PEARLS 28, October 2007, written by Brian R McAvoy

Clinical question
Do school feeding programmes improve the physical and psychosocial health of disadvantaged school children?

Bottom line
Based on the 2004 World Bank List of Economies, school meals may have some small benefits for disadvantaged children. These relate to weight, height in younger children, attendance, maths performance and behaviour. Results from higher income countries are mixed, but generally positive. For height, results from lower income countries are mixed. In randomised controlled trials (RCTs), differences in gains are important only for younger children, but results from the controlled before and after trials (CBAs) are large and significant overall. For educational and cognitive outcomes, children who are fed at school gain more than controls on maths achievement, and on some short term cognitive tasks.

Caveat
In low income countries, children who are fed at school attend school more frequently than those in control groups; this finding translates to an average increase of 4 to 6 days a year per child. It is difficult to say whether this is sufficient to produce significant benefits in learning and academic performance.

Context
Early malnutrition and/or micronutrient deficiencies can negatively affect many aspects of child health and development. School feeding programmes are designed to provide food to hungry children and to improve their physical, mental and psychosocial health.

Cochrane Systematic Review
Kristjansson EA et al. School feeding programs for improving the physical and psychosocial health of disadvantaged elementary school children. Cochrane Reviews, 2007, Issue 1. Article No. CD004676. DOI: 10:1002/14651858.CD004676.pub2. Note: This review contains 18 trials with study size ranging from 10 to 5837 participants.