title: Association between junk food consumption and mental health in a national sample of Iranian children and adolescents: the CASPIAN-IV study.
abstract: OBJECTIVE
  The consumption of high energy and low nutritional content foods, which are known as junk foods, has increased. The aim of this study was to evaluate the association between junk food intake and mental health in a national sample of Iranian children and adolescents.
  
  
  METHODS
  Data were obtained from a surveillance system entitled CASPIAN-IV (Childhood and Adolescence Surveillance and Prevention of Adult Non communicable Disease) study of school students, ages 6 to 18 y in Iran. The students and their parents completed two sets of reliable questionnaires obtained from Global School Health Survey translated to Persian. The student questionnaire comprised several questions such as psychiatric distress (worry, depression, confusion, insomnia, anxiety, aggression, and worthless) and violent behaviors (physical fighting, being a victim, and bullying). The junk foods consisted of sweets, sweetened beverages, fast foods, and salty snacks.
  
  
  RESULTS
  In the sample of 13 486 children and adolescents, the frequency of junk food consumption was significantly associated with psychiatric distress (P < 0.001). There was a significant association between violent behaviors and intake of junk foods (P < 0.001) except for sweets, whereas the association between sweetened beverages consumption and being a victim was not significant (P > 0.05). Additionally, the results of logistic regression showed that daily consumption of sweetened beverages and snacks significantly increased the odds of self-reported psychiatric distress. Also, daily consumption of salty snacks was significantly associated with violent behavior, including physical fighting (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.21-1.60), being a victim (OR, 1.19; 95% CI, 1.04-1.37), and bullying (OR, 1.55; 95% CI, 1.32-1.82).
  
  
  CONCLUSIONS
  Junk food consumption may increase the risk for psychiatric distress and violent behaviors in children and adolescents. Improvement of eating habits toward healthier diets may be an effective approach for improving mental health.
authors.affiliation: Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hoda
authors.initials: H
authors.lastname: Zahedi
authors.affiliation: Department of Pediatrics, Child Growth and Development Research Center, and Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.affiliation: Department of School Health, Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran; Department of Pediatrics, Ahvaz University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Shirin Hasani
authors.initials: SH
authors.lastname: Ranjbar
authors.affiliation: Department of School Health, Bureau of Population, Family and School Health, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Moloud
authors.initials: M
authors.lastname: Payab
authors.affiliation: Bureau of Health and Fitness, Ministry of Education and Training, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Chinian
authors.affiliation: Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Asayesh
authors.affiliation: Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Bagher
authors.initials: B
authors.lastname: Larijani
authors.affiliation: Department of Public Health, Alborz University of Medical Science, Karaj, Iran; Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: mqorbani1379@yahoo.com.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
mesh_terms: D000293:Adolescent; D000374:Aggression; D058445:Bullying; D002648:Child; D019548:Crime Victims; D004032:Diet; D019422:Dietary Sucrose / Q000009:adverse effects; D057140:Fast Foods / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D005518:Food Preferences; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008603:Mental Health; D009753:Nutritive Value; D062410:Snacks; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D014754:Violence
chemical_list: D019422:Dietary Sucrose; D017673:Sodium Chloride, Dietary
keywords: Junk food; Psychiatric distress; Violent behaviors