, we conducted an interventional participatory study with the participation of adolescents parents and health trainers of target middle schools . this paper aimed to compare the effects of these different training methods on the adolescents nutrition health promotion . among the 95,250 female students of tehran 's middle schools , 1823 participants of age 11 - 15 years were selected by stratified quota random sampling method from 15 middle schools of five geographic regions of tehran . the second group received training by school health trainers and the third group received designed training through their parents . the main questionnaire of this multidimensional study included 93 closed questions in which 28 questions focused on nutrition . family suitable nutritional habits pattern means suitable consumption of nutrients , and suitable consumption of various kinds of nutrients was defined as daily consumption of dairy , fruits , and vegetables and at least two or three times a week consumption of meat and cereals . the validity of questionnaire was confirmed through the peer - reviewed literature by 10 experts . its reliability was confirmed by test  retest ( reliability coefficient : 0.8 ) . on assessment following 2 years of intervention , it was 82% in the trained by parents group , 81% in the trained by health trainer group , and 80% in the control group . data analyses were done by the use of spss software version 16 ( chicago , il , usa ) . descriptive statistics alongside the chi - squared (  ) test and analysis of variance ( anova ) were used for the analysis . statistical significance level was set at p < 0.05 ( two tailed ) . participation in this study was voluntary , and self - administered questionnaires were filled anonymously on getting the consent of every participant after they were explained the objectives of the study . there was no significant difference in age , weight , height , body mass index ( bmi ) , and the wrist circumference in the three groups . based on bmi measurements , 64% of participants were thin , 28.6% normal , 6.3% overweight , and 1.1% were obese . 59.5% of the girls had a positive perception of their height , and in this regard , no significant difference was found between the study groups . overall , 14% of the students had imagined themselves as obese girls , and this imagination significantly was higher in the control group compared with the other two groups ( p = 0.0002 ) . 25.1% of the control group participants , 33.9% of those trained by school health trainers , and 41% of those trained by parents had positive perception about their physical form . the pattern of variables related to body image in the control group and the groups trained by school health trainers and parents , respectively , 34.8% , 31.9% , and 33.3% girls had special diet for losing weight . accordingly , having such diet in the trained groups , especially in the parents trained group , was less than in the control group . totally , 50% of the students who were on diet had normal bmi . only about 50% of subjects believed increasing need for calorie  during puberty and 11.9% of them believed it decrease . with regard to participants nutritional habits , moreover , the habit of eating breakfast was significantly higher in the trained groups in comparison with their counterparts in the control group ( p = 0.000 ) . appropriate consumption of various kinds of nutrients , dairy , meat , cereals , fruits , vegetables in the group trained by parents was higher than in the other groups , while use of fatty foods was higher in the control group than in other groups ( p = 0.0005 ) . the study of suitable use pattern of nutrients among the groups showed significant statistical difference in the suitable consumption of dairy , meat , cereals , and vegetables between the group trained by parents and the other groups ( p = 0.000 ) . there was a positive correlation between parents educational level and their family suitable nutritional habits and also with awareness of the adolescents regarding requirement of different nutrients . following special diet for weight loss and skipping meals was significantly lower in the trained groups ( p = 0.002 ) . this study indicated that nutritional health training leads to more tendency to eating breakfast in trained groups ( p = 0.000 ) . 88.2% of the participants believed that there was no difference between family members meal , but 11% of the adolescents thought that the fathers in the families received more and better meal . data analysis showed the high level of parents education led to less gender discrimination in the family . adolescence is a window to a healthy life in future . in order to promote adolescents health , we mobilized parents and school health trainers as the key stakeholders to participate in this interventional program . in the present study , 50% of the participants , despite having normal bmi , were following the weight loss diets , although in the trained groups , weight loss diets consumption was significantly less than in the other groups . also , intake of adequate nutrients in the group trained by parents was higher than in the other groups , while use of fatty foods in the control group was higher than in others . lack of family support , inadequate training , and limitations in the availability of healthy food are some barriers of adolescents healthy nutritional behavior . in some countries , but in our experience , 88% of the participants believed that there was no gender discrimination . as shown in our study , parents play a key role in knowledge transfer to their female adolescents for promotion of attitude and practice . we also faced some limitations such as lack of cooperation of some invited participants and long - term follow - up problems . we suggest that family - based interventional programs provide the best situation for adolescents nutrition health promotion , but there is no doubt that further studies , especially qualitative research , for the analysis of adolescents view points are needed for implementation of these programs .
background : unhealthy nutritional behaviors are a threat to adolescents . in this regard , 
 we compared different training methods through a participatory interventional study.materials and methods : through proportional random selection , 1823 female students were selected from 15 middle schools of tehran . following 2 years of intervention 
 , nutritional habits of three different interventional groups were assessed.results:eating breakfast was significantly higher in the trained groups , and the use of weight loss diets was lower in them than in the control group . 
 also , satisfactory consumption of various kinds of nutrients in the trained groups was more than in the control group.conclusion:participatory health training , especially through parents , leads to adolescence nutritional health promotion .