title: Association of Breakfast Intake with Psychiatric Distress and Violent Behaviors in Iranian Children and Adolescents: The CASPIAN- IV Study.
abstract: OBJECTIVE
  To assess the relationship of breakfast intake with psychiatric distress and violent behaviors among Iranian children and adolescents.
  
  
  METHODS
  This national survey was conducted among 14,880 students, aged 6-18 y. They were selected by stratified multistage sampling method from urban and rural areas of 30 provinces of Iran. Breakfast intake, psychiatric distress, and violent behaviors were assessed by a questionnaire prepared based on the Global school-based student health survey of the World Health Organization. The data were analyzed by the STATA package.
  
  
  RESULTS
  The participation rate was 90.6 %. The percentage of psychiatric distress among breakfast skippers, semi-skippers and non-skippers was 13.4-50.4, 10.1-41.9, and 7.0-33.3 % respectively. The prevalence of psychiatric distress was significantly higher among breakfast skippers than semi-skippers and non-skippers (P value < 0.001). The frequency of psychiatric distress had a significant decreasing trend from breakfast skippers to non-skippers. The prevalence of violent behaviors was significantly higher among breakfast skippers than non-skippers. Students who skipped breakfast reported to be more victimized (29.2 % vs. 26.7 %, respectively, P = 0.04), bullied (21.0 % vs. 16.2 %, respectively, P < 0.001), and had more physical fight (42.6 % vs. 38.5 %, respectively, P = 0.0001) than their other counterparts.
  
  
  CONCLUSIONS
  Students who regularly consumed breakfast were less likely to experience mental health disorders and violent behavior. Adhering to a regular and balanced diet, besides the awareness of parents on the importance of breakfast eating, may be an appropriate approach for preventing mental health problems and violent behavior in children and adolescents.
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, # 111, 19th St, North Kargar Ave., Tehran, Iran.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Ahadi
authors.affiliation: 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.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.affiliation: Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
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 Clinical Psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Mahtab
authors.initials: M
authors.lastname: Aram
authors.affiliation: Department of Pediatrics, Ahvaz University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: 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.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Gita
authors.initials: G
authors.lastname: Shafiee
authors.affiliation: Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Masoud
authors.initials: SM
authors.lastname: Arzaghi
authors.affiliation: Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Asayesh
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, # 111, 19th St, North Kargar Ave., Tehran, Iran. rheshmat@tums.ac.ir.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D062408:Breakfast; D058445:Bullying; D002648:Child; D002652:Child Behavior; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D001523:Mental Disorders; D014754:Violence
keywords: Breakfast; Bullying; Children and adolescents; Psychiatric; Violence