is meal frequency associated with mental distress and violent behaviors in children and adolescents? the caspian iv study

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.