Objective: To 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.
Design: Data were collected by self-administered questionnaire and measure of body weight and height.
Setting: High schools in urban and rural areas in Guilan Province, northern Iran.
Participants: Representative sample of 2302 school girls (1106 in Rasht City and 1196 in rural areas) selected by multistage cluster sampling.
Main outcome measures: Breakfast skipping, snacking habits at school, sleep habits, body weight, and height.
Analysis: Differences 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.
Results: Prevalence 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 implications: The 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.