University of Malawi, Chancellor College, Zomba, Malawi.
J Nutr. 2013 Aug;143(8):1324-30. doi: 10.3945/jn.112.171280. Epub 2013 Jun 26.
In developing countries, schoolchildren encounter a number of challenges, including failure to complete school, poor health and nutrition, and poor academic performance. Implementation of school feeding programs (SFPs) in less developed countries is increasing and yet there is mixed evidence regarding their positive effects on nutrition, education, and cognition at the population level. This study evaluated cognitive and anthropometric outcomes in entry-level primary school children in Malawi with the aim of generating evidence for the ongoing debate about SFPs in Malawi and other developing countries. A total of 226 schoolchildren aged 6-8 y in 2 rural Malawian public primary schools were followed for one school year. Children attending one school (SFP school) received a daily ration of corn-soy blend porridge, while those attending the other (non-SFP school) did not. Baseline and post-baseline outcomes included the Cambridge Neurological Test Automated Battery cognitive tests of paired associate learning, rapid visual information processing and intra-extra dimensional shift, and anthropometric measurements of weight, height, and mid-upper arm circumference (MUAC). At follow-up, the SFP subcohort had a greater reduction than the non-SFP subcohort in the number of intra-extra predimensional shift errors made (mean 18.5 and 24.9, respectively; P-interaction = 0.02) and also showed an increase in MUAC (from 16.3 to 17.0; P-interaction <0.0001). The results indicate that the SFP in Malawi is associated with an improvement in reversal learning and catch-up growth in lean muscle mass in children in the SFP school compared with children in the non-SFP school. These findings suggest that the Malawian SFP, if well managed and ration sizes are sustained, may have the potential to improve nutritional and cognitive indicators of the most disadvantaged children.
在发展中国家，学童面临着许多挑战，包括未能完成学业、健康和营养状况差以及学业成绩不佳。在欠发达国家实施学校供餐计划（SFPs）的情况正在增加，但关于它们对营养、教育和人群认知的积极影响的证据存在差异。本研究评估了马拉维入门级小学生的认知和人体测量学结果，旨在为马拉维和其他发展中国家正在进行的关于 SFPs 的辩论提供证据。在 2 所农村马拉维公立小学中，共有 226 名 6-8 岁的学童接受了为期一年的随访。在一所学校（SFP 学校）上学的儿童每天都可以获得玉米-大豆混合粥的定量配给，而在另一所学校（非 SFP 学校）上学的儿童则没有。基线和基线后结果包括剑桥神经测试自动化电池认知测试，包括配对联想学习、快速视觉信息处理和内外维度转换，以及体重、身高和中上臂周长（MUAC）的人体测量测量。随访时，SFP 亚组的内外维度转换错误数量比非 SFP 亚组减少更多（分别为 18.5 和 24.9；P 交互作用=0.02），MUAC 也有所增加（从 16.3 增加到 17.0；P 交互作用<0.0001）。结果表明，与非 SFP 学校的儿童相比，马拉维的 SFP 与 SFP 学校儿童的反转学习和瘦肌肉质量的追赶性增长改善有关。这些发现表明，如果管理得当且配给量得以维持，马拉维的 SFP 可能有潜力改善最弱势群体儿童的营养和认知指标。
