Abstract:Background: In resource-constrained settings, school nutrition and feeding programs are often implemented to tackle both health and educational disparities. However, their broader psychosocial and academic impacts, particularly the roles of health literacy and mental health, remain insufficiently understood. Objectives: This study aims to investigate the pathways through which school nutrition and feeding programs influence student health and academic outcomes, with a focus on health literacy and mental health as mediating variables. Materials and Methods: Guided by the Health-Promoting Schools (HPS) framework, this study employed a cross-sectional design using data from students in basic and junior high schools. Structural Equation Modeling (SEM) was used to examine the relationships among school feeding programs, health literacy, mental health, physical health, and academic performance. Effect size analysis was conducted to evaluate the magnitude of observed associations. Results: Findings indicate that school nutrition and feeding programs significantly enhance academic outcomes by improving students’ health literacy and mental health. Health literacy emerged as a key mediator between feeding programs and physical health, highlighting the educational value of health-promoting interventions. The programs demonstrated stronger effects in socioeconomically disadvantaged communities. Conclusions: School feeding initiatives serve as effective dual-purpose interventions that promote student health and educational achievement. By advancing Sustainable Development Goals 3 (Good Health and Well-being) and 4 (Quality Education), integrating nutritional support with health education can offer sustainable strategies to address intergenerational cycles of poor health and limited academic attainment in low-resource settings.
Keywords: Global Health Nutrition, School Nutrition and Feeding Programs, Health Literacy, Mental Health, Physical Health, Academic Performance
