Association of Breakfast Habits at Age 3 With Academic Performance in Elementary School: A Retrospective Population-based Cohort Study.

OBJECTIVE: The long-term relationship between breakfast habits in early childhood and academic performance remains unclear. Therefore, this study aimed to investigate the association between breakfast habits at age 3 years and academic performance in the first grade of elementary school. METHODS: We conducted a retrospective analysis of a population-based cohort in Amagasaki City that followed children from birth until entry into elementary school. Academic outcomes included performance in the national language and math, as well as subdomains within each subject. RESULTS: Among 7847 children, regular breakfast consumption at age 3 years was associated with higher academic performance. Children who ate breakfast daily had higher mean scores in national language (73.12 ± 19.19 vs 66.16 ± 22.33) and math (81.09 ± 19.19 vs 73.31 ± 24.71). In multivariable regression analyses, daily breakfast consumption at age 3 years was modestly associated with higher first-grade academic performance, specifically with overall math scores (β = 2.46, 95% confidence interval [CI]: 0.07-4.85), calculation-related skills (β = 1.94, 95% CI: 0.29-3.59), and language-related skills (β = 1.74, 95% CI: 0.02-3.46). Associations with other domains were not significant. These associations remained significant after adjusting for economic status, suggesting an independent association between early childhood breakfast habits and academic performance. Children who did not eat breakfast daily were more likely to have financial difficulties and irregular lifestyles. CONCLUSION: Regular breakfast consumption during early childhood was associated with higher subsequent academic achievement. However, the observed association may reflect underlying social and environmental factors.