Nutrition and education: a randomized trial of the effects of breakfast in rural primary school children

Hunger during school may prevent children in developing countries from benefiting from education. Although many countries have implemented school feeding programmes, few of these have been rigorously evaluated. We conducted a randomized, controlled trial of giving breakfast to undernourished and adequately nourished children. The undernourished group comprised 407 children in grades 2-5 in 16 rural Jamaican schools (weights-for-age < - 1SD of the National Centre for Health Statistics references) and the adequately nourished group comprised of 407 children matched for school and class (weight-for-age > - 1SD). Both groups were stratified by class and school, than randomly assigned to breakfast or control groups. After the initial measurements, breakfast was provided every school day for one year. Children in control group were given one-quarter of an orange and the same amount of attention as children in breakfast group. All children had their heights and weights measured and were given the Wide Range Achievement Test before and after the intervention. School attendance was taken from the school's registers. Compared with the control group, height, weight, and attendance improved significantly in the breakfast groups. Both groups made poor progress in Wide Range Achievement Test scores. Younger children in the breakfast group improved in arithmetic. There was no effect of nutritional group on the response to breakfast. In conclusion, the provision of a school breakfast produced small benefits in children nutritional status, school attendance, and achievement. Greater improvements may occur in more undernourished populations; however, the massive problem of poor achievement levels requires integrated programmes including health and educational inputs as well as school meals.

Early childhood supplementation and cognitive development, during and after intervention

Studies of the effects of supplementation during childhood have been reviewed previously and a meta-analysis of the concurrent effects on development was recently conducted. This review looks at five studies in Latin America and the Caribbean, in which the effects of supplementation have been assesses during the intervention period, as well as one or more years after the interventions ended. These studies are particularly relevant when considering the long-term effects of early childhood undernutrition and the policy implications for human resource development. The studies that will be reviewed were conducted in Mexico; Guatemala; Cali, Colombia; Bogota, Colombia; and Jamaica

Early childhood stimulation programs in Jamaica

Undernutrition and frequent infections are not the only causes of poor development in children living in poverty. These children usually have little in the way of stimulation in their homes

Adolescent girls school achievement: nutrition, health and social factors

In many developing countries there is little information on the nutritional status of adolescents. In general, research in this area has been neglected and attention focused on younger children who are most vulnerable to malnutrition. However, adolescents is a period of rapid growth and nutritional deficiencies may occur. In particular with menarche, iron deficiency may be a problem among adolescent girls (Brabin & Brabin, 1992). Poor levels of school achievement are a major problem in developing countries. Many social factors may affect school achievement, including parental attitudes to education, and the educational and occupational levels of the parents (Wagner, et al 1985). School characteristics such as teacher's training and availability of textbooks are also important (Schiefelbein & Simmons, 1979; Fuller, 1987). There is increasing recognition, however, that health and nutrition may contribute to poor school performance, either through effects on attendance, or by affecting children's ability to learn through poor attention and cognitive function (Pollitt, 1990). Health and nutrition variables have been included in some studies of the determinants of school performance among primary-school children in developing countries. After controlling for socio-economic factors, height-for-age was associated with achievement in several studies (Moock & Leslie, 1986; Agarwal et al, 1987; Florencio, 1988; Clarke et al, 1991) and weight-for-height was associated with achievement in one study (Popkin & Lim-Ybanez, 1982). Anaemia and missing breakfast or feeling hungry, also, have been reported to affect school performance (Popkin & Lim-Ybanez, 1982; Florencio, 1988; Clarke et al, 1991). Most of the children in these studies were of primary-school age and there is relatively little information on the extent to which health and nutrition affect achievement in adolescents.