Associations Among Food Insecurity, Academic Performance, and Weight Status in Primary Schoolchildren in Tehran, Iran: A Cross-sectional Study

Objective: To examine the associations among household food insecurity (FI), academic performance, and weight status in urban primary schoolchildren.

Design: Cross-sectional study.

Setting: Primary schools in Tehran, Iran.

Participants: A total of 803 students (419 boys and 384 girls), aged 10-12 years, were recruited from 43 primary schools.

Main outcome measures: Levels of FI were measured using a locally validated, 18-item household food security survey module. Academic performance was assessed by 152 teachers through a specifically designed, 20-scale questionnaire. Standard anthropometric measurements were also taken.

Analysis: Linear and multinomial regressions were conducted.

Results: At the household level, FI was associated with poorer grades in all subjects studied (except for social science in FI without hunger) (P < .05). At the child level, a significant association was observed between low food security and poorer grades in all subjects studied, whereas for very low food security, this relationship was significant only for mathematics, reading, and science (P < .05). Food insecurity without hunger (odds ratio = 2.56; 95% confidence interval, 1.05-6.23) and low food security (odds ratio = 4.41; 95% confidence interval, 1.58-12.23) were associated with overweight only in girls.

Conclusions and implications: The findings confirm the need for policies and programs to improve students' dietary quality and food security to improve their health as well as educational attainment. Future research is needed to explore further the association between food security and academic performance.