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The effect of nutrition, diet and dietary change on learning, education and performance of children in school
Project Code: N05070
Centre for Food, Physical Activity and Obesity Research, University of Teeside
Ells, L ; Hillier, F; Summerbell, C
The Government is committed to promoting healthier schools and lifestyles among school children, for example through improving the quality of school meals and national nutritional standards. Whilst the commitment to improve school meals was primarily made on health grounds, there was considerable interest in how good nutrition may also impact on behaviour, learning and performance among school aged children. However the evidence base to support clear associations in this area were confused and lacked cohesion. It was therefore recommended that the UK Government ‘be encouraged to undertake an assessment into the links between good nutrition and educational performance’. This review was commissioned by the Food Standards Agency.
1. To create a systematic map of all empirical research that has been undertaken to evaluate the effect of nutrition, diet and dietary change on learning, education and performance in school aged children (4-18years) from the UK and other developed countries.
2. To perform a systematic in-depth review of the best evidence from controlled trials studies that have investigated the effects of nutrition, diet and dietary change on learning, education and performance in school aged children (4-18years) from the UK and other developed countries.
A systematic review of the current evidence base was performed. This involved exploration of the health and education databases using a tailored search strategy. The citations were then uploaded into Evidence for Policy and Practice Information (EPPI) reviewer, which was used to select English language papers investigating the effect of nutrition on educational outcomes in school aged children from thedeveloped world.
Sixty nine studies were identified for key word mapping, of these twenty nine were Randomised / Case Controlled Trials (RCT/CCT) studies that were taken forward for in-depth review. The majority (58%) of all studies originated from the USA. Of the studies selected for in-depth review, fifteen examined the effect of breakfast, of which ten identified an association between breakfast provision and some small cognitive and behavioural improvements. However, the variation in quality and research designs made it impossible to draw any firm conclusions. Six studies examined the effect of short term exposure to sugar intake in populations of predominantly primary school aged children with Attention Deficit Hyperactivity Disorder. However, collectively these studies showed that sugar intake had no clinically significant adverse effects on learning or behavioural outcomes. Five studies investigated the effect of fish oil supplementation in a population aged 5-13 years with symptoms of neuro developmental disorders, however the findings were mixed and therefore
Of the remaining three studies one examined ‘good diet’ in the first year.
Only six studies originated from the UK (3 breakfast, 2 fish oil and 1 vitamin/mineral supplementation). In addition to this, several studies lacked quality in research methodology and reporting (particularly those investigating breakfast consumption).
Many studies failed to account for important confounders such habitual dietary intake, physical activity levels, locality and family context, whilst two thirds of the studies were carried out in primary age children and over a half took place over a short duration (<1 month).
The findings from this review suggest there is insufficient evidence to identify any effect of nutrition, diet and dietary change on learning, education or performance of school aged children from the developed world. Further research is required in settings of relevance to the UK and must be of high quality, representative of all populations, undertaken for longer durations and use universal standardised measures of educational attainment. However, challenges in terms of interpreting the results of such studies within the context of confounders such as family and community context, poverty, disease and the rate of individual maturation and neurodevelopment will remain.
Whilst the importance of diet in educational attainment remains under investigation, the evidence for promotion of lower fat, salt and sugar diets, high in fruits, vegetables and complex carbohydrates, as well as promotion of physical activity remains unequivocal in terms of health outcomes for all school children of school but lack sufficient detail and quality to inform the evidence base. The final two studies examined the effect of vitamin/mineral supplementation: one in Hispanic low income children from the USA, which showed a significant positive effect on IQ in a small sub sample, and the other in UK teenagers which found no effect. These two studies alone provided insufficient evidence to formulate any conclusion
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