This study will assess the impact of a school meal program on the nutritional status and academic performance of primary school children in Lahore, Pakistan. Children aged 6-11 years from selected government primary schools will participate in the study. Children in the intervention group will receive a balanced school meal during school hours for 12 weeks, providing approximately one-third of their daily energy requirement, while children in the control group will continue their usual dietary practices. The study will compare changes in children's nutritional status, including weight, height, body mass index, mid-upper arm circumference, and body composition, as well as school attendance and examination performance. The study will also examine whether nutritional status is related to academic performance.
Childhood nutrition is an important determinant of physical growth, cognitive development, and academic performance. Poor nutrition may affect children's physical health, concentration, school participation, and learning. School meal program provide an opportunity to improve children's access to nutritious food during school hours; however, there is limited evidence from Pakistan on their effects on both nutritional status and academic performance. This study will be conducted among primary school children aged 6-11 years enrolled in Grades 1-5 in selected government primary schools in peri-urban areas of Lahore, Pakistan. The selected schools will be characterized by food insecurity, low socioeconomic status, limited access to basic facilities, and educational vulnerability. The study will use a school-based pre-post intervention design with a control group and will be conducted over 12 weeks. Children in the intervention group will receive a school meal designed to provide approximately one-third of the daily energy requirement for school-aged children. Children in the control group will continue their usual dietary practices and regular school routine without receiving the study meal. Daily records will be maintained to monitor meal distribution and consumption among children in the intervention group, with support from teachers and school staff. Changes in nutritional status will be assessed before and after the 12-week intervention using anthropometric measurements, including height, weight, BMI-for-age, and mid-upper arm circumference (MUAC). Body composition will also be assessed using bioelectrical impedance analysis to obtain indicators such as fat mass and muscle mass. Educational outcomes will be assessed using school records, including school attendance and examination scores. Pre- and post-intervention questionnaires will collect information on dietary intake, socioeconomic background, and general health to provide additional information for interpretation of the study findings. The primary objective of the study is to assess the impact of the school meal program on the nutritional status and academic performance of primary school children in Lahore. The study will also examine the relationship between nutritional status and academic performance. The findings are expected to provide locally relevant evidence regarding the potential contribution of school meal program to child nutrition and educational outcomes and may support evidence-based decision-making regarding school meal programs in Pakistan.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
496
A daily school meal will be provided to primary school children for 12 weeks as part of a school meal program. The meal is designed to provide approximately one-third of the children's daily energy requirements and will be provided during the school day.
University of Veterinary and Animal Sciences, Lahore
Lahore, Punjab Province, Pakistan
Change in body weight (kg)
Change in body weight from baseline to 12 weeks among children participating in the school meal intervention compared with the control group. Body weight will be measured in kilograms using standardized anthropometric procedures.
Time frame: Baseline to 12 weeks
Change in body mass index (BMI, kg/m²)
Change in body mass index from baseline to 12 weeks among children participating in the school meal intervention compared with the control group. BMI will be calculated from measured weight and height.
Time frame: Baseline to 12 weeks
Change in mid-upper arm circumference
Time frame: Baseline to 12 weeks
Change in Dietary Diversity Score (0-10)
Dietary diversity will be assessed based on the number of food groups consumed during the previous 24 hours. The score ranges from 0 to 10, with higher scores indicating greater dietary diversity. Scores of 0-3 indicate low dietary diversity, 4-5 indicate moderate dietary diversity, and \>5 indicate high dietary diversity. Change from baseline to post-intervention will be reported as the difference in dietary diversity score.
Time frame: Baseline to 12 weeks
Change in fat mass (kg)
Time frame: Baseline to 12 weeks
Change in skeletal muscle mass (kg)
Time frame: Baseline to 12 weeks
Change in school attendance rate (%)
Time frame: Baseline to 12 weeks
Number of participants reporting acute illness episodes
Acute illness reported by participants/parents during the specified recall period. The number and percentage of participants reporting illness will be compared between baseline and post-intervention.
Time frame: During the 12-week intervention
Change in academic test score (%)
Academic performance will be assessed using the study-specific curriculum-based test. Change from baseline to post-intervention will be reported as the difference in test scores.
Time frame: Baseline to 12 weeks
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