Background. Despite growing wealth and a strengthening commitment from the government to provide quality education, a significant share of students across rural China still have inadequate access to micronutrient-rich regular diets. Such poor diets can lead to nutritional problems, such as iron-deficiency anemia, that can adversely affect attention and learning in school.

Objective. The overall goal of this paper is to test whether simple nutritional interventions lower rates of anemia and to assess whether this leads to improved educational performance among students in poor areas of rural China.

Approach: We report on the results of a randomized control trial (RCT) involving over 3600 fourth grade students, mostly aged 9 to 12, from 66 randomly-chosen elementary schools in 8 of the poorest counties in Shaanxi Province in China’s poor northwest region. The design called for random assignment of schools to one of three groups: two different types of treatment/intervention schools; a non-intervention, control group. The two interventions were designed to improve hemoglobin (Hb) levels, which is a measure of iron deficiency. One intervention provided a daily multivitamin with mineral supplements, including 5 milligrams of iron, for 5 months. The other informed the parents of their child’s anemia status and suggested several courses of action (henceforth, the information treatment).

Findings: Some 38.3 percent of the students had Hb levels of below 120 g/L, the World Health Organization’s cutoff for anemia for children 9 to 12 years old. In the schools that received the multivitamins with mineral supplements, Hb levels rose by more than 2 g/L (about 0.2 standard deviations). The standardized math test scores of the students in the schools that received the multivitamin with mineral supplements also improved significantly. In schools that received the information treatment, only students that lived at home (and not the students that lived in boarding schools and took most of their meals at schools) registered positive improvements in their Hb levels. The reductions in anemia rates and improvements in test scores were greater for students that were anemic at the beginning of the study period. Overall, these results should encourage China’s Ministry of Education (MOE) to begin to widen its view of education (beyond teachers, facilities and curriculum) and provide better nutrition and health care for students.

Background: High childhood obesity prevalence has raised concerns about future adult health, generating calls for obesity screening of young children. 

Objective: To estimate how well childhood obesity predicts adult obesity and to forecast obesity-related health of future US adults. 

Design: Longitudinal statistical analyses; microsimulations combining multiple data sets. 

Data Sources: National Longitudinal Survey of Youth, Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys.

Methods: The authors estimated test characteristics and predictive values of childhood body mass index to identify 2-, 5-, 10-, and 15 year-olds who will become obese adults. The authors constructed models relating childhood body mass index to obesity-related diseases through middle age stratified by sex and race.

Results: Twelve percent of 18-year-olds were obese. While screening at age 5 would miss 50% of those who become obese adults, screening at age 15 would miss 9%. The predictive value of obesity screening below age 10 was low even when maternal obesity was included as a predictor. Obesity at age 5 was a substantially worse predictor of health in middle age than was obesity at age 15. For example, the relative risk of developing diabetes as adults for obese white male 15-year-olds was 4.5 versus otherwise similar nonobese 15-year-olds. For obese 5-year-olds, the relative risk was 1.6. 

Limitation: Main results do not include Hispanics due to sample size. Past relationships between childhood and adult obesity and health may change in the future. 

Conclusion: Early childhood obesity assessment adds limited information to later childhood assessment. Targeted later childhood approaches or universal strategies to prevent unhealthy weight gain should be considered.

In this paper we present new evidence on the impact of health and nutrition information on anemia rates from three large-scale randomized controlled trials (RCTs) in rural China. Each RCT studies a different type of health education campaign designed in partnership with the Chinese government to reduce the prevalence of iron-deficiency anemia among rural primary school students. These campaigns include single and multiple face-to-face education sessions for parents at their children’s schools as well as dissemination of written health education materials. Across all three studies, we find little evidence of changes in blood hemoglobin concentration or anemia status. In contrast, in our two studies that also examined a multivitamin supplementation intervention, we find meaningful reductions in anemia.

For most scholars the concept of security encompasses issues of state legitimacy, economic and political sovereignty, and protection from military, nuclear, or terrorist assault. Yet billions of people, particularly in the developing world, face more severe, individual security threats on a daily basis, such as inadequate nutrition, disease burdens, lack of potable water, and risks of sexual assault or human trafficking. Such human security concerns can become national security issues when citizens rise up against their governments or threaten to rebel. Human security issues can also emerge as international security threats—those that create conflict or galvanize cooperation among governments—with escalating income and resource inequities between countries. Stanford University has a strong tradition of scholarship in conventional areas of national and international security, as well as in the areas of global food security and health policy. On November 10, 2011, Stanford’s Freeman Spogli Institute for International Studies (FSI) held a major conference to integrate these areas of scholarship, and to launch the Center on Food Security and the Environment (FSE) as a major thrust of its international research and teaching agenda.

The main goal of this paper is to analyze the factors (access, attendance and quality of preschools) that may be affecting the educational readiness of China’s rural children before they enter the formal school system. Using data from a survey of 80 preschools and 500 households in 6 counties in 3 provinces of China, this paper documents the nature of early childhood education (ECE) services and the educational readiness of children aged 4-5 in rural China. We present evidence that ECE services are seriously deficient. Households in many areas of rural China do not have convenient access to preschool facilities. Preschools have poor facilities, inadequate health services, and little concern for the nutrition of their students. Most teachers have little formal training. In part due (perhaps) to the poor quality and low participation in preschool, in this paper we will show that China's rural children score much lower on standardized educational readiness tests. In fact, according to our findings, more than one half of the rural children in our sample are “not ready” for continuing into the next level of formal education. Our analysis implies that it is necessary to improve the facilities and quality of teachers and to increase the probability that children will be sent to ECE institution.