The double burden of malnutrition and its impact on academic achievement and cognitive function in students of rural India.

Background: The study explores the interrelationship between nutritional status, cognitive function (IQ), and academic performance in rural primary school children, recognizing these as critical and interconnected health parameters.

Objectives: To investigate the relationship among nutritional condition, cognitive ability, and academic outcomes in children aged 6-8 years in rural Jharkhand, India.

Methods: A total of 560 children (280 boys and 280 girls), aged between 6 and 8 years, from four rural primary schools in Jharkhand, were included in the study. Nutritional condition was assessed using Body Mass Index (BMI), and cognitive function was evaluated using the Raven Progressive Matrices test.

Results: A high rate of malnutrition was observed: 28.03% of children were undernourished and 28.75% were severely malnourished, with a higher prevalence among boys. Additionally, 4.47% of the children were found to be overweight or obese, indicating a growing double burden of malnutrition in rural areas. A positive association was found between BMI and IQ score (r = 0.41, P ≤ 0.01), indicating that better nutritional status is linked with improved cognitive function. Alarmingly, 50.71% of the children were categorized as "intelligently impaired" based on IQ scores, with only 3.22% scoring in the above-average range. Logistic regression revealed strong associations between academic performance and IQ categories, emphasizing the key role of cognitive function in educational outcomes.

Conclusion: The study highlights the intricate relationship between malnutrition, cognitive development, and academic performance. It underscores the urgent need for integrated interventions targeting both under- and over-nutrition, while prioritizing cognitive enhancement and educational support in resource-constrained rural settings.