1. Introduction
micronutrient deficiencies, Malnutrition, reduced learning aptitude, malnutrition
MALNUTRITION, CHILD MALNUTRITION, HAND INFECTION, MALNUTRITION
Malnutrition is associated with reduced learning aptitude and growth during childhood. We examined the impact of providing two school lunch variants, a standard school meal (school feeding, Addressing malnutrition continues to be an undisputed challenge, especially in the low- and middle-income countries (LMICs). Almost two hundred and fifty million children in LMICs are at risk of not attaining their full developmental potential because of malnutrition and poverty alone [In addition to inadequacy of macronutrients, micronutrient deficiencies, often referred to as ‘hidden hunger’, can have a negative impact on the growth and development of children. Micronutrients, including iron, zinc, iodine and copper, play essential roles in cognitive function, such as motor skills, memory and executive function [Pakistan, with a Global Hunger Index score of 26.1 (severity of hunger designated “serious”) and ranked 99/121 in the Global Hunger Index, is among the countries that are most affected by child malnutrition [Nutrition interventions can support vulnerable children throughout their growth and development. With realization that malnutrition and infection remain the key constraints on development in children and mortality rates higher than previously understood, the value of investments beyond the first 1000 days of life are increasingly being recognized [Increasing micronutrient intakes can be achieved through the provision of supplements, or through fortifying food, either at the point of production (for example iodine added to salt) or through the addition of micronutrient powders to food before it is served [The aim of this study was to assess the impact of providing a school meal compared with no school meal, on cognitive function in early-stage primary school children from a very low resource setting in northwest Pakistan. The potential additional benefit for cognitive function and iron status (haemoglobin levels) of fortifying the school lunch with micronutrients, in the form of a multiple-micronutrient powder (MNP), was also explored.