{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T16:23:00Z","timestamp":1777998180844,"version":"3.51.4"},"reference-count":63,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2013,10,30]],"date-time":"2013-10-30T00:00:00Z","timestamp":1383091200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Nutr"],"published-print":{"date-parts":[[2014,3,14]]},"abstract":"<jats:p>Micronutrient deficiencies and suboptimal energy intake are widespread in rural Kenya, with detrimental effects on child growth and development. Sporadic school feeding programmes rarely include animal source foods (ASF). In the present study, a cluster-randomised feeding trial was undertaken to determine the impact of snacks containing ASF on district-wide, end-term standardised school test scores and nutrient intake. A total of twelve primary schools were randomly assigned to one of three isoenergetic feeding groups (a local plant-based stew (githeri) with meat, githeri plus whole milk or githeri with added oil) or a control group receiving no intervention feeding. After the initial term that served as baseline, children were fed at school for five consecutive terms over two school years from 1999 to 2001. Longitudinal analysis was used controlling for average energy intake, school attendance, and baseline socio-economic status, age, sex and maternal literacy. Children in the Meat group showed significantly greater improvements in test scores than those in all the other groups, and the Milk group showed significantly greater improvements in test scores than the Plain Githeri (githeri+oil) and Control groups. Compared with the Control group, the Meat group showed significant improvements in test scores in Arithmetic, English, Kiembu, Kiswahili and Geography. The Milk group showed significant improvements compared with the Control group in test scores in English, Kiswahili, Geography and Science. Folate, Fe, available Fe, energy per body weight, vitamin B<jats:sub>12<\/jats:sub>, Zn and riboflavin intake were significant contributors to the change in test scores. The greater improvements in test scores of children receiving ASF indicate improved academic performance, which can result in greater academic achievement.<\/jats:p>","DOI":"10.1017\/s0007114513003310","type":"journal-article","created":{"date-parts":[[2013,10,30]],"date-time":"2013-10-30T13:19:09Z","timestamp":1383139149000},"page":"875-886","source":"Crossref","is-referenced-by-count":71,"title":["Animal source foods have a positive impact on the primary school test scores of Kenyan schoolchildren in a cluster-randomised, controlled feeding intervention trial"],"prefix":"10.1017","volume":"111","author":[{"given":"Judie L.","family":"Hulett","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert E.","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nimrod O.","family":"Bwibo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osman M.","family":"Galal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Drorbaugh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte G.","family":"Neumann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2013,10,30]]},"reference":[{"key":"S0007114513003310_ref58","doi-asserted-by":"publisher","DOI":"10.3945\/jn.112.166165"},{"key":"S0007114513003310_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/S0899-9007(03)00037-6"},{"key":"S0007114513003310_ref51","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980012003266"},{"key":"S0007114513003310_ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2008.00082.x"},{"key":"S0007114513003310_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)81897-9"},{"key":"S0007114513003310_ref43","doi-asserted-by":"crossref","first-page":"S3941","DOI":"10.1093\/jn\/133.11.3941S","article-title":"Animal source foods improve dietary quality, micronutrient status, growth and cognitive function in Kenyan school children: background, study design and baseline findings","volume":"133","author":"Neumann","year":"2003","journal-title":"J Nutr"},{"key":"S0007114513003310_ref63","doi-asserted-by":"crossref","first-page":"3972S","DOI":"10.1093\/jn\/133.11.3972S","article-title":"Kenyan school children have multiple micronutrient deficiencies, but increased plasma vitamin B-12 is the only detectable micronutrient response to meat or milk supplementation","volume":"133","author":"Siekmann","year":"2003","journal-title":"J Nutr"},{"key":"S0007114513003310_ref16","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsp065"},{"key":"S0007114513003310_ref12","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1093\/ajcn\/48.3.852","article-title":"Vitamin B-12: plant sources, requirements, and assay","volume":"48","author":"Herbert","year":"1988","journal-title":"Am J Clin Nutr"},{"key":"S0007114513003310_ref22","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199107000-00001"},{"key":"S0007114513003310_ref34","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1600473"},{"key":"S0007114513003310_ref59","first-page":"CD008524","article-title":"Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age","author":"Imdad","year":"2010","journal-title":"Cochrane Database of Systematic Reviews (Online)"},{"key":"S0007114513003310_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61005-3"},{"key":"S0007114513003310_ref45","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1093\/jn\/137.4.1093","article-title":"Designing snacks to address micronutrient deficiencies in rural Kenyan schoolchildren","volume":"137","author":"Murphy","year":"2007","journal-title":"J Nutr"},{"key":"S0007114513003310_ref20","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1093\/ajcn\/65.1.153","article-title":"Epidemiology of iron deficiency anemia in Zanzibari school children: the importance of hookworms","volume":"65","author":"Stoltzfus","year":"1997","journal-title":"Am J Clin Nutr"},{"key":"S0007114513003310_ref18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199109053251004"},{"key":"S0007114513003310_ref57","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2004.tb00055.x"},{"key":"S0007114513003310_ref28","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1093\/jn\/127.7.1333","article-title":"Zinc supplementation affects the activity patterns of rural Guatemalan infants","volume":"127","author":"Bentley","year":"1997","journal-title":"J Nutr"},{"key":"S0007114513003310_ref49","doi-asserted-by":"crossref","first-page":"3957S","DOI":"10.1093\/jn\/133.11.3957S","article-title":"Food supplements have a positive impact on weight gain and the addition of animal source foods increases lean body mass of Kenyan schoolchildren","volume":"133","author":"Grillenberger","year":"2003","journal-title":"J Nutr"},{"key":"S0007114513003310_ref32","author":"Pollitt","year":"1990"},{"key":"S0007114513003310_ref54","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1093\/jn\/137.4.1119","article-title":"Meat supplementation improves growth, cognitive, and behavioral outcomes in Kenyan children","volume":"137","author":"Neumann","year":"2007","journal-title":"J Nutr"},{"key":"S0007114513003310_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61235-5"},{"key":"S0007114513003310_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07744-9"},{"key":"S0007114513003310_ref13","doi-asserted-by":"publisher","DOI":"10.3181\/0703-MR-67"},{"key":"S0007114513003310_ref33","doi-asserted-by":"crossref","first-page":"386","DOI":"10.4269\/ajtmh.2006.74.386","article-title":"A randomized, double-blind, placebo-controlled, clinical trial of the impact of malaria prevention on the educational attainment of school children","volume":"74","author":"Fernando","year":"2006","journal-title":"Am J Trop Med Hyg"},{"key":"S0007114513003310_ref53","doi-asserted-by":"publisher","DOI":"10.1177\/15648265050262S211"},{"key":"S0007114513003310_ref31","doi-asserted-by":"publisher","DOI":"10.2307\/3069675"},{"key":"S0007114513003310_ref2","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1093\/ajcn\/80.1.193","article-title":"Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles","volume":"80","author":"Caulfield","year":"2004","journal-title":"Am J Clin Nutr"},{"key":"S0007114513003310_ref50","volume-title":"Modeling Longitudinal Data","author":"Weiss","year":"2005"},{"key":"S0007114513003310_ref56","doi-asserted-by":"crossref","first-page":"470S","DOI":"10.1093\/ajcn\/68.2.470S","article-title":"Effects of repletion with zinc and other micronutrients on neuropsychologic performance and growth of Chinese children","volume":"68","author":"Sandstead","year":"1998","journal-title":"Am J Clin Nutr"},{"key":"S0007114513003310_ref61","doi-asserted-by":"publisher","DOI":"10.1111\/j.1746-1561.2005.00025.x"},{"key":"S0007114513003310_ref7","doi-asserted-by":"crossref","first-page":"3950S","DOI":"10.1093\/jn\/133.11.3950S","article-title":"School snacks containing animal source foods improve dietary quality for children in rural Kenya","volume":"133","author":"Murphy","year":"2003","journal-title":"J Nutr"},{"key":"S0007114513003310_ref27","doi-asserted-by":"crossref","first-page":"464S","DOI":"10.1093\/ajcn\/68.2.464S","article-title":"Zinc deficiency and child development","volume":"68","author":"Black","year":"1998","journal-title":"Am J Clin Nutr"},{"key":"S0007114513003310_ref38","doi-asserted-by":"publisher","DOI":"10.1179\/147683010X12611460763689"},{"key":"S0007114513003310_ref60","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665111002813"},{"key":"S0007114513003310_ref62","doi-asserted-by":"publisher","DOI":"10.1177\/15648265050262S204"},{"key":"S0007114513003310_ref46","volume-title":"Assessment of Snack Acceptance During a School Feeding Intervention in Rural Kenya: Research Brief 05-03-CNP","author":"Gewa","year":"2005"},{"key":"S0007114513003310_ref35","doi-asserted-by":"publisher","DOI":"10.1159\/000066399"},{"key":"S0007114513003310_ref47","doi-asserted-by":"crossref","first-page":"3965S","DOI":"10.1093\/jn\/133.11.3965S","article-title":"The impact of dietary intervention on the cognitive development of Kenyan school children","volume":"133","author":"Whaley","year":"2003","journal-title":"J Nutr"},{"key":"S0007114513003310_ref26","doi-asserted-by":"crossref","first-page":"1473S","DOI":"10.1093\/jn\/133.5.1473S","article-title":"The evidence linking zinc deficiency with children's cognitive and motor functioning","volume":"133","author":"Black","year":"2003","journal-title":"J Nutr"},{"key":"S0007114513003310_ref48","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980008003698"},{"key":"S0007114513003310_ref23","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.112160"},{"key":"S0007114513003310_ref4","volume-title":"The World Health Report 2002 \u2013 Reducing Risks, Promoting Healthy Life","year":"2002"},{"key":"S0007114513003310_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61690-0"},{"key":"S0007114513003310_ref36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1746-1561.2008.00288.x"},{"key":"S0007114513003310_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/156482650102200201"},{"key":"S0007114513003310_ref21","first-page":"343","article-title":"Vitamin B12 deficiency in resettled Bhutanese refugees \u2013 United States, 2008\u20132011","volume":"60","author":"Walker","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0007114513003310_ref42","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1542\/peds.88.5.934","article-title":"Relationships between morbidity and development in mildly to moderately malnourished Kenyan toddlers","volume":"88","author":"Neumann","year":"1991","journal-title":"Pediatrics"},{"key":"S0007114513003310_ref1","volume-title":"State of the World's Children \u2013 Excluded and Invisible","year":"2006"},{"key":"S0007114513003310_ref52","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114512003121"},{"key":"S0007114513003310_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/S000711450999273X"},{"key":"S0007114513003310_ref15","doi-asserted-by":"publisher","DOI":"10.1177\/15648265030244S206"},{"key":"S0007114513003310_ref25","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/ajcn\/72.3.762","article-title":"Signs of impaired cognitive function in adolescents with marginal cobalamin status","volume":"72","author":"Louwman","year":"2000","journal-title":"Am J Clin Nutr"},{"key":"S0007114513003310_ref44","author":"Otten","year":"2006"},{"key":"S0007114513003310_ref40","doi-asserted-by":"publisher","DOI":"10.3945\/jn.109.118927"},{"key":"S0007114513003310_ref55","volume-title":"Role of Animal Source Foods to Improve Diet Quality and Growth and Development in Kenyan School Children: Final Report of Cohort 2 Data Analyses","author":"Neumann","year":"2005"},{"key":"S0007114513003310_ref8","doi-asserted-by":"publisher","DOI":"10.3945\/jn.108.093823"},{"key":"S0007114513003310_ref5","doi-asserted-by":"crossref","first-page":"3927S","DOI":"10.1093\/jn\/133.11.3927S","article-title":"Micronutrient deficiencies and cognitive functioning","volume":"133","author":"Black","year":"2003","journal-title":"J Nutr"},{"key":"S0007114513003310_ref9","doi-asserted-by":"publisher","DOI":"10.1079\/PNS2006489"},{"key":"S0007114513003310_ref41","volume-title":"Diet Quantity and Quality. Final Report Phase II: Functional Implications of Malnutrition, Kenya Project","author":"Neumann","year":"1992"},{"key":"S0007114513003310_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S0271-5317(98)00027-X"},{"key":"S0007114513003310_ref11","doi-asserted-by":"crossref","first-page":"633S","DOI":"10.1093\/ajcn\/78.3.633S","article-title":"Bioavailability of iron, zinc, and other trace minerals from vegetarian diets","volume":"78","author":"Hunt","year":"2003","journal-title":"Am J Clin Nutr"},{"key":"S0007114513003310_ref39","doi-asserted-by":"crossref","DOI":"10.2139\/ssrn.946107","volume-title":"The Impact of Nutrition During Early Childhood on Education Among Guatemalan Adults","author":"Maluccio","year":"2006"}],"container-title":["British Journal of Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0007114513003310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,11]],"date-time":"2022-03-11T02:17:45Z","timestamp":1646965065000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0007114513003310\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,30]]},"references-count":63,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,3,14]]}},"alternative-id":["S0007114513003310"],"URL":"https:\/\/doi.org\/10.1017\/s0007114513003310","relation":{},"ISSN":["0007-1145","1475-2662"],"issn-type":[{"value":"0007-1145","type":"print"},{"value":"1475-2662","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,30]]}}}