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Open AccessArticle

Micronutrient‐Fortified Milk and Academic  Performance among Chinese Middle School Students:  A Cluster‐Randomized Controlled Trial

Department of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China
Department of Nursing, Shaanxi Provincial Tumor Hospital, Xi’an 710061, China
Department of Medicine, University of Tennessee Medical Center, Knoxville, TN 37996, USA
Xi’an Tie Yi High School, Xi’an 710000, China
Author to whom correspondence should be addressed.
Nutrients 2017, 9(3), 226;
Received: 13 January 2017 / Accepted: 28 February 2017 / Published: 2 March 2017
(This article belongs to the Special Issue Dietary Intake and Behavior in Children)
Many children suffer from nutritional deficiencies that may negatively affect their academic performance. This cluster‐randomized controlled trial aimed to test the effects of micronutrient‐fortified milk in Chinese students. Participants received either micronutrient‐fortified (n = 177) or unfortified (n = 183) milk for six months. Academic performance, motivation, and learning strategies were estimated by end‐of‐term tests and the Motivated Strategies for Learning Questionnaire. Blood samples were analyzed for micronutrients. In total, 296 students (82.2%) completed this study. Compared with the control group, students in the intervention group reported higher scores in several academic subjects (p < 0.05), including languages, mathematics, ethics, and physical performance at the end of follow‐up. Students in the intervention group showed greater self‐efficacy and use of cognitive strategies in learning, and reported less test anxiety (p < 0.001). Moreover, vitamin B2 deficiency (odds ratio (OR) = 0.18, 95% confidence interval (CI): 0.11~0.30) and iron deficiency (OR = 0.34, 95% CI: 0.14~0.81) were less likely in the students of the intervention group, whereas vitamin D, vitamin B12, and selenium deficiencies were not significantly different. “Cognitive strategy” had a partial mediating effect on the test scores of English (95% CI: 1.26~3.79) and Chinese (95% CI: 0.53~2.21). Our findings suggest that micronutrient‐fortified milk may improve students’ academic performance, motivation, and learning strategies. View Full-Text
Keywords: fortified  milk;  micronutrient;  middle  school  students;  academic  performance;  motivated strategies for learning fortified  milk;  micronutrient;  middle  school  students;  academic  performance;  motivated strategies for learning
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Wang, X.; Hui, Z.; Dai, X.; Terry, P.D.; Zhang, Y.; Ma, M.; Wang, M.; Deng, F.; Gu, W.; Lei, S.; Li, L.; Ma, M.; Zhang, B. Micronutrient‐Fortified Milk and Academic  Performance among Chinese Middle School Students:  A Cluster‐Randomized Controlled Trial. Nutrients 2017, 9, 226.

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