Predictors of breakfast consumption among Iranian students: applying social cognitive theory

Year & Volume - Issue: 
Shadi Askari, Nooshin Salimi, Ehsan Bakhshi
Article type: 
PDF File: 
Background — Despite the known significance of regular breakfast consumption, skipping or inadequate consumption of breakfast is common among students. Social cognitive theory (SCT) is one of the most effective theories in predicting nutritional behaviors, especially breakfast-related behaviors Objective — This study aimed to determine the factors related to breakfast consumption based on SCT among students of Islamic Azad University Kermanshah Branch. Methods — In this cross-sectional study, 206 students of Islamic Azad University Kermanshah Branch were selected based on availability sampling. An online questionnaire consisting of demographic information scales, SCT variables and breakfast consumption behavior was sent to student groups. Data were analyzed using descriptive statistical tests, chi-square test, linear regression and correlation analysis in SPSS software version 16. Results — On average, students consume breakfast 4.39 times a week. Overall, 17.6% of students had completely ignored breakfast and 42.4% of them ate breakfast irregularly between one and six times a week. Among the components of social cognitive theory, self-efficacy and observational learning predicted 55.7% of changes in breakfast consumption among students (P<0.001). Conclusions — It seems that social cognitive theory is a useful framework for predicting breakfast consumption behavior among young people, and it is possible to improve breakfast consumption behavior by designing and implementing appropriate educational interventions based on this theory.
Cite as: 
Askari Sh, Salimi N, Bakhshi E. Predictors of breakfast consumption among Iranian students: applying social cognitive theory. Russian Open Medical Journal 2022; 11: e0208.


Breakfast is defined as the first meal of the day. This meal is usually taken before the start of daily activities up to 2 hours after waking up [1]. Breakfast is considered as a good source of energy that should provide about 20-25% of daily energy [2, 3]. Obtaining enough energy in the morning can have significant benefits [4]. Various studies have shown substantial evidence regarding the direct relationship between breakfast consumption and physical and mental condition [5, 6]. Eating breakfast at the beginning of the day can prevent the consumption of snacks and other harmful and extra meals during the day; moreover, it can be associated with a decrease in body mass index (BMI) and a reduced risk of obesity [7-9]. The risk of obesity in children and adolescents who do not eat breakfast is43 percent more than those who eat breakfast regularly [10]. The countless benefits of regular breakfast can lead to better mental health [11], academic achievement [12], better physical function [13], and reduction in stress and depression [14]. There is a significant relationship between skipping breakfast and the prevalence of various diseases and people who do not eat breakfast are faced with an increased risk of non-communicable diseases such as cardiovascular disease [15, 16], diabetes [17], some cancers [18] and mental illnesses [19]. Despite the known significance regular breakfast consumption, this meal is more often ignored by young people [20]. Reportedly, skipping or inadequate consumption of breakfast are common among students [21, 22]. The results of a study conducted in 10 European countries with the highest rate of skipping breakfast showed that 44% of girls and 36% of boys refused to eat breakfast [6]. The rate of skipping breakfast varies among different populations [23]. The study conducted among university students aged 18-27 in Santiago showed that only 53% of them eat breakfast regularly between 5 and 7 times a week [24]. In a similar study of medical students in Iran, only 24% of students consumed breakfast regularly, 10% never ate breakfast, and 66% ate breakfast irregularly and between 1 and 6 times a week [23]. In the present study, social cognitive theory was used as a theoretical framework. This theory, while stating the predictors and effective basics in the formation of behavior, offers solutions to changing behavior. According to the Social Cognitive Theory (SCT), nutritional behaviors are explained by individual factors (e.g., awareness, attitudes and beliefs, self-efficacy and body satisfaction), behavioral factors (e.g., meal patterns, participation in breakfast preparation, and participation in shopping for breakfast ingredients), and socio-environmental factors or interpersonal factors (e.g., access to healthy food at home, parental behavior, and support of family and friends for consuming regular breakfast) [25]. This is one of the most effective theories in predicting nutritional behaviors, especially breakfast-related behaviors [23, 25, 26]. Kermanshah is located in the west of Iran and is bordered by Iraq. In terms of health indicators, Kermanshah with a population of about two million people in 2016 is one of the most deprived provinces of Iran [27, 28]. Based on researches, food insecurity was highly prevalent in Kermanshah families [29, 30], and due to such situation, breakfast plays a major role. Nevertheless, no study has been conducted with the aim of measuring the effective factors in regular breakfast consumption among students in Kermanshah. Therefore, the present study was performed to investigate the predictors of regular breakfast consumption based on SCT in students of Islamic Azad University Kermanshah Branch.


Material and Methods

Study participants and setting

This research is a descriptive cross-sectional analytical study using availability sampling. Also, an online questionnaire was sent for collecting data in 2020 with participation of 206 students of Islamic Azad University, Kermanshah Branch (Kermanshah being a province in western Iran).



To collect data in this study, a researcher-made questionnaire of Salimi et al [23] was used, and its reliability was measured in the study population via Cronbach’s alpha coefficient. This questionnaire consisted of three parts. The first part was the personal information questions including seven questions (such as age, gender, and marital status). The second part was SCT structures which consisted of awareness (6 questions with a maximum score of 6), observational learning (3 questions with a maximum score of 15), outcome expectations and outcome expectancies (5 questions each with a maximum score of 25), social support (6 questions with a maximum score of 30), and self-efficacy (7 questions with a maximum score of 35). In addition, the third part of questionnaire measured breakfast consumption in the past week (never to 7 time in week). To assess the reliability of the questionnaire, the internal correlation method was used. To this end, 25 students who were not present in the main sample first completed the questionnaire as a pilot effort, and then Cronbach’s alpha coefficient was calculated. Thus, Cronbach’s alpha coefficient for observational learning was 90%, outcome expectations 84%, outcome expectancies 86%, awareness 75%, social support 87%, and self-efficacy 95%. Due to the coronavirus pandemic and need to observe social distancing, as well as the absence of students in universities to break the chain of disease transmission, questionnaires were designed online using Google Docs and a link to the questionnaires was sent to all WhatsApp Classmate Groups in Islamic Azad University Kermanshah Branch.


Inclusion criteria

Students studying at Islamic Azad University Kermanshah Branch and a written informed consent to participate in the study.


Statistical analysis

After sending the online questionnaire and completing the questionnaires by the students, the data were analyzed using descriptive statistical tests, chi-squared test, linear regression, and correlation analysis via SPSS software, version 16. Also, p<0.05 was set as the cut-off value of statistical significance.



Students’ demographic information and their relationship with breakfast consumption behavior are presented in Table 1. On average, students consume breakfast 4.39 times a week. Overall, 40% of the students in the present study ate breakfast regularly every day, 17.6% never, 42.4% ate irregularly with one and six times a week. Among the demographic variables, only the grade point average of students had a significant relationship with breakfast consumption, so that students with higher grade point average ate breakfast more often. Table 2 shows the correlations between the structures of SCT and the average of weekly consumption of breakfast. All components of SCT had a significant relationship with students’ breakfast consumption behavior (p<0.001). In the next step, components were entered in the regression model. The purpose of this analysis was to determine the predictors of breakfast consumption in the studied students. Table 3 shows the predictors of breakfast consumption. The results of linear regression analysis showed that among the components of this theory, self-efficacy and observational learning could significantly predict 55.7% changes in breakfast consumption (p<0.001).


Table 1. Demographic variables and their relationship with breakfast consumption behavior

Demographic variables



Average score of breakfast consumption behavior




























Marital status






















Type of accommodation

With family





In a dormitory





Birth rank
















Fourth or greater





Average point





< 0.001






















Table 2. Correlation between the structures of social cognitive theory and breakfast consumption behavior in the studied students



Outcome expectations

Outcome expectancies

Observational learning


Social support

Breakfast consumption behavior














Outcome expectations







Outcome expectancies







Observational learning














Social support







** – Correlation is significant at the 0.01 level (2-tailed).


Table 3. Regression analysis to predict breakfast consumption behavior based on social cognitive theory components in students

R Square



Standardized Coefficients Beta

Std. Deviation




< 0.001

̵̵ 4.503






̵ 1.207

̵ 1.076









Outcome expectations






Outcome expectancies

< 0.001





Observational learning

< 0.001











Social support



To the best of our knowledge, few studies have applied SCT to predict breakfast consumption and its effective factors in students. This study was designed to examine the predictors of regular breakfast consumption based on SCT in students. The results showed that the average of breakfasts consumption in students was 4.39 times a week. In addition, 40% of them ate breakfast regularly and 60% did not eat breakfast at all or ate it irregularly. The findings of a study by Mansouri et al. with the participation of students from 28 different provinces in Iran showed that 4.1% of students consume breakfast less than once a week [31]. Different percentages of breakfast consumption have been reported among students in different countries. In this connection, the study of Pengpid et al., which was conducted among students from 28 Asian countries, revealed that 13.8% of students never eat breakfast, 34.2% had it irregularly, and 51.9% eat breakfast daily and regularly [32]. These different results may be due to differences in dietary patterns in cultures or discrepancies in the definition and evaluation of regular breakfast consumption [12, 24, 33]. Among the studied demographic variables, only the grade point had a direct and significant correlation with the average of breakfasts consumption. The results of several studies show a direct relationship between breakfast consumption and academic performance [34, 35]. Adolphus et al. reported that regular breakfast consumption by adolescents and a high score in math are directly and statistically significantly associated with each other [12]. In the present study, all components of the SCT were significantly associated with breakfast consumption behavior, but among these six components, only self-efficacy and observational learning were significant predictors of breakfast consumption behavior among students of this university. Moreover, it could explain 55.7% of the variance in breakfast consumption. Several theories have been investigated for predicting the pattern of breakfast consumption with varying results. The study of Mirzaei et al. indicated that SCT significantly predicts breakfast consumption and the components of this theory were able to explain 41.4% of the variance in breakfast consumption. In Mirzaei's study, self-regulation was the strongest predictor of breakfast consumption behavior [26]. In a study that used Pender Health Promotion Model (HPM) to predict breakfast consumption, this theory was able to predict 47% of breakfast consumption changes [36]. Additionally, Morvati Sharifabad et al. found that the Theory of Planned Behavior (TPB) could predict 50% of the variance of behavioral intention and 8% of the variance in breakfast consumption behavior [37]. Mullan et al. showed that TPB could predict 47.6% and the Health Action Process Approach (HAPA) could explain 44.8% of the variance in breakfast consumption [38]. The results of our study confirmed the successful performance of SCT in predicting breakfast consumption and showed that self-efficacy was the strongest predictor in breakfast consumption. Students with higher self-efficacy consumed breakfast more regularly. Numerous studies have accentuated an important role of self-efficacy as a predictor of breakfast consumption [20, 25, 26, 39]. Higher self-efficacy seems to increase breakfast by overcoming barriers. In the study by Pournarani et al., there was a significant correlation between the mean of perceived barriers and self-efficacy in breakfast consumption. They demonstrated that to change breakfast behavior, self-efficacy can be enhanced by reducing perceived barriers [40]. In the present study, barriers such as lack of time, lack of sleep, repetitive and dislike of breakfast foods, lack of support from family and friends in preparing and consuming breakfast, as well as, overweight in measuring students’ self-efficacy were discussed. After self-efficacy, observational learning is another important predictor of breakfast behavior in this study. Observational learning is a natural human tendency to observe and imitate the behaviors of others. Accordingly, it is thought that individuals may learn a behavior by observing the experiences of others and not just by their own experience [41]. Some studies have shown that observational learning is not related to breakfast consumption [23, 25, 26]. To explain this lack of relation, they stated that living in a dormitory, being away from family and parents, and having less access to television as an important source of observational learning could be involved. In our study, about 80 percent of the students lived with their families and only 20 percent lived in dormitories, which can be a compelling reason. Although awareness, outcome expectations, outcome expectancies, and social support did not significantly predict breakfast behavior, all these components were significantly associated with breakfast consumption.

Like other studies, this study had some limitations such as being cross-sectional that makes it difficult to infer between dependent and independent variables. Also, measuring breakfast eating behavior by self-reporting may lead to the under- or overestimation of this behavior



In general, it can be stated that SCT is an appropriate framework for predicting breakfast behavior in young people. Also, self-efficacy and observational learning could predict 55.7% of changes in breakfast behavior in students. It seems that by designing and implementing educational interventions based on these structures, it is possible to deal with skipping the breakfast.



 The authors would like to thank the students of Islamic Azad University Kermanshah Branch for their participation and cooperation in this study.


Conflict of interest

All authors have no conflict of interest to declare.


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments, or comparable ethical standards.

  1. Mohiuddin AK. Skipping breakfast everyday keeps well-being away. J Food Sci Nutr Res 2018; 1(1): 18-30.
  2. Leidy HJ. The benefits of breakfast consumption to combat obesity and diabetes in young people. American Journal of Lifestyle Medicine 2013; 7(2): 99-103.
  3. St-Onge MP, Ard J, Baskin ML, Chiuve SE, Johnson HM, Kris-Etherton P, et al. Meal timing and frequency: implications for cardiovascular disease prevention: a scientific statement from the American Heart Association. Circulation 2017; 135(9): e96-e121.
  4. Ruddick-Collins LC, Johnston JD, Morgan PJ, Johnstone AM. The Big Breakfast Study: Chrono‐nutrition influence on energy expenditure and bodyweight. Nutr Bull 2018; 43(2): 174-183.
  5. Salimi N, Karimi-Shahanjarini A, Hazavehei SMM, Roshanaei G. The Effect of Education on Increase Breakfast Consumption Among Female Students Based on Social Cognitive Theory (SCT). Health Scope 2018; 7(4); e61758.
  6. Barrett N, Riordan F, Michels N, Andersen LF, vant Veer P, Moreno LA, et al. Breakfast Skipping and overweight/obesity among European adolescents, a cross-sectional analysis of the HELENA dataset: a DEDIPAC study. HRB Open Res 2018; 1: 19.
  7. Kahleova H, Lloren JI, Mashchak A, Hill M, Fraser GE. Meal frequency and timing are associated with changes in body mass index in Adventist Health Study 2. J Nutr 2017; 147(9): 1722-1728.
  8. Yahia N, Brown CA, Snyder E, Cumper S, Langolf A, Trayer C, et al. Prevalence of metabolic syndrome and its individual components among midwestern university students. J Community Health 2017; 42(4): 674-687.
  9. Sa J, Heimdal J, Sbrocco T, Seo DC, Nelson B. Overweight and physical inactivity among African American students at a historically Black University. J Natl Med Assoc 2016; 108(1): 77-85.
  10. Ardeshirlarijani E, Namazi N, Jabbari M, Zeinali M, Gerami H, Jalili RB, et al. The link between breakfast skipping and overweigh/obesity in children and adolescents: A meta-analysis of observational studies. J Diabetes Metab Disord 2019; 18(2): 657-664.
  11. Lesani A, Mohammadpoorasl A, Javadi M, Esfeh JM, Fakhari A. Eating breakfast, fruit and vegetable intake and their relation with happiness in college students. Eat Weight Disord 2016; 21(4): 645-651.
  12. Adolphus K, Lawton CL, Dye L. Associations between habitual school-day breakfast consumption frequency and academic performance in British adolescents. Front Public Health 2019; 7: 283.
  13. Burns RD, Fu Y, Brusseau TA, Clements-Nolle K, Yang W. Relationships among physical activity, sleep duration, diet, and academic achievement in a sample of adolescents. Prev Med Rep 2018; 12: 71-74.
  14. Ferrer-Cascales R, Sánchez-SanSegundo M, Ruiz-Robledillo N, Albaladejo-Blázquez N, Laguna-Pérez A, Zaragoza-Martí A. Eat or skip breakfast? The important role of breakfast quality for health-related quality of life, stress and depression in Spanish adolescents. Int J Environ Res Public Health 2018; 15(8): 1781-1790.
  15. Bandyopadhyay D, Ashish K, Hajra A, Ghosh RK. An interesting insight into breakfast and cardiovascular disease. Int J Cardiol 2018; 256: 7.
  16. Uzhova I, Fuster V, Fernández-Ortiz A, Ordovás JM, Sanz J, Fernández-Friera L, et al. The importance of breakfast in atherosclerosis disease: insights from the PESA study. J Am Coll Cardiol 2017; 70(15): 1833-1842.
  17. Uemura M, Yatsuya H, Hilawe EH, Li Y, Wang C, Chiang C, et al. Breakfast skipping is positively associated with incidence of type 2 diabetes mellitus: evidence from the Aichi Workers’ Cohort Study. J Epidemiol 2015; 25(5): 351-358.
  18. Verdalet-Olmedo M, Sampieri CL, Morales-Romero J, de Guevara HM-L, Machorro-Castaño ÁM, León-Córdoba K. Omission of breakfast and risk of gastric cancer in Mexico. World J Gastrointest Oncol 2012; 4(11): 223-229.
  19. Dabbagh-Moghadam A, Mozaffari-Khosravi H, Nasiri M, Miri A, Rahdar M, Sadeghi O. Association of white and red meat consumption with general and abdominal obesity: a cross-sectional study among a population of Iranian military families in 2016. Eat Weight Disord 2017; 22(4): 717-724.
  20. Sadr Hashemi F, Soltani R, Hassanzadeh A, Ali Eslami A. Relationship between breakfast consumption and self-efficacy, outcome expectations, evaluation and knowledge in elementary students. Int J Pediatr 2017; 5(1): 4163-4174.
  21. Lim RBT, Tham DKT, Müller-Riemenschneider F, Wong ML. Are University Students in Singapore Meeting the International and National Recommended Daily Servings of Fruits and Vegetables? Asia Pac J Public Health 2017; 29(3): 199-210.
  22. Lorenzini R, Betancur-Ancona DA, Chel-Guerrero LA, Segura-Campos MR, Castellanos-Ruelas AF. Nutritional status of university students from México in relation with their lifestyle. Nutr Hosp 2015; 32(1): 94-100. Spanish.
  23. Salimi N, Karimi-Shahanjarini A, Roshanaei G. Regular breakfast consumption and its predictors based on the social cognitive theory in female students of Hamadan University of Medical Sciences. J Educ Community Health 2014; 1(3): 20-27. Persian.
  24. Díaz-Torrente X, Quintiliano-Scarpelli D. Dietary Patterns of Breakfast Consumption Among Chilean University Students. Nutrients 2020; 12(2): 552.
  25. Panahi R, Sadr Hashemi F, Javanmardi E, Yousefi F, Rahmani K, Ghaderi N, et al. Factors associated with breakfast consumption based on Social Cognitive Theory in primary school students in Marivan City, 2017. Journal of Health in the Field 2020; 7(3): 12-21. Persian.
  26. Mirzaei A, Ghofranipour F, Ghazanfari Z. Social cognitive predictors of breakfast consumption in primary school’s male students. Glob J Health Sci 2016; 8(1): 124-132.
  27. Sabermahani A, Barouni M, Seyedin H, Aryankhesal A. Provincial human development index, a guide for efficiency level analysis: the case of Iran. Iran J Public Health 2013; 42(2): 149-157.
  28. Yazdani MH, Montazer FJ. Analysis of Indicators of Health Status in Provinces and Ten Regions of Iran. Journal of Health & Development 2020; 6(4): 290-301. Persian.
  29. Pasdar Y, Nachvak SM, Darbandi M, Morvaridzadeh M, Rezaeian S, Daneshi Maskooni M. A Population-based Cross-sectional Study of Food Insecurity and the Influential Factors in Households in Kermanshah,Iran. J Hum Environ Health Promot 2019; 5(3): 116-120.
  30. Damari B, Abdollahi Z, Hajifaraji M, Rezazadeh A. Nutrition and food security policy in the Islamic Republic of Iran: situation analysis and roadmap towards 2021. East Mediterr Health J 2018; 24(02): 177-188.
  31. Mansouri M, Hasani-Ranjbar S, Yaghubi H, Rahmani J, Tabrizi YM, Keshtkar A, et al. Breakfast consumption pattern and its association with overweight and obesity among university students: a population-based study. Eat Weight Disord 2020; 25(2): 379-387.
  32. Pengpid S, Peltzer K. Skipping Breakfast and Its Association with Health Risk Behaviour and Mental Health Among University Students in 28 Countries. Diabetes Metab Syndr Obes 2020; 13: 2889-2897.
  33. Spence C. Breakfast: The most important meal of the day? International journal of gastronomy and food science. 2017; 8: 1-6.
  34. Lee HJ, Kim CH, Han I, Kim SH. Emotional State According to Breakfast Consumption in 62276 South Korean Adolescents. Iran J Pediatr 2019; 29(6): e92193.
  35. Masoomi H, Taheri M, Irandoust K, H’Mida C, Chtourou H. The relationship of breakfast and snack foods with cognitive and academic performance and physical activity levels of adolescent students. Biological Rhythm Research 2020; 51(3): 481-488.
  36. Imani-Nasab MH, Ardalan A, Cheraghi N, Piri ZA, Ebrahimzadeh F, Bastami F. Determinants of breakfast consumption among adolescent girls: Application of the Health Promotion Model using Structural Equation Modeling. Research Square 2020; Preprint.
  37. Morowatisharifabad MA, Barzegar F, Nadjarzadeh A, Fallahzadeh H, Mehrjoyan N. Determinants of Consumer Behavior Breakfast The Students in Grades Four, Five Six Primary Schools in City AbarkuhBased on the Theory of Planned Behavior. Tolooebehdasht 2018; 17(3): 64-76.
  38. Mullan B, Wong C, Kothe E, Maccann C. Predicting breakfast consumption: A comparison of the theory of planned behaviour and the health action process approach. British Food Journal 2013; 115(11): 1638-1657.
  39. Dehdari T, Rahimi T, Aryaeian N, Gohari MR, Esfeh JM. Developing and testing a measurement tool for assessing predictors of breakfast consumption based on a health promotion model. J Nutr Educ Behav 2014; 46(4): 250-258.
  40. Pournarani R, Aghamolaei T, Mohseni S. Relationship of self-efficacy, benefits, barriers, and Processes of Change with stages of change for Breakfact counsumption in student of Jiroft City. J Prevent Med 2016; 3(1): 44-51. Persian.
  41. Glanz K, Rimer BK, Viswanath K, Eds. Health behavior and health education: theory, research, and practice. 4th Ed. San Francisco: Jossey-Bass. 2008; 592 p.
About the Authors: 

Shadi Askari – BSc, Student of Public Health, Department of Public Health, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran.
Nooshin Salimi – PhD, Assistant Professor, Department of Public Health, Kermanshah Branch, Islamic Azad University, Kermanshah, Iran.
Ehsan Bakhshi – MSc, Researcher, Kermanshah Health Center, Kermanshah University of Medical Science, Kermanshah, Iran.

Received 5 February 2021, Revised 5 November 2021, Accepted 1 February 2022 
© 2021, Russian Open Medical Journal 
Correspondence to Nooshin Salimi. Phone: +989186212848. E-mail: