Nutrition, diet, and academic performance among school-age children in urban low-income settings: A case-control study in Addis Ababa, Ethiopia

Objective To examine the effects of nutrition, dietary practices, and other related factors on academic performance and IQ among children in Addis Ababa, Ethiopia.

Methods A case-control study was conducted among 309 children aged 6–14 years attending public and private schools in low-income districts of Addis Ababa from March to August 2023. Binary and multinomial logistic regression models were used to estimate crude (COR) and adjusted odds ratios (AOR) with 95% confidence intervals.

Results Hand washing (AOR = 3.7; 95% CI: 1.4, 9.8), access to toilets (AOR = 3.37; 95% CI: 1.25, 9.09), and effective teaching (AOR = 2.94; 95% CI: 1.04, 8.33) good academic performance. Stunting (AOR = 0.16; 95% CI: 0.04, 0.59), underweight (AOR = 0.25; 95% CI: 0.09, 0.70), and overweight (AOR = 0.04; 95% CI: 0.01, 0.14) were associated with poor academic performance. Low meal frequency (AOR = 2.65; 95% CI: 1.06, 6.67) and teachers with BA/BSc degrees (AOR = 6.97; 95% CI: 1.14, 42.68) predicted lower IQ.

Conclusion Many factors, especially nutrition and diet, strongly influence academic and cognitive performance; targeted school interventions improve outcomes.