To propose and apply an instrument to assess the breakfast quality of children and adolescents in the Mediterranean area.

Randomized, cross-sectional survey of breakfast consumption using a validated semi-quantitative FFQ administered at school by trained dietitians between Tuesday and Friday. A Breakfast Quality Index (BQI) score was developed, assigning a positive value to the consumption of cereals, fruit, vegetables, dairy products, MUFA, Ca and compliance with energy recommendations, and to the absence of SFA and trans-rich fats. Data were analysed by Student's t test and ANOVA.

Schools in Granada and Balearic Islands (Spain).

All schoolchildren (n 4332) aged 8–17 years at randomly selected and representative schools between 2006 and 2008, stratified by age and sex.

Breakfast was not consumed by 6·5 % of participants. BQI score was highest for children aged 7–9 years and decreased with age (P = 0·001). Females scored higher in all age groups. The lowest score was in males aged 14–17 years and the highest in females aged 7–9 years (P = 0·006).

The proposed BQI appears useful to estimate the breakfast quality of schoolchildren and to form a basis for nutrition education.