Breakfast skipping may increase the risk of overweight/obesity and anemia in adolescents in low- and middle-income countries (LMICs), but more high-quality studies assessing nutrition outcomes are needed.
Adolescence is a critical period of rapid growth and development, during which proper nutrition is vital. Malnutrition is a widespread issue among teenagers worldwide, especially in LMICs. Skipping breakfast is a common dietary habit among teens in LMICs. Our review suggests that breakfast skipping can lead to negative health outcomes, such as increasing adolescents’ risk of being overweight or obese, as well as experiencing anemia or nutrient deficiencies.
1.1 The Review in Brief
Adolescents who infrequently consume breakfast are twice as likely to be overweight or obese compared to regular eaters. Adolescents who irregularly consume breakfast are more than twice as likely to have anemia compared to regular breakfast consumers.
1.2 What Is This Review About?
Breakfast skipping is a common dietary habit among teenagers, yet this life stage of important growth and development requires optimal nutrition. Scientific articles have reported many negative health consequences, such as overweight/obesity and anemia, of breakfast skipping in adolescents. However, these findings have never been synthesized specifically for adolescents in LMICs, who face unique health and nutrition challenges. As a result, the impact of breakfast skipping on the health and nutrition status of this population remains unclear.
1.3 What Is the Aim of This Review?
This Campbell systematic review aims to analyze the scientific evidence available from LMICs, regarding the relationship between breakfast habits, anthropometry (e.g., body mass index [BMI]), and nutrition-related outcomes (e.g., anemia) in adolescents 10–19 years old. The review summarizes evidence from 41 observational studies, including 39 cross-sectional and 2 prospective cohort studies.
1.4 What Are the Main Findings of This Review?
1.4.1 What Studies Are Included?
All study designs evaluating the habit of skipping breakfast among adolescents aged 10–19 in LMICs were eligible for inclusion. This review included 41 studies, with 36 contributing to the quantitative meta-analysis. These studies utilized various definitions of breakfast skipping, including frequency per week and yes/no categorization.
1.4.2 Are Adolescent Breakfast Habits Associated With Obesity and Anemia?
In low- and middle-income countries, adolescent breakfast skipping is associated with an increased likelihood of overweight and obesity. The likelihood of developing anemia differed between the breakfast habit groups, although only a limited number of studies reported on this association, as well as for other secondary outcomes, limiting the overall evidence.
1.5 What Do the Findings of This Review Mean?
Breakfast skipping may negatively contribute to the complex interplay of factors resulting in overweight and obesity. It may also be a risk factor for anemia, although our review indicates a very low certainty of evidence, and results should be interpreted cautiously. This review underscores the necessity for more research to be conducted on the health and nutrition implications of this widespread practice in the daily diets of adolescents globally.
1.6 How Up-to-Date Is This Review?
The review authors searched for studies up to June 2023. This Campbell Systematic Review was published in 2025.