In-school Snacking, Breakfast Consumption, and Sleeping Patterns of Normal and Overweight Iranian High School Girls: A Study in Urban and Rural Areas in Guilan, Iran

ObjectiveTo investigate the relationship of snacking during school hours, sleep time, and breakfast consumption by weight status of Iranian high school girls in urban and rural areas in Guilan Province, Iran.DesignData were collected by self-administered questionnaire and measure of body weight and height.SettingHigh schools in urban and rural areas in Guilan Province, northern Iran.ParticipantsRepresentative sample of 2302 school girls (1106 in Rasht City and 1196 in rural areas) selected by multistage cluster sampling.Main Outcome MeasuresBreakfast skipping, snacking habits at school, sleep habits, body weight, and height.AnalysisDifferences in the frequency of the measured variables between the urban and rural girls and overweight and normal weight girls were tested using the chi-square test, P < .05.ResultsPrevalence of obesity was significantly (P < .05) lower in urban areas (4.1%) than in rural areas (5.2%). Prevalence of overweight was significantly higher in those who usually skipped breakfast (P < .001). Consumption of food items of low nutrient density as snacks during the school day was common in this population, especially in rural areas.Conclusion and ImplicationsThe school environment may contribute to the high prevalence of overweight/obesity observed among Iranian adolescent females. Students should be encouraged to eat breakfast and choose nutritious snacks during the school day.