1 Health Promotion Research Center, Zahedan University of Medical Sciences

2 Child 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

3 Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

4 Department of Health Education and Promotion, School of health, Iran University of Medical Sciences, Tehran, Iran

5 Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

6 Department of Pediatrics, Ahvaz University of Medical Sciences, Ahvaz, Iran

7 Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran

8 Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran

9 Department of Epidemiology and Biostatistics, Shahid Beheshti University of Medical Science, Tehran, Iran


Background: This study aimed to assess the relationship between meal frequency with mental distress and violent behavior among a nationally representative sample of Iranian children and adolescents.
Materials and Methods: The participants of this national study were 14,880 Iranian students with 6 to 18 years of age. They were selected from urban and rural regions of Iran by multi-stage cluster sampling method. The data were obtained about demographic information, mental distress, violent behaviors and meal frequency by the questionnaire of the World Health Organization-Global School-based Student Health Survey (WHO-GSHS).
Results: The response rate was 90.6%. The participants who were categorized as the group eating 3 meals per week significantly experienced less mental distress than those who were categorized as consuming 2 meals and one/no meal per week (P-value < 0.05). The min rate of violent behaviors was observed among participants who were classified as consuming 3 meals group and the max rate in one/no meal group. Participants who were categorized as consuming one/ no meal and 2 meals per week had higher risk of mental distress and violent behaviors compared with those whom consumed 3 meals per week.
Conclusions: Meal skipping was significantly associated with mental problems and violent behaviors among Iranian children and adolescents and this association was independent of known confounders.