Nutritional improvement status of primary and secondary school students in the pilot nutrition improvement areas of Hainan, China from 2014 to 2021

Objective: In 2013, Hainan Provincial Government launched the pilot project of the “Nutrition Improvement Program for Rural Compulsory Education Students” (NIPRCES) in Qiongzhong County. The study aims to provide a more scientific basis for subsequent program implementation by monitoring the nutritional status of students in the course of the nutrition improvement program. Design: It has been monitoring the nutritional health of students in the pilot area annually since 2014. Multi-stage sampling was used to select 6 each for primary and secondary schools. The Cochran Armitage trend test (CATT), χ2 test and Bonferroni correction were used to analyze the data. Setting: China Participants: 18,762 participants aged 6~15 in Hainan Provence Qiongzhong County, China Results: : In 2014-2021, the average height of both boys and girls has increased. The prevalence of undernutrition showed a significant downward trend (P<0.05) decreasing by 7.11%, and the prevalence of overnutrition showed an upward trend (both P< 0.05) rising by 2.86% and 2.74%, respectively. There was a downward trend in the prevalence of undernutrition among students in all grades (all P< 0.05), and a significant upward trend in obesity among students in grades 1-6 (all P< 0.05). For all students, the prevalence of undernutrition in Li students showed a downward trend (P<0.05), and the prevalence of obesity in Han, Li, and other ethnic minorities showed an upward trend (all P < 0.05). Conclusions: : After implementing the NIPRCES, the prevalence of malnutrition among students has declined. However, their prevalence is still high, while the overnutrition prevalence is rising.