Micronutrients and Nutritional Supplements and School Performance and / or Cognitive Ability * ( Continued from previous page )

This article reviews research from published studies on the association between nutrition among school-aged children and their performance in school and on tests of cognitive functioning. Each reviewed article is accompanied by a brief description of its research methodology and outcomes. Articles are separated into 4 categories: food insufficiency, iron deficiency and supplementation, deficiency and supplementation of micronutrients, and the importance of breakfast. Research shows that children with iron deficiencies sufficient to cause anemia are at a disadvantage academically. Their cognitive performance seems to improve with iron therapy. A similar association and improvement with therapy is not found with either zinc or iodine deficiency, according to the reviewed articles. There is no evidence that population-wide vitamin and mineral supplementation will lead to improved academic performance. Food insufficiency is a serious problem affecting children’s ability to learn, but its relevance to US populations needs to be better understood. Research indicates that school breakfast programs seem to improve attendance rates and decrease tardiness. Among severely undernourished populations, school breakfast programs seem to improve academic performance and cognitive functioning. (J Sch Health. 2005;75(6):199-213) Parents, educators, and health professionals have long touted the association between what our children eat and their school performance. Evidence for this correlation is not always apparent, and biases on both sides of the argument sometimes override data when this topic is discussed. Understanding existing evidence linking students’ dietary intake and their ability to learn is a logical first step in developing school food service programs, policies, and curricula on nutrition and in guiding parents of school-aged children. The National Coordinating Committee on School Health and Safety (NCCSHS) comprises representatives of several federal departments and nongovernmental organizations working to develop and enhance coordinated school health programs. The NCCSHS has undertaken a project to enhance awareness of evidence linking child health and school performance and identifying gaps in our knowledge. NCCSHS has conducted a search of peerreviewed, published research reporting on the relationship between students’ health and academic performance. In addition to nutrition, NCCSHS has sponsored research reviews of the association between academic performance and asthma, diabetes, sickle cell anemia, sleep, obesity, and physical activity. SELECTION OF ARTICLES Articles meeting the following specific characteristics were selected. (1) Subjects were school-aged children (5 to 18 years), (2) article was published after 1980 in a peerreviewed journal, and (3) findings included at least 1 of the following outcome measures: school attendance, academic achievement, a measure of cognitive ability (such as general intelligence, memory), and attention. Students’ level of attention was only acceptable as an outcome measure for purposes of inclusion in this review, if attention was measured objectively in the school environment. Studies of the impact of nutritional intake in children prior to school age were not included. Studies were identified using MedLine and similar Internet-based searches. If a full article could not be retrieved, but a detailed abstract was available, the research was included. Outcomes other than academic achievement, attendance, and cognitive ability, although considered major by the authors, may not be described at all or are only briefly alluded to in the tables of research descriptions.