Is snack consumption associated with meal skipping in children and adolescents? The CASPIAN-IV study

  • Roya Kelishadi
  • Nafiseh Mozafarian
  • Mostafa QorbaniEmail author
  • Mohammad Esmaeil Motlagh
  • Saeid Safiri
  • Gelayol Ardalan
  • Mojtaba Keikhah
  • Fatemeh Rezaei
  • Ramin HeshmatEmail author
Original Article



The present inquiry set to assess the relationship between snack consumption and meal skipping in Iranian children and adolescents.


Overall, 14,880 students, aged 6–18 years, were selected via multistage cluster sampling method from rural and urban areas of 30 provinces of Iran. A validated questionnaire of food behaviors including questions on snacks consumption and taking/skipping meals was completed. Consuming and skipping meals and their related factors were reported in both crude and adjusted models.


Overall, 13,486 students with a mean age of 12.47 ± 3.36 years completed the study (90.6% participation rate). Among them, 32.08, 8.89, and 10.90% skipped breakfast, lunch, and dinner, respectively. Compared to their counterpart groups, the frequency of meal skipping was higher in girls, urban inhabitants, and students in higher school grades (P < 0.05). Snack consumption was associated with an increased odds ratio of meal skipping in many types of snack groups.


Meal skipping and snack consumption were frequent among Iranian children and adolescents. Evidence based interventions are proposed to improve the students’ eating habits.


Snack consumption Meal skipping Children Adolescents 



The study was funded by the Ministry of Health and Medical Education.


This study was conducted by collaboration of 30 universities of Medical sciences in Iran.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

The study was approved by ethical committees of all contributing organizations.

Informed consent

Informed written consent was obtained from students’ parents.


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Roya Kelishadi
    • 1
  • Nafiseh Mozafarian
    • 1
  • Mostafa Qorbani
    • 2
    • 3
    Email author
  • Mohammad Esmaeil Motlagh
    • 4
  • Saeid Safiri
    • 5
  • Gelayol Ardalan
    • 1
  • Mojtaba Keikhah
    • 1
  • Fatemeh Rezaei
    • 6
  • Ramin Heshmat
    • 3
    Email author
  1. 1.Paediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable DiseaseIsfahan University of Medical SciencesIsfahanIran
  2. 2.Non-Communicable Diseases Research CenterAlborz University of Medical SciencesKarajIran
  3. 3.Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
  4. 4.Paediatrics DepartmentAhvaz Jundishapur University of Medical SciencesAhvazIran
  5. 5.Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and MidwiferyMaragheh University of Medical SciencesMaraghehIran
  6. 6.Department of Social Medicine, Medical SchoolJahrom University of Medical SciencesJahromIran

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