Breakfast and Snack Patterns among Iranian Children and Adolescents: A Systematic Review

Document Type : Systematic Review


Pediatric Endocrinologist, Aliasghar Children's Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.



Background: Breakfast is the most important meal of the day, but many children and adolescents miss the morning meal every day. This study aims to investigate the pattern of breakfast and snack consumption and their effective factors among primary and high school students in Iran.
Materials and Methods: In this systematic review, two independent researchers selected articles that reported on the status of breakfast and snacks among students in the Scopus, EMBASE, Cochrane Library, Web of Science, CINAHL, Medline, CIVILICA databases, and Google Scholar search engine, without time restrictions up to December 2022.
Results: A total of 21 studies involving 45,778 children and adolescents were included. The results showed that 32.2% (9.3-32.2) of school children and 32.08% (2.1-32.08) of high school students skipped breakfast. Also, 97.7% (10.5-97.7) of children and 92.8% (17.3-92.8) of adolescents reported regular breakfast. The midmorning snack intake was reported among 97.7% (13-97.7) of children and 96.2% (48.6-96.2) of adolescents. The primary reasons for missing breakfast were low appetite, waking up late in the morning, non-flavored foods, and inattention of mothers. A significant relationship was found between snack consumption and maternal age, maternal educational level, gender, urban inhabitants, and birth order of the students (p<0.045). There was an inverse relationship between students’ age, economic situation, and breakfast consumption (p=0.01 and r= -0.143).
Conclusion: Breakfast skipping and snack consumption were frequent among children and adolescents. The most important reasons for missing breakfast were low appetite, waking up late in the morning, non-flavored foods, and mothers’ inattention. It is necessary to plan school health promotion programs for parents and students to encourage students to eat healthy breakfasts and snacks.