Int. J. Environ. Res. Public Health 2010, 7 3 and malnutrition additionally plays an important role in academic performance [24,25]. Hence, health surveillance questionnaires to detect students with health problems associated with academic functioning should inquire about social support, general health, physical and psychological health, study-related issues, help-seeking behaviour and life events in the past [26]. However, as regards the triad of educational satisfaction, health parameters and educational achievement, the literature suggests several gaps. First, these three important and related aspects have rarely been simultaneously examined in conjunction with each other. Most studies of health-promoting profiles of students, such as the European Health and Behaviour Survey conducted in 20 countries, did not explore the associations between health and academic achievement [27]. Indeed Al-Kandari and Vidal [28] noted that no study has yet been published on e.g., nursing students‘ health promoting lifestyle profiles, particularly examining their relationship with academic performance and nursing courses. Conversely, most studies of the factors associated with students‘ educational attainment were mainly concerned with educational and/or demographic variables and did not concurrently explore the students‘ health-related parameters [29]. For instance, Ofori [30] researched two variables (age, entry qualifications) on university students‘ performance (educational achievement) but no health parameters were examined. Equally, surveys of students‘ satisfaction with their educational experiences did not simultaneously investigate the students‘ health parameters and/or educational achievement [31,32]. Likewise, studies of the impact of health and wellbeing on academic achievement and cognitive performance usually do not include any indicators of satisfaction with the educational experience [7]. Narrow examinations of the issues omit the inclusion of many important variables, jeopardising a study findings‘ validity and generalisability. Second, geographically, the majority of research that assessed the associations between health/health programmes and academic achievement was undertaken in the USA [33-35], with fewer studies from the UK or elsewhere [28]. Third, we are not aware of research that included the actual satisfaction with the educational experience as an independent variable in predicting the students‘ achieved grades. When such or parallel measures of satisfaction were employed, they were used as an outcome rather than a predictor: Felner et al. [36] included student self-reported positive experience of the school climate as an outcome (achievement measure). Fourth, the associations between health/health programmes and academic attainment were mostly examined in elementary, middle or high school children [7,36-39], rather than university/college students [28]. Fifth, in relation to the outcomes of academic achievement, many studies employed objective measure/s, usually the student‘s final marks, to gauge academic performance, e.g., arithmetic scores [40]; academic grades [41]; math grades [42]; reading scores [43]; science grades [44]; or grade point average of a course of study[28]. Less studies employed, in addition to objective measures of student achievement, other subjective measures (e.g., the personal importance to students in achieving good grades in their studies, or the student‘s subjective appraisal of their overall academic performance in comparison with their peers) in order to gauge students‘ subjective academic performance and understand their subjective perceptions of their academic attainment. Finally, despite the associations between health/wellbeing and academic achievements, the literature reveals few conceptual models that could help advance the understanding of such relationships. Hence there is