Maryam Bahreynian - Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
Roya Kelishadi - Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
Mostafa Qorbani - Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran
Mohammad Esmaeil Motlagh - Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

Background: Aggression and violence are significant serious public health issues worldwide. Dietary intake might play an important role in development and establishment of such behaviors. This study aims to explore the association of nutritional intake and aggressive behaviors among a nationally representative sample of Iranian children and adolescents. Material and methods: This nationwide cross-sectional study was conducted on a multi-stage sample of 14880 students, aged 6-18 years, living in 30 provinces in Iran. Parents were asked to report dietary intake of children as frequency of food groups and/or items. The World Health Organization-Global School-based Health Survey (WHO-GSHS) was used to measure components related to aggression including physical fight, verbal aggression, and being bullied by other students.Results: The participants consisted of 13486 students (90.6% participation rate) with mean age of 12.47 years (95% CI: 12.40, 12.54), 49.2% were girls, and 75.6% from urban areas. Physical fighting was more prevalent among urban boys [(48.63%), CI (46.75, 50.5)] while bulling was the most common aggressive behavior among boys [(29.7%), CI (28.03, 31.42)] and girls [(25.26%), CI (23.66, 26.93)] living in urban areas. Daily consumption of fast foods, sweets, soda, salty snacks and fried foods was higher among those who frequently experienced physical aggression and bullying. Bullying to others increased significantly with consumption of fast food (Odds ratio: 1.43, CI: 1.07, 1.92) and red meat (Odds ratio: 1.14, CI: 1.02, 1.28). Salty snack consumption showed a significant association with physical fighting (Odds ratio: 1.29, CI: 1.15, 1.44). Conclusion: These findings suggest that some unhealthy foods might affect the mental health of children and adolescents, improvement of dietary habits should be considered for prevention of violence in the vulnerable age group of childhood and adolescence.

Aggressive behaviors, Violence, Nutrition, Dietary intake, Adolescents, Children