Meal Frequency in Iranian Children and Adolescents at National and Sub-National Levels: The CASPIAN-IV Study

Background: This study aims to assess the pattern of meal frequency consumption of Iranian children and adolescents at national and subnational levels according to the socioeconomic status (SES) of the living region. Methods: This multi-centric study was conducted in 2011-2012 among 14,880 students, aged 6-18 years, who were selected by multistage random cluster sampling from 30 provinces. Meal frequency was assessed by the World Health Organization Global School-based student Health Survey (WHO-GSHS) questionnaire. Data were compared at national and sub-national levels according to the SES of the living region. Results: Overall, 13486 students completed this study (participation rate: 90.6%). The frequency of breakfast, lunch, and dinner skipping was 32.08% (95% CI: 30.99, 33.2), 8.58% (95% CI: 7.71, 9.54), and 10.90% (95% CI: 10.21, 11.62), respectively. The frequency of consuming 1 meal, 2 meals, and 3 meals a day was 9.60% (95% CI: 8.94, 10.31), 29.28% (95% CI: 28.31, 30.26), and 61.12 % (95% CI: 59.89, 62.34), respectively. The mean number of days per week of breakfast consumption was 5.14 (95% CI: 5.08, 5.20), the corresponding figure was 6.39 (95% CI: 6.35, 6.42), and 6.24 (95% CI: 6.21, 6.28) for lunch and dinner, respectively. These frequencies had no significant difference according to the SES of the living region. Conclusion: Most Iranian children and adolescents consumed all three main meals, however irrespective of SES; in general skipping breakfast was more frequent than skipping lunch and dinner. Regular meal intake, notably breakfast, should be considered in health promoting programs for all children and adolescents.