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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.

Is Meal Frequency Associated with Mental Distress and Violent Behaviors in Children and Adolescents? the CASPIAN IV Study