Meal skipping among adolescents in the Philippines: prevalence, associated factors, and associations with dietary, mental health, and health risk behavioural outcomes.

Abstract

Background: Meal skipping is poorly understood among adolescents in Southeast Asia. The study aimed to investigate the type of and any meal skipping prevalence, its associated factors (sociodemographic and protective) and associations between meal skipping types and dietary, mental, and various health risk behaviour outcomes among school adolescents in the Philippines.

Method: The 2019 Philippines Global School-based Student Health Survey (GSHS), a nationally representative survey of teenagers aged 11 to 18 (mean age 13.8 years, Standard Deviation-SD = 1.5) that used a multistage sampling technique, provided the study's data. In order to determine the variables associated with meal skipping (breakfast, lunch, dinner, any meal) and associations of meal skipping with six dietary indicators, four mental health indicators, and ten health risk behaviours, the study used bivariate and multivariable multinomial and binary logistic regression analysis.

Results: The past-month prevalence of most skipping breakfast was 37.1%, most skipping lunch 20.1%, most skipping dinner 10.8%, and any meal skipping 68.1%. Most of the students (89.1%) reported having been exposed to healthy eating classes in school, and 51.7% said that they cannot buy soft drinks in school. Female sex, older adolescents, lower socioeconomic status, not being religious, no school truancy, low or no peer and/or parental support were associated with meal (breakfast, lunch, and/or dinner) skipping. Exposure to skipping breakfast, lunch, dinner, or any meal increased the odds of low vegetable, soft drink, and fast-food intake, overweight, obesity, suicidal ideation, plan, attempt, psychological distress, sedentary behaviour, alcohol use, drug use, physical injury, poor hand, and oral hygiene, and not always wearing a seatbelt.

Conclusion: Almost seven in 10 adolescents skipped any meal in the past month. Sociodemographic and protective factors were associated with meal skipping. Exposure to meal skipping was associated with 15 out of 17 dietary, mental health, and other health risk behaviour outcomes. In order to lower various adverse health outcomes in adolescents, the results thus showed how important it is to improve in a regular meal pattern, particularly meal frequency and meal skipping. Interventions incorporating parental and peer engagement could be strengthened alongside school health education to effectively address meal skipping behaviours.