The Impact of Social Status and School Meal on Psychosocial Behavior inGovernmental Primary School Children in Egypt

摘要

Background: Recent studies indicate that children in food-insecure households experience considerable psychological and emotional distress. Food hardship due to limited household resources is associated with greater numbers of behavior problems in children, Including hyperactivity and aggression as well as anxiety. Objective: to assess the effect of School Feeding Program (SFP) after five years of its implementation, on psychosocial behavior of primary school children at some governmental schools in relation to their socioeconomic status. Methods: A cross-sectional study was conducted in three governorates in Egypt. Intervention group consisted of 903 pupils in the 5th grade chosen randomly from schools have taken school meal for five years. The control group was 886 age and sex-matched pupils chosen randomly from schools have never taken school meal from the same district. The snack consists of a pie fortified with minerals and vitamins. Assessment of nutritional status, socio-demographic and dietary behavior was performed. Psycho social behavior was rated by school teachers using Pediatrics Symptom Check List-17 (PSC-17). Results: 4.7% of total sample had psychosocial problems. Externalizing behavior was rated among 19% of children, while 13.6% showed internalizing problems. Logistic regression analysis revealed that number of meals consumption /day is the strongest predictors of psychosocial behavior of children followed by maternal education and child order. As for attention deficits, the analysis showed that father income and maternal education level are the social factors, while having no school meals followed by breakfast skipping are the strongest nutritional predictors of attention problems. Externalizing behavior is better in children provided school meal in combination with number of meals consumed per day +/- breakfast. School meal was the most powerful predictor of internalizing behavior followed by family income and mother education. Conclusion: mother education, family income as well as nutritional factors (school meal, breakfast, number of meals) has the most impact on psychosocial behavior of children.