Skip to main content
SpringerLink
Log in

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

Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity volume 25, pages 241–246 (2020)Cite this article

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Roberts C, Freeman J, Samdal O et al (2009) The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions. Int J Public Health 54(Suppl 2):140–150. https://doi.org/10.1007/s00038-009-5405-9

    Article  PubMed  PubMed Central  Google Scholar 

  2. Bullinger M (2002) Assessing health related quality of life in medicine. An overview over concepts, methods and applications in international research. Restor Neurol Neurosci 20:93–101. https://content.iospress.com/articles/restorative-neurology-and-neuroscience/rnn00198. Accessed Dec 2017

  3. Eriksen HR, Ihlebaek C (2002) Subjective health complaints. Scand J Psychol 43(2):101–103. https://doi.org/10.1111/1467-9450.00274

    Article  PubMed  Google Scholar 

  4. Taillefer MC, Dupuis G, Roberge MA et al (2003) Health-related quality of life models: systemic review of the literature. Sol Indic Res 64:293–323. https://doi.org/10.1023/A:1024740307643

    Article  Google Scholar 

  5. Gobina I, Valmaa R, Tynjala J et al (2011) The medicine use and corresponding subjective health complaints among adolescents, a cross-national survey. Pharmacoepidemiol Drug Saf 20(4):424–431. https://doi.org/10.1002/pds.2102

    Article  PubMed  Google Scholar 

  6. Ravens-Sieberer U, Torsheim T, Hetland J et al (2009) Subjective health, symptom load and quality of life of children and adolescents in Europe. Int J Public Health 54:151–159. https://doi.org/10.1007/s00038-009-5406-8

    Article  PubMed  Google Scholar 

  7. Roelen CA, Koopmans PC, Groothoff JW (2010) Subjective health complaints in relation to sickness absence. Work 37(1):15–21. https://doi.org/10.3233/WOR-2010-1052

    Article  PubMed  Google Scholar 

  8. Pendergast FJ, Livingstone KM, Worsley A et al (2016) Correlates of meal skipping in young adults: a systematic review. Int J Behav Nut Phys Act 13:125. https://doi.org/10.1186/s12966-016-0451-1

    Article  Google Scholar 

  9. Ghafari M, Doosti-Irani A, Amiri M et al (2017) Prevalence of the skipping breakfast among the Iranian students: a review article. Iran J Public Health 46(7):882–929. http://ijph.tums.ac.ir/index.php/ijph/article/view/10385/5789. Accessed Nov 2017

  10. Kelishadi R, Mozafarian N, Qorbani M et al (2017) Is snack consumption associated with meal skipping in children and adolescents? The CASPIAN IV study. Eat Weight Disord 22(2):321–328. https://doi.org/10.1007/s40519-017-0370-4

    Article  PubMed  Google Scholar 

  11. Zilberter T, Zilberter EY (2014) Breakfast: to skip or not to skip. Front Public Health 2:59. https://doi.org/10.3389/fpubh.2014.00059

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chen J, Cheng J, Liu Y et al (2014) Association between breakfast eating habits and health-promoting lifestyle, suboptimal health status in Southern China: a population based, cross sectional study. J Transl Med 12:348. https://doi.org/10.1186/s12967-014-0348-1

    Article  PubMed  PubMed Central  Google Scholar 

  13. Moschiano F, Messina P, D’Amico D et al (2012) Headache, eating and sleeping behaviors and lifestyle factors in preadolescents and adolescents: preliminary results from an Italian population study. Neurol Sci 33:87–90. https://doi.org/10.1007/s10072-012-1048-3

    Article  Google Scholar 

  14. Motlagh ME, Ziaodini H, Qorbani M et al (2017) Methodology and early findings of the fifth survey of childhood and adolescence surveillance and prevention of adult noncommunicable disease: the CASPIANV study. Int J Prev Med 8:4. https://doi.org/10.4103/2008-7802.198915. eCollection 2017

    Article  PubMed  PubMed Central  Google Scholar 

  15. Global School-based Student Health Survey (GSHS) (2012) World Health Organization. http://www.who.int/chp/gshs/en/. Accessed Jan 2018

  16. Kelishadi R, Majdzadeh R, Motlagh ME,et al (2012) Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the CASPIAN IV study. Int J Prev Med 3:699–705. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482997/

  17. World Health Organization (2008) Training course on child growth assessment. WHO, Geneva. http://www.who.int/childgrowth/training/module_c_interpreting_indicators.pdf. Accessed Jan 2018

  18. Salmon J, Campbell KJ, Crawford DA (2006) Television viewing habits associated with obesity risk factors: a survey of Melbourne school children. Med J Aust 184:64–67. https://www.mja.com.au/journal/2006/184/2/television-viewing-habits-associated-obesity-risk-factors-survey-melbourne. Accessed Nov 2017

  19. Djalalinia SH, Qorbani M, Rezaei N, Sheidaei A, Mahdavi-Gorabi A, Kasaeian A (2017) Joint association of screen time and physical activity anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study. J Pediatr Endocrinol Metab 30(7):731–738. https://doi.org/10.1515/jpem-2016-0486

    Article  PubMed  Google Scholar 

  20. Adeniyi AF, Okafor NC, Adeniyi CY (2011) Depression and physical activity in a sample of Nigerian adolescents: levels, relationships and predictors. Child Adolesc Psychiatry Ment Health 5:16. https://doi.org/10.1186/1753-2000-5-16

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kowalski KC, Crocker PR, Donen RM (2004) The physical activity questionnaire for older children (PAQ-C) and adolescents (PAQ-A) manual. College of Kinesiology, University of Saskatchewan 87, Canada. https://www.prismsports.org/UserFiles/file/PAQ_manual_ScoringandPDF.pdf. Accessed Mar 2018

  22. Kelishadi R, Motlagh ME, Roomizadeh P et al (2013) First report on path analysis for cardiometabolic components in a nationally representative sample of pediatric population in the Middle East and North Africa (MENA): the CASPIAN III study. Ann Nutr Metab 62(3):257–265. https://doi.org/10.1159/000346489

    Article  CAS  PubMed  Google Scholar 

  23. Haugland S, Wold B, Stevenson J et al (2001) Subjective health complaints in adolescence: a cross national comparison of prevalence and dimensionality. Eur J Public Health 11(1):4–10. https://doi.org/10.1177/140349480203000309

    Article  CAS  PubMed  Google Scholar 

  24. Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Ser B 57:289–300. https://doi.org/10.2307/2346101

    Article  Google Scholar 

  25. Kafeshani O, Sarrafzadegan N, Nouri F, Mohammadifard N (2015) Major dietary patterns in Iranian adolescents: Isfahan healthy heart program, Iran. ARYA Atheroscler 11(Suppl 1):61–68. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530660/. Accessed Dec 2017

  26. Leech RM, Worsley A, Timperio A et al (2015) Understanding meal patterns: definitions, methodology and impact on nutrient intake and diet quality. Nutr Res Rev 28:1–21. https://doi.org/10.1017/S0954422414000262

    Article  PubMed  PubMed Central  Google Scholar 

  27. Shenkin A (2006) Micronutrients in health and disease. Postgrad Med J 82:559–567. https://doi.org/10.1136/pgmj.2006.047670

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Chen X, Sekine M, Hamanishi S et al (2005) Lifestyles and health related quality of life in Japanese school children: a cross-sectional study. Prev Med 40(6):668–678. https://doi.org/10.1016/j.ypmed.2004.09.034

    Article  PubMed  Google Scholar 

  29. Farhang MA, Dehgan P, Jahangiry L (2018) Mental health problems in relation to eating behavior patterns, nutrient intakes and health related quality of life among Iranian female adolescents. PLoS One 13(4):e0195669. https://doi.org/10.1371/journal.pone.0195669

    Article  CAS  Google Scholar 

  30. Huang CJ, Hu HT, Fan YC et al (2010) Association of breakfast skipping with obesity and health-related quality of life: evidence from a national survey in Taiwan. Int J Obes 34(4):720–725. https://doi.org/10.1038/ijo.2009.285

    Article  Google Scholar 

  31. Yi Y-H, Kim Y-J, Lee S-Y, Lee J-G, Jeong D-W, Cho Y-H et al (2015) The correlation of meal frequency and nutrition with mental health status in women aged 20–39 years: the 5th Korea National Health and Nutrition Examination Survey, 2010–2012. Korean J Obes 24(2):101 107. https://doi.org/10.7570/kjo.2015.24.2.101

    Article  Google Scholar 

  32. Seremet N, Karaagaoglu N, Kaner G, Tel K (2015) Gastroesophageal reflux symptoms and nutritional preferences. Ethno Med 9(3):305–318. https://doi.org/10.1080/09735070.2015.11905448

    Article  Google Scholar 

  33. Casucci G, Terlizzi R, Cevoil S (2014) Headache in school age. Neurol Sci 35:31–35. https://doi.org/10.1007/s10072-014-1738-0

    Article  PubMed  Google Scholar 

  34. Torelli P, Evangelista A, Bini A et al (2009) Fasting headache: a review of the literature and new hypotheses. J Headache Pain 49(5):744–752. https://doi.org/10.1111/j.1526-4610.2009.01390.x

    Article  Google Scholar 

  35. Lim SL, Canavarro C, Zaw MH et al (2012) Irregular meal timing is associated with helicobacter pylori infection and gastritis. ISRN Nutr 2013, https://doi.org/10.5402/2013/714970(eCollection 2013)

    Article  Google Scholar 

  36. Fujiwara Y, Machida A, Watanabe Y et al (2005) Association between dinner-to-bed time and gastro-esophageal reflux disease. Am J Gastroenterol 100:2633–2636. https://doi.org/10.1111/j.1572-0241.2005.00354.x

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

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.

Author information

Authors and Affiliations

  1. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Bahar Azemati, Ramin Heshmat, Zeinab Ahadi, Ali Azemati & Gita Shafiee

  2. Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, USA

    Bahar Azemati

  3. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Emam ali complex, Azimiyeh St, Karaj, Iran

    Mostafa Qorbani

  4. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Mostafa Qorbani & Gita Shafiee

  5. Health Psychology Department, Research Center of Education Ministry Studies, Tehran, Iran

    Hasan Ziaodini

  6. Office of Adolescents and School Health, Ministry of Health and Medical Education, Tehran, Iran

    Mohammad Esmail Motlagh

  7. Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jarib Ave, Azadi Squre, Isfahan, 73461-81746, Iran

    Roya Kelishadi

Authors
  1. Bahar Azemati
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ramin Heshmat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mostafa Qorbani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Zeinab Ahadi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ali Azemati
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gita Shafiee
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hasan Ziaodini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mohammad Esmail Motlagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Roya Kelishadi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Mostafa Qorbani or Roya Kelishadi.

Ethics declarations

Conflict of interest

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.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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). https://doi.org/10.1007/s40519-018-0559-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40519-018-0559-1

Keywords

search

Navigation