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Many students lag in attendance and performance, and subsequently drop out of school altogether due to very often undiagnosed health issues.

Iron deficiency and/or anemia, a deficiency of red blood cells, is particularly progressive among young women, attributable to poor diet coupled with the monthly loss of blood during menstruation.

“Cross-sectional” data for children between the ages of 6 and 16 is provided by the National Health and Nutrition Examination Survey III, 1988–1994, which evidences that of, 5,398 children tested, 3% (about 162) were iron-deficient,[1] and figures were highest among adolescent girls (8.7%).

It was illustrated that average standardized math scores were lower for iron deficient children, with or without anemia (86.4 and 87.4 vs. 93.7).  Children with iron deficiency, by logistic regression, had greater than twice the risk of scoring below average in math than those with normal iron status (odds ratio: 2.3; 95% confidence interval: 1.1 – 4.4).

Elevated risk for iron-deficient school-aged children without anemia was just as prevalent (odds ratio: 2.4; 95% confidence interval: 1.1 – 5.2).

Statistical source: Pediatrics (The official journal of the American Academy of Pediatrics) Vol. 107 No. 6 June 2001, pp 1381–1386, “Iron Deficiency and Cognitive Achievement Among School-Aged Children and Adolescents in the United States.”   Received September 8, 2000; accepted November 2, 2000, Jill S. Halterman, Jeffrey M. Kaczorowski, C. Andrew Aligne, Peggy Auinger, and Peter G. Szilagyi from the Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Children’s Hospital at Strong and Rochester General Hospital, Rochester, New York.

Another study was conducted on 78 iron-deficient anemic and 41 non-anemic economically deprived children residing in rural Central Java, Indonesia.  The students were assigned, at random, to an iron or placebo group.  All of the students were treated for ancylostomiasis (a disease caused by hookworm infestation that exacerbates anemia) before iron supplementation. Three months of treatment resulted in “substantive” mean Hgb (hemoglobin), Hct (hematocrit), and transferrin saturation increases.

T1 scores, when entered on a covariate, demonstrated significantly higher delta achievement scores for the iron-treated students.

Statistical Source: The American Journal of Clinical Nutrition, Vol. 42, 1221–1228, 1985, “Iron Deficiency Anemia and Educational Achievement” by AG Soemantri, E. Pollitt and I. Kim.

Student Trace Element Testing

Student Wellcare and/or other school health examinations should entail trace mineral blood and/or hair tests to determine if students are iron deficient and/or if they are deficient in any trace elements. Treatment/ iron and other relevant supplements should be available in school infirmaries for students who are determined to be iron deficient and/or deficient of any trace elements.  Schools should additionally include iron-rich foods and beverages in school meals.

Wellcare or other school health examinations such as would entail trace element testing and treatment of trace element deficiencies should be available free of charge to students who do not have health insurance, in light of the significance of health to student performance.

Upgrading Cafeteria Menus

School meals should be properly portioned and include foods from each of the food groups (grains, vegetables, fruits, milk, meat, and beans). Unhealthy foods should be eliminated altogether, with the exception of those as might be periodically served during certain special occasions.

Serving thin-crust pizza, cheese, and other breads and/or those with reduced oil content, and oven-frying foods, like chicken and fish, etc. that would ordinarily be deep fried would be a major stride towards improving student health. All schools should implement programs similar to Mississippi’s “Health is Academic” initiative, which entails, among various components, replacing fryers with combination-oven steamers. http://www.healthyschoolsms.org/ohs_main/success.html http://www.healthyschoolsms.org/ohs_main/documents/FryertoOvenGUIDEapril608.pdf

Adding grape juice, which is a great source of iron, and orange juice, which helps with the absorption of iron, to school cafeteria beverage choices would also significantly improve student iron levels.  The availability of fruit, including oranges,* and vegetables, salads especially, and iron-rich cereal, also helps (*oranges that are served during school meals should be pre-peeled and/or sliced and placed in cups with lids to hold them intact to curtail the need for instructors, etc. to assist students with peeling them, as this poses contamination risks).

The USDA’s MyPlate Recipes website http://pinterest.com/MyPlateRecipes/, which is the culmination of numerous recipes as contributed by top recipe creators, including The Partnership for a Healthier America and Michelle Obama’s “Let’s Move!” initiative, is an excellent site to peruse for healthy recipe ideas to incorporate into school cafeteria menus.


[1] Developmental problems in some children are linked to iron deficiency anemia during infancy.

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