According to the Healthy Eating Council of the United Kingdom, breakfast is a vital meal that should not be omitted¹. It is formally defined as 'the first meal of the day, that breaks the fast after the extended period of sleep, is consumed within 2 to 3 hours of waking, comprises food and beverages from at least one food group, and may be consumed in any location'². The significance of breakfast lies in its capacity to provide between 20% and 25% of the total daily energy intake required to support morning activities^1,2.

Consuming a high-quality breakfast provides significant health benefits, including improved weight management, better regulation of daily caloric intake, the promotion of healthy routines, a more balanced nutritional profile, increased satiety, and optimal performance during daily activities^3,4. Conversely, extending the overnight fasting period may reduce morning insulin and glucose levels, thereby inducing physiological stress. In the long term, this metabolic disruption can impair cognitive functions—such as attention and short-term memory—and increase the risk of weight gain, cardiovascular diseases, dyslipidemia, and type 2 diabetes mellitus^4,5.

Despite its established importance, breakfast omission rates range from 4% to 24% in adults and from 4% to 26% in adolescents and young adults⁵. Several authors have reported superior academic performance among students who habitually consume breakfast compared to their peers who skip it or suffer from experience malnutrition⁴. Within the university context, researchers have identified prevalent unhealthy behaviors—such as low physical activity, irregular meal schedules, low nutrient density, and a high incidence of eating disorders—all of which can directly impair academic achievement⁶. Furthermore, a study conducted among university students revealed that 62.5% of those surveyed did not eat breakfast regularly, consequently reporting difficulties in remaining alert during early morning classes⁴.

In this context of changing dietary habits, the COVID-19 pandemic altered food-related practices, including eating schedules and dietary choices, as lockdown dynamics modified eating patterns. In Spain, research indicated an increased consumption of fruits, vegetables, legumes, and fish, alongside a reduced intake of foods high in fat, sugar, and salt, which was associated with efforts to improve health outcomes during the COVID-19 pandemic. Conversely, in Argentina, confinement heightened stress and anxiety levels, leading to a greater consumption of ultra-processed foods and a low intake of fruits and vegetables (averaging only two servings per day), which was below the recommendations established by the World Health Organization (WHO)⁸.

Given the historical and culturally complex nature of breakfast, as well as the limited research regarding its biocultural dimension, further studies in this field are warranted. A comprehensive understanding of this practice would facilitate the identification of culturally informed health-promotion strategies, taking into account both specific contexts and personal dietary choices. Therefore, the objective of this study was to describe the perception of breakfast habits among students at a university institution in Cali, Colombia.

# Study type

A descriptive cross-sectional survey-based study was conducted between February and June 2024 in accordance with the *Strengthening the Reporting of Observational Studies in Epidemiology* (STROBE) guidelines⁹.

# Population and sample

The study population comprised undergraduate students enrolled at a university institution in Cali, Colombia, during the first academic semester of 2024.

A cluster sampling method was utilized, in which courses were randomized and a participation rate of at least 90% of the enrolled students in each class was ensured through scheduled visits. This resulted in a total of 15 courses and 522 students, with an average of 35 students per course. The sample size was calculated using a formula for complex designs, with parameters including a 95% confidence level, a 5% sampling error, and a design effect of 1.5. A 10% anticipate data loss rate was factored into the calculation to estimate a total sample size of 574 students. Ultimately, 577 students participated after completing the recruitment process across the 15 selected courses.

# Selection Criteria

Undergraduate students enrolled in any academic program who provided written informed consent were included in the study. Conversely, students enrolled in evening shifts were excluded, as well as individuals who, despite being on campus at the time of the survey, were not affiliated with or enrolled in the institution.

# Instruments

A self-administered survey was designed, structured into two main sections: 1) sociodemographic and academic characteristics; and 2) considerations and perceptions regarding breakfast. The survey design was based on the *Breakfast Consumption Habits Questionnaire*, with prior authorization from the Ethics Committee. The instrument was developed based on international references and had previously been pilot-tested on a population with similar characteristics and academic conditions^10,12. The questionnaire included both multiple-choice and open-ended questions, depending on the type of variable being assessed.

The sociodemographic variables included socioeconomic status, gender, marital status, place of residence, ethnicity, population group affiliation, age, and academic program. Socioeconomic stratum was categorized into three levels based on the classification established by the National Administrative Department of Statistics (DANE): low (strata 1 and 2), medium (strata 3 and 4), and high (strata 5 and 6)¹¹. Marital status was dichotomized into two categories: stable union (cohabitation or married) and no stable union (single, divorced, or widowed). Additionally, variables related to transportation and academic programs were incorporated.

The breakfast intake variable was operationalized into two categories: 'always eats breakfast,' defined as consuming breakfast every day of the week, and 'sometimes eats breakfast,' defined as irregular breakfast consumption (i.e., when the student does not habitually eat breakfast consistently throughout the week).

The perception of breakfast was evaluated using a 5-point Likert-type scale, where 1 corresponded to 'strongly disagree,' 2 to 'disagree,' 3 to 'indifferent,' 4 to 'agree,' and 5 to 'strongly agree

# Procedures

The survey was administered by visiting the classrooms where the sampled courses were conducted. As a prerequisite for administration, a classroom attendance rate of at least 90% was required; subsequently, the survey was administered to all students present who met the eligibility criteria. If this attendance threshold was not met, the classroom visit was rescheduled.

Academic schedules were obtained following institutional authorization, and students completed the digital survey using the Google Forms platform, which was accessed by scanning a QR code. The informed consent form was embedded at the beginning of the instrument and was required to be read and accepted by the participants before they could proceed to answer the questions.

Direct communication was established with each instructor to coordinate access to the classrooms. The specific timing for survey administration was determined in collaboration with the students, with the survey administered at the end of the session in most cases. Researchers were present throughout the administration process to address any queries and facilitate data collection. The survey took approximately 12 to 15 minutes to complete.

# Statistical analysis

Data were initially entered into a Microsoft Excel 2010 database and subsequently exported to IBM SPSS Statistics (Version 23) software for analysis. A univariate analysis utilizing absolute and relative frequencies (percentages) was performed to characterize the sociodemographic profile of the participants, identify breakfast habits, and determine their perceptions of breakfast Additionally, bivariate analyses and Chi-square (χ²) association tests were conducted to explore potential associations between sociodemographic and academic characteristics and breakfast habits. A statistical significance level of ɑ = 0.05 was set for the tests. Results were presented in tabular form, including calculated statistics, p-values, and observed frequencies by category.

# Ethical considerations

All participants understood and signed the informed consent form. This research was approved by the Institutional Ethics Committee (320.02.15.01.02).

The characterization questionnaire describes the sociodemographic and academic aspects of the 577 participants (Tables 1 and 2). Participants were aged 16 to 20 (50.4%), belonged to a low socioeconomic stratum (52.7%), and were not in a stable relationship (93.9%); 65.7% (379) lived with their parents, and 42.3% (244) used public transportation, followed by 26% (150) who used motorcycles. A statistically significant association was identified between gender and breakfast frequency (p = 0.04). A higher proportion of women (58.9%) reported always eating breakfast (31.4%) compared with men (25.5%). A significant association was also observed between marital status and breakfast frequency (p = 0.026). Individuals in a stable union (6.1%) showed a higher proportion of regular breakfast consumption (74.3%) compared with those not in a stable relationship (56.1%).

Of the participants, 28.9% (167) belonged to the Physiotherapy academic program, followed by Sports Professional with 26.9% (155).

Regarding students' perceptions of breakfast and their views on breakfast during the COVID-19 pandemic (Table 3), the frequency and quality of breakfast were reported to have remained unchanged (53.2% and 57.4%, respectively). However, a higher percentage of students who reported an increase in breakfast frequency during the pandemic reported eating breakfast only occasionally (24.1%) (p < 0.001). Similarly, perceptions regarding breakfast quality during the pandemic showed a significant association with current breakfast frequency (p < 0.001). Furthermore, 41.9% (242) of participants believed that eating breakfast daily offered various benefits; 45.8% (264) considered that breakfast improved intellectual performance, memory, and concentration throughout the day (p < 0.001); and 47.7% (275) were indifferent to the association between breakfast consumption and obesity (p = 0.003). Finally, perceptions concerning energy consumption and the importance of eating breakfast at home showed significant associations with breakfast frequency (p = 0.001).

The sociodemographic characteristics of the study population contextualize the breakfast consumption habits reported by university students. The majority of the participants belonged to low and middle socioeconomic strata (52.7% and 44.2%, respectively), lived with their parents (65.7%), and used public transportation as their primary means of commuting (42.3%),findings that are consistent with those reported in other nutritional studies involving university students^12-13. These conditions may limit the availability of time and resources needed to prepare or consume breakfast at home before traveling to the university. In this regard, Arias Salazar et al.¹⁵ indicated that the mode of transportation and the location of breakfast preparation are logistical factors that significantly influence breakfast omission. Furthermore, 17.5% of the participants identified as Afro-descendant and 4.3% as Indigenous, groups that have historically faced greater barriers to accessing a nutritious and diverse diet in Colombia (18). The ethnic and demographic diversity of the sample highlights the need to consider cultural and socioeconomic contexts when designing food education interventions within the university environment.

International literature describes multiple shifts in dietary habits during COVID-19 pandemic lockdowns. Some groups improved their practices due to the consumption of home-cooked meals and an increased intake of fruits and vegetables, whereas others worsened, characterized by a higher consumption of sweets and ultra-processed products, with notable variations across contexts and available resources. These findings align with the results of the present study and previous research, where more than half of the participants maintained their breakfast frequency and quality^23-25. Furthermore, the ELANS study highlights a higher probability of breakfast consumption among adults (OR = 1.49), physically active individuals (OR = 1.29), and individuals with an adequate body weight (OR = 0.63)⁵.

Perceptions of breakfast constitute relevant behavioral determinants of dietary habits. In the present study, 45.8% of the students considered that eating breakfast improves memory and concentration, whereas 47.7% were indifferent regarding its relationship with obesity control. These findings are consistent with the literature, which indicates that positive beliefs about breakfast are significantly associated with a higher frequency of its consumption^26,27. A qualitative study involving U.S. university students found that those who perceive breakfast as a source of energy and productivity enhancement are more likely to consume it regularly²⁶. Similarly, Badrasawi et al.²⁷ reported that adolescents with more favorable perceptions of breakfast exhibit greater adherence to this habit. The observed indifference toward the breakfast-obesity relationship could be explained by insufficient food education, a situation that reinforces the need for educational interventions within the university environment^17-19.

Nutrition education is recognized as a key factor in enhancing individual dietary habits¹⁴. For instance, research conducted among Chilean university students revealed a significant positive correlation between nutritional knowledge and dietary diversity, indicating that higher levels of literacy in nutrition are associated with more varied diets¹⁴. Additionally, students who engaged in health-promoting behaviors—including smoking cessation, alcohol abstinence, and regular physical exercise—exhibited superior nutritional knowledge and greater dietary diversity¹⁴. Conversely, a longitudinal or cross-sectional study conducted in Colombia in 2021 demonstrated that university students' dietary habits progressively deteriorated, accompanied by an increase in body mass index (BMI), as they advanced through their academic programs¹³.

A meta-analysis examining the relationship between breakfast omission and cardiovascular risk indicators¹⁶ demonstrated that individuals who habitually skipped breakfast exhibited significantly elevated blood pressure levels compared to breakfast consumers .Furthermore, Gwin et al.²⁰ reported that regular consumption of a high-quality breakfast over a seven-day period effectively mitigates the nocturnal intake of carbohydrates, sugars, and fats, while concurrently enhancing overall sleep quality. Consequently, the establishment and maintenance of structured breakfast habits may serve as a critical preventative strategy against the development of chronic non-communicable diseases in future populations^13,21.

One of the most consistent findings of the present study is that perceptions regarding breakfast—its importance, nutritional value, cognitive effects, and role in obesity prevention—are strongly associated with its frequency (p < 0.05). This finding aligns with a qualitative study involving US university students, who stated that breakfast provides energy and improves productivity, and that the consistency of the habit is influenced by health beliefs and personal preferences²⁶. Another study also found that adolescents with more positive perceptions of breakfast—such as the belief that it improves concentration, performance, and overall health—are more likely to eat breakfast regularly²⁷. In addition, the quality and weekly frequency of breakfast are associated with better academic performance²⁸.

Breakfast habits among university students can be influenced by various social, economic, and cultural factors specific to the study population. Modifiable dietary habits, nutritional education, and the availability of financial resources—particularly among students from low- and middle-socioeconomic strata—may influence learning processes and cognitive performance and are associated with adequate nutrition and healthy habits among university students^18,22.

The findings of this study establish a valuable baseline for future longitudinal research on the dietary behaviors of university populations and may contribute to national-scale assessments of youth health status. Furthermore, these data provide higher education institutions with empirical evidence that may support the design of targeted intervention strategies within student wellness frameworks, thereby supporting the development of health literacy and the adoption of health-promoting behaviors, including healthy nutritional habits.

In addition, alternative perceptions identified within the dataset merit academic discussion. Regarding the proposition that breakfast constitutes the most critical meal of the day, 67% of the sampled students expressed agreement or strong agreement (p < 0.001). This finding indicates an overwhelmingly positive cognitive attitude toward the meal, despite the fact that such perceptions do not consistently translate into regular consumption patterns. This divergence between attitudinal disposition and actual dietary behavior has been extensively documented in previous literature and highlights the compounding influence of contextual constraints on behavioral intentions²⁶. Regarding the perceived importance of consuming breakfast at home, 66.1% of respondents expressed agreement or strong agreement (p = 0.001). Conversely, 23.7% demonstrated neutrality, a finding that potentially mirrors logistical constraints—such as commuting durations and residential location—that impede this dietary practice¹⁵. In terms of the energetic contribution of breakfast, 75.7% of the sample recognized that this meal should ideally fulfill 20% to 25% of daily caloric requirements (p < 0.001), indicating an adequate baseline of nutritional knowledge. However, this literacy does not display a linear association with consumption frequency, reinforcing the premise that behavioral intention and contextual factors heavily mediate the trajectory between knowledge and practical execution^14,26. Finally, the prevalent indifference observed concerning the role of breakfast in mitigating obesity risk (47.7%; p = 0.003) may stem from a lower public awareness of this specific epidemiological link compared to other established health benefits. This prominent neutrality underscores the critical need for targeted educational interventions that explicitly address empirical evidence linking breakfast omission to weight gain and subsequent metabolic disorders^4,5,16.

A study limitation was the inability to include postgraduate students, which hinders the generalizability of the results to the entire university population. Future research should employ focus groups to identify additional factors influencing breakfast habits.

Breakfast habits among university students appear to be influenced by socioeconomic factors and resource availability. Statistically significant associations were identified between breakfast frequency and both gender (p = 0.040) and marital status (p = 0.026), suggesting that these sociodemographic variables may be associated with this dietary behavior. Changes observed during the COVID-19 pandemic were heterogeneous; more than half of the students maintained their reported baseline breakfast frequency and quality, suggesting the relative stability of this habit under lockdown conditions.

A notable finding is that 47.7% of students reported indifference regarding the relationship between breakfast consumption and weight management, which may indicate gaps in nutritional knowledge in this population. Subjective perceptions of breakfast may be associated with this dietary habit, although the cross-sectional design does not allow causal relationships to be established or the relative influence of these perceptions compared with academic or sociodemographic variables. These results highlight the potential value of educational intervention strategies designed to enhance nutritional literacy and cultivate healthy dietary behaviors within the university environment.