IMPACTS OF MALNUTRITION TO CHILDREN’S ACADEMIC

PERFORMANCE IN TABACO SOUTH CENTRAL ELEMENTARY SCHOOL

A Research Proposal Presented to the

Faculty of Mariners’ Polytechnic College Foundation Inc.

Rawis, Legazpi City

In Partial Fulfillment of the Requirements

In Practical Research I

11-Tourism

Jannah Marie Katigbak

Edelyn Mae Biñas

Catalyn Nicole Nierva

March 2018
 Chapter I

The Problem and its Background

Introduction

Malnutrition is the largest health problem of children in developing countries.

Malnutrition in early childhood has serious, long-term consequences because it impedes

motor, sensory, cognitive, social and emotional development. Malnourished children are

less likely to perform well in school and more likely to grow into malnourished adults at

greater risk of disease and early death. Given its impact on health, education and

productivity, persistent under nutrition is a major obstacle to human development and

economic growth in the country, especially among the poor and the vulnerable, where the

prevalence of malnutrition is highest.

As a student, he experiences difficulties in performing well in school because of

various factors such as attitude of his teachers as well as their teaching methods, stress,

and eating unhealthy foods. He is also having difficulties in his quizzes and class

performance.

Tabaco South Central Elementary School, being one of the highest number of

enrollees from different barrio schools in Tabaco City, have the most number of

undernourished children according to the DepEd.

The main objective of the researchers is to explore the relationship of cognitive

functioning in school-age children with the impacts of malnutrition. Also, to assess the

nutritional status of grades three to six learners of Tabaco South Central Elementary

School, and to assess the association between malnutrition and academic performance
among them. The research findings will determine how malnutrition affects their

academic performance.

This is primarily for the purpose of lessening the number of malnourished

children in Tabaco South Central Elementary School, enabling them to be actively

participating in school activities that can raise their academic performance.

Statement of the Problem

The objective of this epidemiological study is to enhance study habits and

academic performance of the elementary students in Tabaco South Central Elementary

School that belong to the malnourished group. The result is used as a basis for an

intervention program given by the school.

Research Questions

1. What is the profile of selected malnourished children in terms of:

a. Age

b. Eating Habits

c. Family Background

2. How will the performance level of children suffering from malnutrition differ to

healthy active pupils?

3. What are the effects of poorly nourished children to their level of interest in

academics?

4. What school-sponsored health enrichment programs can be given to enhance the

performance of Tabaco South Central Elementary pupils?

Scope and Delimitation

This study was focused on the Malnutrition of children in their third to sixth grade

that affect the academic performance in Tabaco South Central Elementary School in

Tabaco City, Albay for the school year 2017-2018.

Significance of the Study

The findings of this study will have a particular result and will benefit the society

considering that many children from different places suffer from malnutrition. The goal

of this study is designed to help the poorly nourished children of Tabaco South Central

Elementary School to improve their academic performance and be active in school

activities. This study is important because it seeks to assess, examine and evaluate the

impact of poor nutrition on the academic performance of grade three to six learners in

Tabaco South Central Elementary School, with the aim of finding and suggesting

solutions thus minimising consequences caused by poor nutrition on the academic

performance of learners. The results may serve as a basis for TSCES for implementing

school-sponsored health enrichment programs that can be a big help for the students with

poor nutrition.
 Chapter II

Review of Related Literature and Related Study

Related Literature

Malnutrition is an impairment of health resulting from a deficiency, excess, or

imbalance of nutrients in the diet. It includes both under nutrition or deficiency and over

nutrition or excessive consumption. Under nutrition refers to a deficiency of calories

and/or one or more nutrients in the diet. An undernourished person is underweight. Over

nutrition refers to an excess of calories and/or one or more nutrients in the diet. An excess

intake of calories results in overweight which can lead to obesity. Child malnutrition

occurs when a child’s intake of nutrients (fat, protein, vitamins and minerals, etc.) is

insufficient to sustain the needs of her body.

The concept of Nutrition, Malnutrition and under nutrition

Food can be defined as any substance which nourishes the body and is fit to eat. It

may be solid or liquid. Food provides the body with materials for providing energy,

growth and maintenance and regulating various processes in the body. These materials of

which food is made up of termed nutrients. Six nutrients are of importance in nutrition,

which are proteins, carbohydrates, fats, vitamins, minerals and water. Nutrients are the

chemical substances present in food, which the body needs to carry out its functions.

Food is the source of nutrients except vitamin D. Nutrition on the other hand is the

combination of process by which the human body receives and utilizes nutrients which

are necessary for carrying out various functions and for the growth and renewal of its

components (Roday, 2007).

Nutrition and Academic performance

Hunger, whether caused by a skipped meal, an unbalanced meal, or chronic

under-nourishment, interferes with concentration at school. The body can’t stockpile

glucose, the main source of energy from food. Completely dependent upon glucose for

energy, the brain is a powerhouse requiring consistent food intake to function properly.

This makes the brain sensitive to variations in glucose levels, so just one skipped

breakfast can reduce a child’s learning ability for morning lessons. Even well-nourished

children had trouble solving problems after skipping breakfast (McKnelly, 2015). Good

nutrition is a cornerstone for survival, health and development for current and succeeding

generations.

Well -nourished children perform better in school, grow into healthy adults and in

turn give their children a better start in life. Undernourished children have lowered

resistance to infection; they are more likely to die from common childhood ailments like

diarrhea disease and respiratory infections, and for those who survive, frequent illness

saps their nutritional status, locking them in to a vicious cycle of recurring sickness and

faltering growth. Their plight is largely invisible: three quarters of the children who die

from causes related to malnutrition were only mildly or moderately undernourished,

showing no outward sign of their vulnerability (Smith & Lawrence, 2000).

Nutrition and cognitive capabilities

Neurotransmitters relay chemical messages to the brain to increase function, and

each chemical plays a different role in maximizing neuron capabilities. The brain needs

amino acids and choline from outside sources (dietary intake) in order to maintain the

brain’s necessary amount of neurons to release other necessary chemicals such as

serotonin, acetylcholine, and norepinephrine. serotonin involves “control of appetite,

sleep, memory and learning, temperature regulation, mood, behaviour (including sexual

and hallucinogenic behaviour), cardiovascular function, muscle contraction, endocrine

regulation, and depression”, Likewise, acetylcholine and norepinephrine both play roles

in controlling the central nervous system, heart contractions, and attention having a

decreased amount of zinc in the diet affects memory by slowing down the brain’s ability

to recall information. A connection was also made between short attention spans and low

iron levels in children, which also affect recall capabilities (Rausch, 2013). The human

brain needs sufficient energy – specifically glucose and a variety of micronutrients to

perform cognitive functions. a long – term deficiency of any or numerous macro or micro

–nutrients causes malnutrition and consequential cognitive impairment, the extent of

which depends on the duration and degree of the malnourishment and the timing of its

occurrence in development (Wood house &Lamport,2012).

Under nutrition and Brain Development

One of the USC study about malnutrition in early years reveals that malnutrition

in early years leads to lower IQ and later antisocial behavior. The study also shows that

while social class did not play a significant factor in behavior, intelligence level did, poor

nutrition, characterized by zinc, iron, vitamin B and protein deficiencies, leads to low IQ,

which leads to later antisocial behavior these are all nutrients linked to brain development

(USC,2004). Malnutrition not only harms the body but leaves an imprint on the minds of

who survive it. The study has revealed that poor diet during early development (0-3

years) leads to learning and memory deficits, lower IQ and school achievement, and

behavioral problems in childhood and adolescence. There has also been links between
food deficiencies and mental health problems in young people. Conditions such as

Bipolar disorder and schizophrenia seem to involve functional deficiencies of certain

highly unsaturated fatty acids, such as Omega-3. The research provides important

evidence for the beneficial effects, both to individuals and society, of ensuring that our

children receive the nutrition they deserve (Grantham, 2011).

Undernourishment as a Cause of poor school performance

Education is one of the most important aspects of human resource development.

Poor school performance not only results on the child having a low self-esteem, but also

causes significant stress to the parents. There are many reasons for children to

underperform at school such as medical problem, below average intelligence, specific

learning disability, attention deficit hyperactivity disorder, emotional problems, a poor

socio cultural home environment psychiatric disorders and even environmental causes.

Under the medical problem for children to underperform at school is one of the major

aspects is malnutrition and nutritional deficiencies; malnutrition in early childhood is

associated with poor cognition in later years and this is independent of psychosocial

adversity. Chronic iron deficiency anemia, zinc deficiency and inadequate intake of

vitamins A, B1, B2,B6,D3 and E and niacin amide adversely affect long term cognitive

development (Karande&Kulkarini, 2005)

The research shows that not having a nutritious diet can severely impair a child’s

ability to read and write a simple sentence and answer basic math questions correctly

regardless of the amount and quality of schooling they received. Improving the

nutritional status of children and women in the crucial 1,000- day window from the start

of a women’s pregnancy until her child’s second birthday could greatly increase a
children’s ability to learn and to earn. This research was based on studies of thousands of

children in four countries (Ethiopia, India, Peru and Vietnam), and found that at the age

of 8, children who are stunted due to chronic malnutrition are 19 percent more likely to

make a mistake reading a simple sentence like “I like dogs” or “the sun is hot” than they

would have been expected to do had they not been. Malnutrition negatively effects brain

development causing delays in motor and cognitive development, such as: attention

deficit disorder, impaired school performance, decreased IQ scores, memory deficiency,

learning disabilities, reduced social skills, reduced language development and reduced

problem-solving abilities (Orphan nutrition, 2014). Children living in poverty and

underdeveloped countries remain at high risk for cognitive impairment and lower

academic achievement. It is understood that children of low socioeconomic status often

do not have consistent access to sufficient food; their brains, therefore, are starved, short

or long- term, for the energy and nutrients needed to function.

Impacts of Malnutrition on Health and Development

When the diet doesn’t supply all nutrients in required amounts, it results in ill-

health or malnutrition. Good nutrition and health are closely interlinked. Clean,

wholesome, and nutritious food promotes health and keeps away disease. A balanced diet

is one of the essential factors in ensuring good health. To ensure that the consumer

obtains the maximum health benefits from the food that is served, all food handless

concerned with purchasing, storing, cooking and serving food, and planning meals should

have a basic knowledge of nutrition and hygiene (Roday, 2007).

Malnourished children experience developmental delays, weight-loss and illness

as a result of inadequate intake of protein, calories and other nutrients. They are at risk
for a variety of short-term and long-term complications. Because so much development

occurs in the first few years of life, nutrient deficiencies can have major short-term

implications in young children which are immune implications and growth implications,

and long term implications such as growth and cognitive delays. The short-term

implications of malnutrition eventually give way to long-term complications (Orphan

nutrition, 2014).

At worst severe malnutrition leads to death. The WHO currently attribute more

than one third of child mortality to malnutrition making it the leading cause of child death

worldwide. For survivors, chronic malnourishment, both short and long term, leaves the

body lacking the nutrients for proper health and development and vulnerable to infection

and disease. The physical effects of malnutrition include; Fatigue, low energy and

dizziness, Swollen, bleeding gums and decaying teeth ,Underweight, muscle weakness

and poor growth, Poor immune function leaving the body vulnerable to infection, Poor

cognitive functions such as learning memory and attention ,Problems with organ

function, that may lead to disease states such as coronary heart disease or osteoporosis,

Insulin- resistance resulting from a diet with low nutritional value, Disease such as

marasmus, and obesity result from under, or over eating respectively, Cancer risk is

increased by eating certain foods and additives that are high in carcinogens (Grantham,

2011).

In addition to the consequences of malnutrition on the non-economic measures of

poverty, child malnutrition imposes substantial economic costs on the economy.

Malnutrition leads to higher mortality and the loss of the economic potential of the child,

malnourished survivors have higher morbidity, requiring additional health care services
and divert the time of caregivers from productive activities, malnutrition leads to lower

cognitive development and, thus, slower learning throughout life, malnutrition also leads

to fewer years of completed schooling on average due to late enrolment, increased grade

repetition, absenteeism, and earlier dropout. This, as well as the impaired cognitive

development mentioned above, means that malnourished children end up as less

productive adults (Benson, 2005).

The effect of undernourishment on absenteeism, repeating and drop out of school

There is direct relationship between prevalence of malnutrition in a country and

the contribution by malnourished children to educational wastage. Children who are

undernourished and whose learning is slow have difficulties in mastering school material

and are among those with high chances of chronic absenteeism, repeating grades and

dropping out early from school (Pollitt, 1984).

The fight to keeps kids in school is linked to the drive for increased student

achievement. Poor attendance had a disproportional impact up on poorest students and

economically disadvantaged. Sadly, poverty and school absence often feed each other.

The condition that students living in poverty face (poor nutrition, lack of access to health

care) exacerbate poor attendance. And slipping school attendance often leads a person

back down the poverty path (Lauver, 2013).

Factors of Undernourishment

Factors like education of parents, the income of the family, the child’s caretaking

arrangement, his health and dietary intake determine in part for undernourishment and the

child’s schooling and performance. In developing countries protein energy malnutrition

and micronutrient deficiencies are high. Accordingly, in these countries malnutrition, as a

risk factor for the educational future of children, should be a major concern for health,

nutrition and educational policies (Levinger, 1992). The basic causes of malnutrition

include the number of people in the demographic household, ethnicity, education level of

parents, occupation of parents, family income, housing status, urbanization, poverty,

unemployment, politics, social structures, religion, beliefs and ideological factors and

family food expenditure per month. Income growth has an impact on reducing under

nutrition. other factor such as level of education also a very high impact in reducing

undernourishment good education levels mean that individuals know how to access and

utilize information that is helpful to the attainment of good nutrition (UNICEF,2000).

The main causes of under nutrition in Ethiopia are household food insecurity, lack of care

of the vulnerable segments of the population and inadequate health services and

environmental hygiene are the underlying determinants of nutrition and are closely

interrelated (Benson, 2005).

Related Studies

According to the study of Woodhouse, A and Lamport, A.M entitled “The

relationship of food and Academic Performance” (2012) says that children living in

poverty and underdeveloped countries remain at high risk for cognitive impairment and

lower academic. It is understood that children of low socioeconomic status often do not

have consistent access to sufficient food; their brains, therefore, are starved, short or long

term, for the energy and nutrients needed to function properly.

Another study by Hodgkin, E.G entitled “Nutrition and Academic Achievement,

Are They Related?” (2007), has a link between proper nutrition and academic

achievement. Academic performance depends on what you eat. It is found that students

who paid attention to their daily nutrient needs performed academically better in school,

Inadequate nutrition negatively influenced intelligence and academic performance, Low

levels of protein and iron indicated a correlation with low achievement scores, those with

poor nutrition scored lower on tests of vocabulary, reading comprehension, arithmetic,

and general knowledge, those who did not have breakfast scored lower in tests of speed

and accuracy of response on problem-solving, those slightly malnourished showed that

their intelligence and performance were affected. Improved nutrition corrected this

impairments, Temporary hunger adversely affected attention, interest, and learning.

Theoretical Framework

This study is hinged on Abraham Maslow's Theory of Needs (1943) that has been

represented in a hierarchical pyramid with five levels which is Physiological needs,

Safety needs, Love and Belongingness needs, Esteem needs, and Self-actualization needs.

This theory argues that people aim to satisfy basic needs before they seek to achieve

higher needs subsequently.

 Physiological Needs - refers to what is essential for the survival of the students such

as food, water, shelter, and clothing.

 Safety Needs - in this second level of Maslow’s theory, the need of children’s

security and safety are one of the factors which affects their proper health.

 Love and Belongingness - at this stage, a child must not feel loneliness, depression,

and anxiety. To feel loved and accepted by other people is what they need to

perceive.

 Esteem Needs – at this point, children must gain respect and appreciation of others,

making them feel confident in their abilities so that they will not develop feelings of

inferiority.

 Self-Actualization – the child is in need for personal growth, without being less

concerned with the opinion of others that will make them fulfill their potential.

One's actions are motivated by different factors in order to achieve certain needs.

Maslow observed the body's need for food for keeping essential nutrients from the body.

Maslow stated that the physiological needs are the most predominant among all the needs

of a person. In the contrary, achievement is one of the least dominant among the needs
according to Maslow. Maslow's premise should be observed that once need at a certain

level is satisfied, needs at higher level can be acquired and it will dominate a person's

thinking and performance. Therefore, according to this theory, the needs on lower levels

should be satisfied in order to motivate one's need for achievement. Excellent

performance in academics cannot be expected from students who are not sustained with

proper nutrients and basic needs.

The Hierarchy of Needs theory provides an understanding to a person’s motivation,

personal growth and performance. This theory will help the researchers to understand a

fundamental link between food intake and academic performance of the students of

Tabaco South Central Elementary School.

Conceptual Framework

Malnutrition affects a child’s personal growth and academic performance. This study

aims to understand the fundamental link between child’s health condition and its effects

to the behavior and performance in school. The result of the research study will help the

malnourished children improve their academic performance. The framework will validate

how malnutrition can affect the child’s behavior and how it affects the academic

performance including the factors affecting their poor performance. The variables that

causes the problem contains the Profile and Roles of Malnourished Children and their

Performance. The methods to be used in analyzing data are informal interviews and

questionnaires that will be given to the participants. The possible outcome of the study

will improve the child’s level of interest in academics, enhance their eating habits, and

have better school performance and have better school performance.

Conceptual Paradigm

 Profile of Analysis of data  Improved

Malnourished through: level of
Children interest in
 Informal
a) Age academics
interviews
b) Eating  Enhanced
 questionnaire
Habits eating habits
s
c) Family  Better school
background Performance
 Roles of
Malnourished
Students
a) Interaction
b) Evaluation
c) Examination
d) Participation
 Performance

Figure 1- Paradigm about The

Impacts of Malnutrition to the
Children’s Academic
Performance in Tabaco South
Central Elementary School

Definition of Terms:

Esteem needs- Esteem needs are of two types: internal esteem needs (self- respect,

confidence, competence, achievement and freedom) and external esteem needs

(recognition, power, status, attention and admiration).

Hierarchical- a system in which people or things are put at various level or ranks

according to their importance.

Malnutrition - they are physically weak and extremely thin because they have not eaten

enough food.
Neurotransmitters- a chemical by which a nerve cell communicates with another nerve

cell or with a muscle.

Physiological needs- These are the basic needs of air, water, food, clothing and shelter.

In other words, physiological needs are the needs for basic amenities of life.

Safety needs- Safety needs include physical, environmental and emotional safety and

protection. For instance- Job security, financial security, protection from animals, family

security, health security, etc.

Self-actualization need- This include the urge to become what you are capable of

becoming / what you have the potential to become.

Social needs- Social needs include the need for love, affection, care, belongingness, and

friendship.

Undernourished Children - weak and unhealthy because they have not been eating

enough food or the right kind of food.

Well-nourished children- Having been provided with plenty of the material necessary

for life and growth.

REFERENCES:

Benson, T. (2005). An assessment of the causes of malnutrition in Ethiopia: A

contribution to the formulation of a National Nutrition Strategy for Ethiopia. International

Food Policy Research Institute Washington, DC, USA.

Grantham, M.S. (2011). A review of studies of the effect of severe malnutrition on

mental development. Kids company plate pledge.

Hodgkin, E. G. (2007). Nutrition and academic achievement: Are they related? An

international journal of faith, thought and action.

Karande, S. & Kulkarni, M. (2005). Poor school Performance. Symposium on

developmental and behavioral disorders. Indian journal of pediatrics.

Lauver, W.N. (2013). Closing the Attendance Gap. Educational leadership.

Levinger, B. (1992). Nutrition, health and education, current issue and trends.

International basic education programs.

Maslow, A. (1943). A theory of human motivation. Psychological Review (50), 370-396.

Maslow, A. H. (1962). Toward a Psychology of being. Princeton: D. Van Nostrand

Company.

Maslow, A. H. (1970). Religions, values, and peak experiences. New York: Penguin.

(Original work published 1966)

Maslow, A. H., Frager, R., & Cox, R. (1970). Motivation and personality (Vol. 2, pp.

1887-1904). J. Fadiman, & C. McReynolds (Eds.). New York: Harper & Row.
Maslow, A. H. (1987). Motivation and personality (3rd ed.). Delhi, India: Pearson

Education.

Maslow, A. H. (2013). Toward a psychology of being. Start Publishing LLC.

 Chapter III

RESEARCH METHODOLOGY

Research Design

This study entitled: Impacts of Malnutrition to Children’s Academic Performance in

Tabaco South Central Elementary School is a qualitative research that attempts to gain

data regarding the impact of malnutrition to academic performance of children in Tabaco

South Central Elementary School. The study adopted a qualitative phenomenological

case study design in order to look for and present the effects of malnutrition on the

academic performance of grade learners in a public school in Tabaco City District,

Albay. Qualitative phenomenological case study approach is used to highlight the

specific and to identify phenomena through how they are perceived by the actors in the

situation. A case study design was developed in order to gain insights into not only what

was happening to children’s access to schooling, but also why events might be happening

in that way. One of the advantages of this approach is that it allows the researcher to gain

an understanding of social phenomena from participants’ perspective in their natural

setting.

Respondents of the Study

The respondents of this study will be coming from grades four to six learners of

Tabaco South Central Elementary School. The researchers will be selecting children who

are suffering from malnutrition based on their nutritional status. In selecting the

respondents, purposive sampling will be used. The researchers will seek assistance from

the class advisers for the children’s Body Mass Index (BMI) record. The height and
weight will determine whether they are malnourished or not. Also the general weight

average (GWA) of students from First Quarter up to third Quarter.

Instrument of the Study

For this study, the survey-questionnaire instrument will be used in gathering data.

The researchers will personally distribute questionnaires that includes checklist as a data

collection tool and will guide the students in the course of data gathering. This will also

enable the researchers to administer informal interviews with the respondents for

additional information. The questionnaire is constructed to guarantee that the respondents

will be able to answer the given questions by marking a check on the right area provided

in the questionnaire. The data gathered will be kept confidential.

Data Gathering Procedure

The researchers will make a request letter allowing them to conduct the data

gathering at the testing venue. The letter will be retrieved upon approval. The survey

questionnaire is formulated from related research and questions formed by the

researchers. The questions are arranged from simplest to the most complex. The

questionnaires will be collected after the respondents have completely answered the

given questions.
Statistical Treatment

Statistical tools were used to analyze the data that will be gathered from the

research respondents. Children were statistically analyzed with the data instruments of

the study. To interpret the data effectively, the researcher will employ the Average

Weighted Mean tool. This will be used to determine the assessment of the respondents

with regards to their personal profiles.

Fx
Where: X=
N

X – General Weight Average

F – Food Frequency

x – Body Mass Index (BMI)

N −¿ Number of malnourished children