Childhood Literacy and Dietary Diversity: Findings from a Large Scale School Feeding Program in the Western Highlands of Guatemala

Background and Purpose. Malnourishment is a significant barrier to children’s development and education, particularly in low- and middle-income countries (LMIC). Food for Education (FFE) programs are designed to promote nutrition and health of school age children, and indirectly to promote economic growth and social equity. Evidence suggests that FFE programs alleviate immediate hunger, and increase school enrollment and attendance among school-aged children.  In addition, FFE programs promote the investment in human capital and foster community and economic growth. One of the most prominent FFE program is the McGovern-Dole Food for Education initiative, funded by the USDA, whose primary aim is to improve childhood literacy. Yet, few studies have examined the influence of food intake on literacy among FFE participants. Therefore, the purpose of this study is to examine the association between food intake and higher literacy rates among children - many of whom are of indigenous K’iche’ Mayan ethnicity - benefitting from the USDA-funded FFE program in the Western Highlands of Guatemala.

Methods. The sample consisted of 3,504 children from 118 schools in 4 municipalities who participated in the FFE program. All students in 3rd and 6th grade received a reading comprehension assessment and food intake survey. In addition, selected classrooms were observed using a structured protocol to assess child attentiveness. Literacy in school-age children was measured using a 30-item reading comprehension assessment written in Spanish developed by a local organization. Dietary diversity was measured through the Household Dietary Diversity Scores, developed by the UN Food & Agriculture Organization, to examine intake of 11 different food groups. Covariates include gender, grade, K’iché status, age, and average children’s attentiveness. Generalized linear mixed models (GLMM) were employed to examine the association between food intake and children’s literacy.

Results. Results of the GLMM revealed that dietary diversity was not significantly associated with child literacy rate. Of all the food groups on the dietary diversity scale, only intake of eggs had a positive and strong association with child literacy (b = 1.21, p < 0.01). In addition, being K’iché was negatively associated with child literacy (b = -1.65, p < 0.001), whereas grade was positively associated with child literacy (b = 14.10, p < 0.001).

Conclusions and Implications. Our findings suggest that child literacy was not associated with dietary diversity but rather with the intake of eggs. Yet, eggs are not part of the food packages provided to schools by FFE. One implication is that the addition of eggs to the program may result in enhanced literacy for students, as existing research suggests that egg intake improves cognitive performance. An alternative explanation in this study is that egg intake serves as a proxy for children’s higher family socioeconomic status. A potential implication is that FFE programs should aim at enhancing children’s cognitive development and school performance, not only through reducing hunger, but also through addressing nutritional values of food intake among children in low-income families.