Poslusna, K, Ruprich, J, de Vries, JHM, Jakubikova, M and van't Veer, P (2009) Misreporting of energy and micronutrient intake estimated by food records and 24 h recalls, control and adjustment methods in practice. British Journal of Nutrition 101, S73S85.
Roßbach, S, Diederichs, T, Nöthlings, U, Buyken, AE and Alexy, U (2018) Relevance of chronotype for eating patterns in adolescents. Chronobiology International 35, 336347.
Seaman, SR, White, IR, Copas, AJ and Li, L (2012) Combining multiple imputation and inverse-probability weighting. Biometrics 68, 129137.
Smith, AP (1998) Breakfast and mental health. International Journal of Food Sciences and Nutrition 49, 397402.
Smith, KJ, Gall, SL, McNaughton, SA, Blizzard, L, Dwyer, T and Venn, AJ (2010) Skipping breakfast: longitudinal associations with cardiometabolic risk factors in the Childhood Determinants of Adult Health Study. American Journal of Clinical Nutrition 92, 13161325.
Smith, KJ, Gall, SL, McNaughton, SA, Cleland, VJ, Otahal, P, Dwyer, T and Venn, AJ (2017) Lifestyle behaviours associated with 5-year weight gain in a prospective cohort of Australian adults aged 26–36 years at baseline. BMC Public Health 17, 54.
Steel, Z, Marnane, C, Iranpour, C, Chey, T, Jackson, JW, Patel, V and Silove, D (2014) The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. International Journal of Epidemiology 43, 476493.
Stunkard, AJ, Faith, MS and Allison, KC (2003) Depression and obesity. Biological Psychiatry 54, 330337.
Szajewska, H and Ruszczynski, M (2010) Systematic review demonstrating that breakfast consumption influences body weight outcomes in children and adolescents in Europe. Critical Reviews in Food Science and Nutrition 50, 113119.
Tahara, Y and Shibata, S (2013) Chronobiology and nutrition. Neuroscience 253, 7888.
Wilson, JE, Blizzard, L, Gall, SL, Magnussen, CG, Oddy, WH, Dwyer, T, Venn, AJ and Smith, KJ (2019) An age-and sex-specific dietary guidelines index is a valid measure of diet quality in an Australian cohort during youth and adulthood. Nutrition Research 65, 4353.
Witbracht, M, Keim, NL, Forester, S, Widaman, A and Laugero, K (2015) Female breakfast skippers display a disrupted cortisol rhythm and elevated blood pressure. Physiology and Behavior 140, 215221.
Wittchen, HU (1994) Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. Journal of Psychiatric Research 28, 5784.
Wittmann, M, Dinich, J, Merrow, M and Roenneberg, T (2006) Social jetlag: misalignment of biological and social time. Chronobiology International 23, 497509.
World Health Organization (1997) Composite International Diagnostic Interview, CIDI-Auto 2.1: Administrator's Guide and Reference. Geneva: World Health Organization.
World Health Organization (2017) Depression and Other Common Mental Disorders: Global Health Estimates. Geneva: World Health Organization.


Type Description Title
Supplementary materials

Wilson et al. supplementary material
Wilson et al. supplementary material

 PDF (287 KB)
287 KB

An eating pattern characterised by skipped or delayed breakfast is associated with mood disorders among an Australian adult cohort

  • J. E. Wilson (a1), L. Blizzard (a1), S. L. Gall (a1), C. G. Magnussen (a1) (a2), W. H. Oddy (a1), T. Dwyer (a3), K. Sanderson (a1) (a4), A. J. Venn (a1) and K. J. Smith (a1)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed