Meal Regularity among School-going Adolescents in Bouaké, Côte d'Ivoire: Role of Living Conditions and Association with Nutritional Status

Background: Meal regularity during adolescence may be influenced by living conditions, but evidence from secondary schools in Bouaké remains limited. Aim: To analyse the meal habits of secondary school students in Bouaké (Côte d'Ivoire) in relation to their living conditions and nutritional status. Study Design: Cross-sectional descriptive and analytical study. Place and Duration of Study: Lycée Moderne Belleville, Bouaké (Côte d'Ivoire), during the 2023-2024 school year. Methodology: A total of 314 students aged 11-22 years (172 boys and 142 girls) completed a structured questionnaire covering the intake, frequency, place, timing and composition of their three daily meals. Weight and height were measured. Body mass index-for-age and height-for-age Z-scores were calculated using the 2007 World Health Organization growth references. Determinants were identified by multivariable logistic regression. Results: Only 46.8% of students ate breakfast every day and 43.6% ate three meals daily. Compared with students reporting good living conditions, those with average or poor living conditions were more likely to skip breakfast (adjusted odds ratio [aOR] = 4.80; 95% confidence interval [CI]: 2.34-9.83; P < .001). Lack of money was the main reason among the latter (56.0%), whereas lack of time predominated among students with good living conditions (52.2%). Thinness was more frequent among students eating three meals daily (13.1% vs 4.0%; aOR = 3.65; 95% CI: 1.42-9.38; P = .007). Stunting was less frequent among those eating at least one meal away from home (aOR = 0.56; 95% CI: 0.33-0.97; P = .04). Conclusion: Irregular meal patterns follow a marked social gradient. School breakfast programmes targeting disadvantaged students are warranted.