Table 1.
Characteristics of the included studies
| Reference, year | Country | Design | Sample characteristics, N (% women) | Participants; age, years (mean ± SD) | How was meal skipping measured? | Definition of meal skipping | Frequency of meal skipping | Correlates of meal skipping |
|---|---|---|---|---|---|---|---|---|
| 1. Afolabi et al. 2013 [34] | Nigeria | Cross-sectional | University students; 140 (40% F) | N/R | Q: Do you skip meals? (Yes/No)
Q: Why do you skip meals? |
“Yes”; Text | 53.6% M skipped meals, 35% F skipped meals |
Reasons for skipping meals: -Time 48%, -Appetite 19%, -Cannot cook 13%, -Illness 3%, -Money 6% |
| 2. Akarslan et al. 2008 [61] | Turkey | Cross-sectional | Young adults; 416 (59% F) | 18-25 years; (23.2 ± 0.97 years) | Q: Frequency of B, L, D? (Almost always/Sometimes/Very seldom/Never in a one year period) |
N/R | 70% had regular main meals. Regular B 69.2%, Regular L 75.5%, Regular D 76.0% |
SEX: (0 TMS) |
| 3. Aryee et al. 2013 [35] | Ghana | Cross-sectional | Nurses; 220; (66% F) | 20–60 years; (67.3% 20–30 years) | Q: Do you meal skip? (Yes/No) |
“Yes” | 53.6% skipped meals | BMI: (+TMS) |
| 4. Bahl et al. 2013 [36] | USA | Cross-sectional | College students (Business); 353 (43% F) | N/R | Q: How many days during the last week (0–7) did you skip meals? | Numerical | Participants who had mindfulness training skipped meals on 1.25 days during the last week compared to 1.94 days for the non-training group | MINDFULLNESS: (- TMS) SATISFIED: (quality of life - TMS) |
| 5. Beerman et al. 1990 [62] | USA | Cross-sectional | College students (Nutrition); 152 (56% F) | 74% ≤ 21 years | Q: Do you skip meals? (Regularly/Rarely) | “Regularly” | 66% of on or off campus students skipped meals. 36% of those living in Greek housing skipped meals. |
LIVING SITUATION: (Greek housing -TMS) SEX: (0 TMS) Reasons for meal skipping: -Time 61% |
| 6. Chung et al. 2003 [37] | Korea | Cross-sectional | College students; 180 (100% F) | 20.41 ± 1.82 years | Q: What is your breakfast status? (Rarely eating, Frequently eating or Daily eating) |
“Rarely eating” or “Frequently eating” | 74.4% skipped B | BMI: (0 TMS) |
| 7. Colić Barić et al. 2003 [38] | Croatia | Cross-sectional | University students; 2075 (53% F) | 21.7 ± 2.0 years | Specially designed FFQ | Numerical; Regular B, defined as having B 6 or 7 times per week |
B consumed on 3.4 days/week, L 6 days/week, D 4.7 days/week. 32.2% F and 25.7% M consumed B regularly |
SEX: (F + L, +D) BMI: (+BS) EXERCISE: (3.5 h versus 2.6 h of exercise per week -BS) |
| 8. Danquah et al. 2010 [39] | Ghana | Cross-sectional | University students; 150 (75% F) | 64.6% 21–30 years | Q: Do you eat breakfast? (Yes/No) |
“No” | 25% skipped B, 8% skipped L, 5% skipped D |
ETHNIC: (Caucasian -BS) SEX: (F + BS) AGE: (15–20 years -BS) COURSE TYPE: (Science students + BS) Reasons for skipping B: -No time (57%), -Not hungry (22%), -Eat late at night (5%), -Busy schedule (3%), -No reason (13%). Reasons for skipping L: -No time (50%), -Not hungry (25%), -No reason (3%), Reasons for skipping D: -No time (38%), -Busy schedule (12%), -Watching my weight (50%) |
| 9. Deepika 2015 | India | Cross-sectional | College students; 120 (80% F) | 18–23 years | Q: Do you A) Take all three meals, B) Skip meals with substitute or C) Skip meals without substitute? | “B” or “C” | 83.3% skipped meals | Reason for skipping meals: -Time 40%, -Taste 30%, -Social desirable 28.3%, - Habit 1.7% |
| 10. Eittah 2014 [41] | Egypt | Cross-sectional | University students (Nursing); 300 (100% F) | 17–22 years; (20.05 ± 1.62 years) | Q: Do you always neglect to eat - B, L, D? (Yes/No) |
“Yes” | 72.7% skipped B, 7.3% skipped D, 6% skipped B and D |
MENSTRUAL REGULARITY: (Menstrual regularity -BS) |
| 11. Eldisoky, 2003 [42] | Saudi Arabia | Cross-sectional | University students; 61 (100% F) | 19–24 years | Q: Do you usually have B? (Yes/Sometimes/No) |
“Sometimes” or “No” | 63% skipped B, 61% skipped L, 31% skipped D |
MOTHERS EDUCATION LEVEL: (0 TMS) Reasons for skipping meals: -Hunger 48%, -Time 31%, -Weight control 21% |
| 12. Evagelou et al. 2014 [43] | Greece | Cross-sectional | University students (Nursing); 435 (83.4% F) | N/R | Q: N/R (Rarely/At least one/Two/Three/Four/Five/Six/Seven times a week) |
N/R | 31% skipped B | SEX: (0 BS) |
| 13. Freedman 2010 [63] | USA | Cross-sectional | College freshman; 756 (61% F) | N/R | Q: Frequency of meal intake? (Never/1-3 times a week/4-6 times a week/7 days a week) | “Never” | 24.7% skipped B, 7% skipped D |
LIVING SITUATION: (On campus + BS) SEX: (F + DS) ETHINICITY: (Caucasian -BS, -DS) |
| 14. Huang et al., 1994 [44] | USA | Cross-sectional | College students (Nutrition); 1912 (68% F) | M 20 years, F 19 years | 1 day-food record (weekday) | Meal not reported in food record | 22% skipped B, 8% skipped L, 5% skipped D |
SEX: (0 TMS) |
| 15. Kapinos & Yakusheva, 2011 [31] | USA | Longitudinal | University students; 388 (63% F) | 18.1 years | Q: Over the past year, how many meals per day did you typically eat? | Numerical | 2.88 meals/day at baseline, 2.61 meals/day one year later |
ENROLLING IN UNI: (Second year of uni + TMS) LIVING SITUATION: (M living in dormitories with a dining hall -TMS) |
| 16. Kim et al., 2010 [45] | China | Cross-sectional | First year University students; 2427 (63.4% F) | 18.9 years | Q: Have you in the past month skipped meals? (Often/Occasionally/Never) | N/R | Skipped meals at least monthly in past year -16.2%, Skipped meals in the past week - 4.8% | INTERNET USE: (4 + hours/day + TMS) |
| 17. Lamia Dhia & Ban Faud 2014 [46] | Iraq | Cross-sectional | University students; 350 (Sex NR) | N/R | Q: No of meal/day? Q: If missed what is the most missed meal? |
Numerical; Text | 51.1% consumed < 3 meals/day. Of those who missed a meal 88.5% skipped B, 11.5% skipped D |
Reasons for meal skipping: -Time |
| 18. Laska et al. 2010 [1] | USA | Cross-sectional | Young adults; 1687 (56% F) | 18–23 years; (20.5 years) | Q: How often do you eat B, L, D during the past week? (Never/1–2 d/3–4 d/5–6 d/Every day) | Numerical | B consumption ranged from 2.7 to 3.5 days/week, L 5.3–5.8, D 6.1–6.5. |
LIVING SITUATION: (Living with parents + BS, +DS) |
| 19. Lee & Yoon 2014 [47] | Korea | Cross-sectional | University students (Food and Nutrition 50.3%); 159 (62.3% F) | 18–28 years; 56% 18–20 years | Q: Missed meal? Q: Reason of skipping meal? |
Text; Text | 83.6% skipped B, 6.9% skipped L, 8.2% skipped D |
AGE: (18–20 years + TMS) Reason for skipping B: -Time 61%, -Habit 17.6%, -Appetite 11.9% |
| 20. Musaiger & Radwan 1995 [48] | United Arab Emirates | Cross-sectional | University students; 215 (100% F) | 18–30 years; (19.7 ± 1.3 years) | Specially designed questionnaire on meal pattern | N/R | 15.8% skipped B, 11.2% skipped L, 7% skipped D |
BMI: (0 TMS) |
| 21. Neslisah & Emine 2011 [49] | Turkey | Cross-sectional | University students; 400 (42% F) | 19–24 years; (21.7 ± 1.8 years) | 1 × 24 h diet record | Meal not reported in food record | 47.7% skipped B, 25.2% skipped L |
SEX: (M+ BS) (F + LS) |
| 22. Nicklas et al. 1998 [12] | USA | Cross-sectional | Young adults; 504 (58% F) | 19–28 years; (23 years) | 1 × 24 h diet recall | B had to equal or exceed macronutrient value of 1 serving of milk. | 37% skipped B | ETHNICITY: (0 BS) SEX: (0 BS) |
| 23. Nzeagwu & Akagu 2011 [50] | Nigeria | Cross-sectional | University students; 342 (63% F) | 16–25 years; 81% 20–25 years | Q: What meal do you usually skip? Q: Why do you skip meals? |
Text; Text | 27.8% skipped B, 16.9% skipped L, 5.6% skipped D, 4.4% skipped B and L, 2.3% skipped B and D, .5% skipped L and D |
Reasons for skipping meals: -Time 40.5%, -Fasting/religion 6.7%, -Weight control 10.4%, -Money 9.9% |
| 24. Ozilgen 2011 [51] | Turkey | Cross-sectional | University students; 408 (56% F) | 18–24 years | Q: How many times a day do you eat B, L, and D? | Numerical | ~80% F skipped meals, ~72% M skipped meals, ~77% M skipped B, ~61% F skipped B |
SEX: (M + BS) |
| 25. Sakamaki et al. 2005 [52] | Japan and Korea | Cross-sectional | University students (141 Korean), 124 Japan); 265 (100% F) | (20 ± 1.8 years) | Q: Do you always take breakfast? (Daily/3-4 times per week/Once or twice per week/Rarely) |
Everything except “Daily” | 21% Japanese skipped B, 64% Korean skipped B |
ETHNICITY: (Japanese –BS) |
| 26. Sato-Mito et al. 2011 [32] | Japan | Cross-sectional | University students living at home (Dietetics); 3304 (100% F) | 18–20 years; (18.1 ± 0.3 years) | Q: During the previous month how many meals have you skipped? | Numerical | B skipped 1.00 ± 1.74 times/week, L skipped 0.20 ± 0.73 times/week, D skipped 0.32 ± 1.09 times/week |
SLEEP: (Feel asleep later in the night + TMS) |
| 27. Shimbo et al. 2004 [53] | Japan | Cross-sectional | University Students; 71 (100% F) | 19–23 years; | 1 × 24 h food duplicate portion samples | Meal not reported in food record | 14% skipped B | LIVING SITUATION: (Living away from home + BS) |
| 28. Suliburska et al. 2012 [54] | Poland | Cross-sectional | Young adults; 600 (50% F) | 18 years | Q: How many meals do you consumed in a typical day of the week? | Numerical | 5% of overweight ate >2 meals/day, 9% of normal weight ate >2 meals/day |
BMI: (Overweight –TMS) SEX: (F-TMS) LIVING SITUATION: (Rural + TMS) |
| 29. Suliga et al. 2012 [55] | Poland | Cross-sectional | University students; 925 (100% F) | N/R | Q: Frequency of main meals (B, L, D, and S)? (Daily/2-6 times a week/Rarely) |
“Rarely” | 11% rarely ate B, 8.2% rarely ate L, 12.6% rarely ate D |
BODY WEIGHT SELF PERCEPTION: (+ TMS) |
| 30. Tanaka et al. 2008 [33] | Japan | Cross-sectional | University students (Medicine); 127 (30.4% F) | (20.5 ± 0.8 years) | Q: B consumption (Every day/Not every day/Completely skipping everyday) |
“Completely skipping everyday” | 15.7% skipped B | FATIGUE: (+BS) |
| 31. Tominaga et al. 2012 [56] | Japan, Korea and Austria | Cross-cultural | University students; 276 Japan, 103 Korea, 127 Austria, (100% F) | Japan; (19.9 ± 1.2 years), Korea (21.5 ± 1.8 years), Austria (22.3 ± 5.2 years) | Q: Frequency of B, L, D (Never/Occasionally/Sometimes/Almost every day) |
“Never” or “Occasionally” or “Sometimes” | JAPAN - 50% skipped B, 15% skipped L, 17% skipped D. KOREA - 54% skipped B, 51% skipped L, 46% skipped D. AUSTRIA - 42% skipped B, 29% skipped L, 47% skipped D |
ETHNICITY: (Austrian –BS), (Japanese –LD and DS) |
| 32. Ukegbu et al. 2015 [57] | Nigeria | Cross-sectional | University students; 200 (47% F) | 16–25 years | 2 × 24 h recalls. Consecutive days including a weekend day. | Meal not reported in food record | 41.5% skipped B, 21.5% skipped L, 7% skipped D |
Reason for meal skipping: -Time 42.5%, -Weight control 23.5%, -Fasting/religion 21.5%, -Money 12.5% |
| 33. Yahia et al. 2008 [58] | Lebanon | Cross-sectional | University students; 220 (56.4% F) | (20 ± 1.9 years) | Q: Do you take breakfast? (Daily/3-4 times per week/1-2 per week/Rarely) | “Rarely” | 67% skipped B | SEX: (M + BS) |
| 34. Yildiza et al. 2011 [59] | Turkey | Cross-sectional | University students (Medical); 301 (100% F) | 18–25 years; (21.2 ± 1.7 years) | Q: Frequency of B, L, D? (Never/Occasionally/Most of the days/Everyday) |
“Never” or “Occasionally” or “Most of the days” | 74% skipped B, 57% skipped L, 37% skipped D, 69.7% were skipping at least one meal per day. |
Reason for meal skipping: -Time 46.7% |
| 35. Yilmaz et al. 2014 [60] | Turkey | Cross-sectional | University students (Medical); 995 (48% F) | M (21.25 ± 1.97 years); F (20.94 ± 1.77) | Q: I usually skip meals? (Yes/No) |
“Yes” | 35.8% skip B, 27.9% usually skip meals |
DEPRESSION: (+BS) |
N/R not reported, M males, F females, B breakfast, L lunch, D dinner, BMI body mass index, FFQ food frequency questionnaire, BS Breakfast skipping, LS Lunch skipping, DS Dinner skipping, TMS Total meal skipping, (0) = No association, (+) = Positive association, (-) = Negative association