Social inequalities in meal skipping patterns among children and adolescents: The CASPIAN-V study

Mostafa Qorbani; Amir Kasaeian; Amir-Masood Rafiemanzelat; Ali Sheidayi; Shirin Djalalinia; Kourosh Nouri; Hadith Rastad; Dorsa Salimi; Kimia Ghaderi; Mohammad Esmaeil Motlagh; Ramin Heshmat; Roya Kelishadi

doi:10.1002/osp4.527

Social inequalities in meal skipping patterns among children and adolescents: The CASPIAN-V study

Obes Sci Pract. 2021 Jun 5;7(6):690-698. doi: 10.1002/osp4.527. eCollection 2021 Dec.

Authors

Mostafa Qorbani^{1

2}, Amir Kasaeian^{3

4

5}, Amir-Masood Rafiemanzelat⁶, Ali Sheidayi⁷, Shirin Djalalinia⁸, Kourosh Nouri⁹, Hadith Rastad¹⁰, Dorsa Salimi⁶, Kimia Ghaderi⁶, Mohammad Esmaeil Motlagh¹¹, Ramin Heshmat^{2

12}, Roya Kelishadi⁶

Affiliations

¹ Non-communicable Diseases Research Center Alborz University of Medical Sciences Karaj Iran.
² Chronic Diseases Research Center Endocrinology and Metabolism Population Sciences Institute Tehran University of Medical Sciences Tehran Iran.
³ Hematology, Oncology and Stem Cell Transplantation Research Center Research Institute for Oncology, Hematology and Cell Therapy Tehran University of Medical Sciences Tehran Iran.
⁴ Digestive Diseases Research Center Digestive Diseases Research Institute Tehran University of Medical Sciences Tehran Iran.
⁵ Inflammation Research Center Tehran University of Medical Sciences Tehran Iran.
⁶ Department of Pediatrics Child Growth and Development Research Center Research Institute for Primordial Prevention of Non-communicable Disease Isfahan University of Medical Sciences Isfahan Iran.
⁷ Department of Epidemiology and Biostatistics School of Public Health Tehran University of Medical Sciences Tehran Iran.
⁸ Development of Research & Technology Center Deputy of Research and Technology, Ministry of Health and Medical Education Tehran Iran.
⁹ Student Research Committee, Alborz University of Medical Sciences Karaj Iran.
¹⁰ Social Determinants of Health Research Center, Alborz University of Medical Sciences Karaj Iran.
¹¹ Department of Pediatrics Ahvaz Jundishapur University of Medical Sciences Ahvaz Iran.
¹² Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences Tehran Iran.

Abstract

Background & aim: The appropriate meal consumption affects the children's and adolescents' health. Few studies have shown an association between the socioeconomic inequality and the eating behavior among children and adolescents. Therefore, the aim of this study was to assess the socioeconomic inequality in meal skipping patterns among children and adolescents.

Materials & methods: The data were accessible through the fifth round of a school-based program in Iran in 2015. In this cross-sectional nationwide study, 14,286 students aged 7-18 years were selected via the multistage cluster sampling from 30 provinces of Iran. The Global School-based Health Survey validated questionnaire was used to assess the socioeconomic variables and meal consumption patterns among children and adolescents. Socioeconomic status (SES) was computed using principle component analysis method. Multivariate logistic regression analysis was used to assess the socioeconomic inequality in meal skipping patterns.

Results: The frequency of breakfast, lunch, and dinner skipping were 13.8% (95% CI: 13.3-14.5), 6.8% (95% CI: 6.4-7.2), and 7.5% (95% CI: 7.1-7.9), respectively. In multivariate model, living in a two-parent family compared to living in a single-parent family decreased the odds of breakfast skipping (OR: 0.53, 95% CI: 0.42-0.67)). Low SES level was associated with higher odds of skipping breakfast (OR: 1.79, 95% CI: 1.50-2.14) and dinner (OR: 1.80, 95% CI: 1.42-2.28). Moreover, maternal illiteracy and unemployment were associated with skipping breakfast, lunch, and dinner (all p values < 0.05).

Conclusion: Some demographic and socioeconomic characteristics, such as maternal illiteracy and unemployment, low SES level, and living in a single-parent family were suggested as the main predictors of meal skipping patterns in children and adolescents.

Keywords: adolescents; children; inequality; meal skipping; socioeconomic status.