"Are People Who Skip Breakfast More Prone to Feeling Down?" A Study of Over 20,000 People Shows the Relationship Between "Meal Rhythm" and Mental Health

"Are People Who Skip Breakfast More Prone to Feeling Down?" A Study of Over 20,000 People Shows the Relationship Between "Meal Rhythm" and Mental Health

How Skipping Meals Relates to Mental Health Issues

"Skipping breakfast," "having lunch at different times every day," "eating the first meal late at night."
In modern life, such irregular eating habits are not uncommon. Work, household chores, studies, caregiving, night shifts, commuting, smartphone time, or simply being exhausted—reasons vary from person to person.

However, the rhythm of meals might not just be a lifestyle habit but could also be linked to mental health. A new study featured by the psychology and neuroscience media outlet PsyPost shows that the frequency of skipping meals and irregular meal times are associated with higher levels of depressive symptoms.

The key point is not just "what you eat." The focus this time is on "when and how regularly you eat." The study indicates that people with a high diversity of meals, including staples, vegetables, fruits, meats, legumes, nuts, and dairy products, might experience a weaker connection between irregular eating and depressive symptoms.

In other words, when considering the relationship between mental health and diet, both "nutritional balance" and "meal rhythm" cannot be ignored.


"Irregular Meals" and Depressive Symptoms Observed in Data from Over 20,000 People

The study was conducted by Hyejin Tae and Jeong-Ho Chae from the Stress Clinic at Seoul St. Mary's Hospital in Korea. The analysis was based on data from 21,568 adults who participated in the Korean National Health and Nutrition Examination Survey.

Participants were asked how many times a week they had breakfast, lunch, and dinner over the past year. The study considered meal patterns "irregular" if a specific main meal was consumed less than five times a week.

The diversity of foods consumed by participants was also assessed. The food groups included grains, vegetables, fruits, meats, legumes/nuts, and dairy products. Those who incorporated many food groups were considered to have a high dietary diversity.

The evaluation of depressive symptoms used a widely used screening tool called PHQ-9, a nine-item questionnaire that asks about mood, loss of interest or pleasure, sleep, fatigue, appetite, self-blame, concentration, motor retardation or restlessness, and thoughts of self-harm.

The analysis also considered factors such as age, gender, income, education, marital status, smoking, drinking, exercise, obesity, and hypertension. It was confirmed that people with irregular eating habits were more likely to report depressive symptoms.

According to the PsyPost article, those with the highest irregularity in meal patterns had 1.55 times higher odds of having depressive symptoms compared to those who ate very regularly.

Of course, this number alone does not mean "skipping meals causes depression." However, it does indicate a significant connection between meal rhythm and mental state.


Why Skipping Breakfast Has Drawn Attention

What stands out in this study is the presence of breakfast.

Among those with irregular eating habits, those who habitually skipped breakfast showed a stronger association with depressive symptoms. Breakfast is not just a meal but is considered one of the signals that inform the body's internal clock of "the start of the day."

The human body has a circadian rhythm that regulates sleep, hormone secretion, body temperature, blood sugar regulation, and digestive activity. Meal timing affects this rhythm. Eating in the morning helps the body recognize that "active time has begun."

Conversely, in a lifestyle where breakfast is skipped and meals are concentrated in the afternoon, evening, or late at night, blood sugar levels, hormone secretion, and gastrointestinal activity rhythms may become disrupted. The PsyPost article also mentions that irregular meal times could be linked to stress-related hormones like cortisol, gut bacteria, and inflammatory responses.

However, caution is needed here. Among those who skip breakfast are night shift workers, those who wake up late, people practicing intermittent fasting, those whose medications suppress appetite, and those who must economize on food expenses. It is premature to label skipping breakfast as a "bad habit" without considering these factors.

What this study indicates is that irregular eating, including skipping breakfast, tends to coincide with depressive symptoms. Whether it is a cause, a result, or both creating a vicious cycle needs careful consideration.


The Potential Cushion of "Dietary Diversity"

Interestingly, the association between irregular eating and depressive symptoms was weaker among those with high dietary diversity.

This is not simply about "eating a lot." The study examines whether meals include a variety of food groups. It's important not to rely solely on grains, meat, pastries, or instant noodles but to include vegetables, fruits, legumes, dairy products, and protein sources to some extent.

Why does a diverse diet relate to mental health? Several reasons are conceivable.

First, it makes it easier to incorporate a wide range of nutrients involved in brain and neurotransmitter function, such as vitamins, minerals, dietary fiber, and quality proteins and fats. Second, a diet rich in dietary fiber, fermented foods, and plant-based foods can affect gut health and potentially influence gut-brain communication. Third, those who maintain a diverse diet may also have other healthy habits such as regular sleep, exercise, and social connections.

Thus, it is not entirely possible to separate whether dietary diversity itself directly protects mental health or if it appears as part of an overall healthy lifestyle.

Nevertheless, there are practical tips for busy people. It is not necessary to aim for a perfect diet, but to move slightly away from "eating the same thing every day." For example, add eggs or tofu to your usual staple, use frozen vegetables, keep nuts or yogurt on hand, or include a piece of fruit. These small adjustments can broaden your dietary range.


On Social Media, the Reaction "Isn't the Causality Reversed?" Stands Out


 When this study was shared on social media, the central reaction was the question, "Does skipping meals lead to depression, or does depression lead to skipping meals?"

In Reddit's science community, there were comments suggesting that the article's content closely resembles the diagnostic criteria for depression. Indeed, the PHQ-9 includes an item on "loss of appetite or overeating." Therefore, investigating the relationship between eating habits and depressive symptoms naturally raises the question of measurement overlap.

Another user pointed out that when in a depressive state, one might lack the energy to cook, leading to skipped meals or resorting to simple foods. This aligns with the limitations acknowledged by the researchers themselves in the article. Cross-sectional studies measure dietary habits and depressive symptoms simultaneously, making it impossible to determine which occurred first.

On social media, there were mentions of ADHD, busy medical professionals, and irregular work schedules. Difficulty in switching attention or varying work schedules can make it hard to fix meal times. Some practical comments included using smartphone alarms to routinize meals.

Additionally, there were reactions highlighting economic circumstances. Some suggested that "skipping meals is not a mental issue but due to insufficient food budget." This is an important point. Irregular eating habits are deeply influenced not only by individual will but also by income, work hours, family structure, living environment, food prices, and the availability of social support.

Thus, the reactions on social media did not simply agree or disagree with the study's conclusions but brought up multiple issues such as "lifestyle rhythm," "diagnostic criteria," "poverty," "neurodevelopmental traits," and "work environment."


Viewing "Eating Regularly" as a Sign of Balance, Not a Cure

The most important misunderstanding to avoid when reading this study is the oversimplification that "eating regularly will cure depression."

Depression involves many factors, including genetic predisposition, life stress, trauma, sleep disorders, physical illnesses, medication effects, isolation, and financial difficulties. Diet is just one part of the whole picture.

However, irregular eating can serve as a potential "sign of imbalance in mind and body."

For example, someone who used to eat breakfast normally can no longer eat at all. They skip lunch more often. They increasingly eat late at night. They lack the energy to cook and eat the same things repeatedly. These changes might not be mere laziness but signs of fatigue, stress, or depression.

Conversely, when feeling down, making sudden lifestyle changes or starting exercise can be difficult. However, small actions like "eating something at a set time," "adding one nutritious item," or "setting an alarm to remind you to eat" might be easier to start.

The key here is not to moralize eating. Telling someone who can't eat to "eat properly" might be burdensome. Instead, consider that "they might be too exhausted to eat" or "they might need a system to support their lifestyle rhythm."


Practical Measures for Busy People

If you want to incorporate the study results into your life, it's better to create a reproducible system rather than aiming for a perfect diet.

For those who can't afford breakfast, prepare options that don't require cooking, such as yogurt, bananas, boiled eggs, nuts, cheese, soy milk, miso soup, or protein drinks. For those who tend to skip lunch, keep non-perishable snacks in your bag or workplace. For those who tend to binge eat late at night, include a small snack in the evening.

To increase dietary diversity, think in terms of "daily or weekly" rather than "perfect at every meal." If you have fewer vegetables today, add frozen vegetables tomorrow. If you haven't eaten fruit, incorporate it a few times a week. If you eat mostly meat, mix in tofu, natto, fish, or eggs.

On days when you have no appetite, don't insist on solid foods; start with soup, miso soup, yogurt, or smoothies. When depressive symptoms are strong, organizing meals can be challenging, so relying on family, friends, healthcare providers, or support services is an option.

The important thing is to consider dietary improvement as "environmental design" rather than "willpower."


Study Limitations and Future Needs

This study is large-scale and valuable for considering the relationship between eating habits and depressive symptoms. However, its limitations are clear.

Firstly, as a cross-sectional study, it cannot determine causality. Irregular eating might increase depressive symptoms, or depressive symptoms might lead to irregular eating. Alternatively, third factors like stress, lack of sleep, poverty, long working hours, or chronic illness might affect both.

Secondly, the content and frequency of meals are based on self-reporting. People may not accurately remember what and when they ate, and they might give answers that appear healthier.

Thirdly, since PHQ-9 includes an item on appetite, there is partial overlap in evaluating eating behavior and depressive symptoms. This point was also critically noted on social media.

In the future, studies that track the same individuals over a long period to see whether irregular eating or mood decline occurs first are needed. Research that examines whether interventions to regularize meal times improve depressive symptoms is also required.


Conclusion: Meal Rhythm Might Reflect Mental State

The value of this study is not in simply preaching "don't skip breakfast." Rather, it highlights the possibility that meal rhythm is closely connected to mental state.

Skipping meals might be a result of busyness, depression, financial issues, neurodevelopmental traits, or work patterns. However, regardless of the reason, if irregular eating persists, it is worth considering it as a sign of increased mental and physical stress.

"Are you eating properly?" is not just about health management but a clue to understanding how pressured your life is.

A perfect diet is not necessary. It's okay if you can't have three meals at the same time every day. Start by creating an anchor of supportive meals somewhere in your day and gradually expand the range of foods.

Mental health issues cannot be solved by diet alone. However, revisiting meal rhythm can be an entry point to recognizing your condition and rebuilding your life.


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