The Indian Journal of Pediatrics

, Volume 83, Issue 9, pp 922–929 | Cite as

Association of Breakfast Intake with Psychiatric Distress and Violent Behaviors in Iranian Children and Adolescents: The CASPIAN- IV Study

  • Zeinab Ahadi
  • Roya Kelishadi
  • Mostafa Qorbani
  • Hoda Zahedi
  • Mahtab Aram
  • Mohammad Esmaeil Motlagh
  • Gelayol Ardalan
  • Gita Shafiee
  • Seyed Masoud Arzaghi
  • Hamid Asayesh
  • Ramin HeshmatEmail author
Original Article



To assess the relationship of breakfast intake with psychiatric distress and violent behaviors among Iranian children and adolescents.


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.


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.


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.


Breakfast Psychiatric Bullying Violence Children and adolescents 



This nationwide survey was conducted in Iran with corporation of the Ministry of Health and Medical education; Ministry of Education and Training, Child Growth and Development Research Center, Isfahan University of Medical Sciences; and Endocrinology and Metabolism Research Center of Tehran University of Medical Sciences.


All authors read and approved the final manuscript. RH will act as guarantor for the paper.

Compliance with Ethical Standards

Conflict of Interest


Source of Funding


Ethical Approval

Ethical approval was obtained for the main study, no approval has been sought for this research.


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Copyright information

© Dr. K C Chaudhuri Foundation 2016

Authors and Affiliations

  • Zeinab Ahadi
    • 1
  • Roya Kelishadi
    • 2
  • Mostafa Qorbani
    • 3
  • Hoda Zahedi
    • 4
  • Mahtab Aram
    • 5
  • Mohammad Esmaeil Motlagh
    • 6
  • Gelayol Ardalan
    • 2
  • Gita Shafiee
    • 7
  • Seyed Masoud Arzaghi
    • 8
  • Hamid Asayesh
    • 9
  • Ramin Heshmat
    • 1
    Email author
  1. 1.Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
  2. 2.Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable DiseaseIsfahan University of Medical SciencesIsfahanIran
  3. 3.Department of Community MedicineAlborz University of Medical SciencesKarajIran
  4. 4.Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences InstituteTehran University of Medical SciencesTehranIran
  5. 5.Department of Clinical Psychology, Science and Research BranchIslamic Azad UniversityTehranIran
  6. 6.Department of PediatricsAhvaz University of Medical SciencesAhvazIran
  7. 7.Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences InstituteTehran University of Medical SciencesTehranIran
  8. 8.Elderly Health Research Center, Endocrinology and Metabolism Population Sciences InstituteTehran University of Medical SciencesTehranIran
  9. 9.Department of Medical EmergenciesQom University of Medical SciencesQomIran

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