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Association of meal skipping with subjective health complaints in children and adolescents: the CASPIAN-V study



Few studies have assessed the relationship between meal skipping with subjective health complaints in children and adolescents. The aim of our study was to determine the association between meal skipping and subjective health complaints in this population.


A total of 14,400 students aged 7–18 years were selected using multistage stratified cluster sampling method from 30 provinces of Iran. Data were collected as a part of the fifth national school-based surveillance program (CASPIAN-V) in Iran. Information about students’ lifestyle, health behaviours, health status and health complaints were gathered through a validated questionnaire.


The mean (standard deviation) age of participants was 12.3 (3.2) years old. Breakfast skipping was associated with increased odds of stomachache (OR 1.77, 95% CI 1.56, 2.00), backache (OR 1.68, 95% CI 1.46, 1.92), difficulty in getting to sleep (OR 1.66, 95% CI 1.48, 1.86), feeling nervous (OR 1.59, 95% CI 1.43, 1.76) and irritability (OR 1.29, 95% CI 1.02, 1.25). There were 27, 63, 58 and 107% increase in odds of headache, stomachache, backache and difficulty in getting to sleep by lunch skipping, respectively. While dinner skipping was related to 39, 59 and 52% increase in odds of headache, feeling low and difficulty in getting to sleep, respectively, it was associated with decreased odds of stomachache (OR 0.33, 95% CI 0.25, 0.44).


Our study suggests that meal skipping is associated with some somatic and psychological health complaints among children; therefore, regular meal consumption, at least three times a day, is highly recommended in this population.

Level of evidence

V, cross-sectional descriptive study.

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This nationwide survey was performed in Iran with cooperation of Ministry of Education and Training, the Ministry of Health and Medical Education, the Child Health Promotion Research Center, the Isfahan University of Medical Sciences and the Endocrinology and Metabolism Research Center of Tehran University.

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Correspondence to Mostafa Qorbani or Roya Kelishadi.

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The authors declare that there is no conflict of interest.

Ethical approval

Study protocols were approved by the Ethics committee of Isfahan University of Medical Sciences, Project number: 194049.

Informed consent

After complete explanation of the study objectives and protocols, written and verbal informed consent was obtained from the parents and students, respectively.

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Azemati, B., Heshmat, R., Qorbani, M. et al. Association of meal skipping with subjective health complaints in children and adolescents: the CASPIAN-V study. Eat Weight Disord 25, 241–246 (2020).

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