NUTRITIONAL STATUS AND ITS ASSOCIATION WITH ACADEMIC PERFORMANCE AMONG SCHOOL-AGE CHILDREN IN PAKISTAN: A COMMUNITY-BASED SURVEY

Abstract

BACKGROUND: Nutritional deficiencies remain a major public health concern in Pakistan, significantly affecting children’s growth, cognition, and educational performance. School-age children, a vulnerable group in developing regions, often suffer from undernutrition and micronutrient deficiencies that may compromise learning potential and academic success.

OBJECTIVE: To assess the nutritional status, including BMI and key micronutrient deficiencies, and to examine their association with cognitive and academic performance among school-age children in Pakistan.

 METHODOLOGY: A community-based cross-sectional study was conducted in Lahore, Jamshoro, and Peshawar from March to October 2022, involving 420 children aged 6–12 years. Anthropometric measurements were recorded following WHO protocols. Hemoglobin, ferritin, vitamin D, and zinc levels were analyzed to determine micronutrient status. Academic achievement was assessed using mean school scores, while cognitive function was evaluated using the Raven’s Colored Progressive Matrices test. Data were analyzed using SPSS v26.0 with ANOVA, chi-square, and multiple linear regression tests, considering p < 0.05 as statistically significant.

 RESULTS: Among participants, 26.7% were underweight, 45.5% were anemic, and 48.1% had vitamin D deficiency. Children with normal BMI had significantly higher academic scores (74.9 ± 7.8%) compared to underweight peers (64.2 ± 8.5%). Normal hemoglobin levels were associated with superior academic performance (75.2 ± 8.1%) and cognitive scores (63.7 ± 8.8 percentile). BMI (r = 0.41, p < 0.001) and hemoglobin (r = 0.33, p = 0.002) were independent predictors of academic success.

CONCLUSION: Poor nutritional status and micronutrient deficiencies were strongly associated with reduced academic and cognitive performance. School-based nutrition programs focusing on balanced diets and micronutrient supplementation are crucial to improving child health and learning outcomes in Pakistan.

 KEY TERMS: Academic performance; Anemia; Body mass index; Child nutrition; Cognitive function; Micronutrient deficiencies; Pakistan