Prevalence and Risk Factors of Malnutrition among Primary School Children in Iran


1 Pediatrician, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Assistant Professor of Pediatrics, Department of Pediatric, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Associate Professor, Fellowship of Clinical Toxicology, Department of Clinical Toxicology, MTRC Medical Toxicology Research Centre, Mashed University of Medical Sciences, Mashed, Iran.

5 Kerman University Of Medical Sciences, Kerman, Iran.



Background: Malnutrition is a serious threat to children’s health and the primary cause of childhood mortality in the WHO Eastern Mediterranean Region. The present study aimed to evaluate the prevalence and risk factors of malnutrition among Iranian primary school children.
Materials and Methods: In this systematic review, a systemic search of online databases (Medline, EMBASE, Scopus, Web of Science, Cochrane Library, CIVILICA, SID, and Google Scholar search engine) was conducted for related studies with no time limit up to June 2022. Two reviewers evaluated the quality of eligible studies and carried out the selection procedure.
Results: Twelve related studies were selected. The prevalence of malnutrition based on weight-for-age, height-for-age, and weight-for-height were 46.6% (underweight, 3.2-46.6%), 36.9% (stunting, 3-36.9%), and 53.3% (wasting, 3.7-53.3%), respectively. The logistic regression analyses showed that the risk of malnutrition in rural areas was 1.34 times that of urban areas, in girls 1.17 times more than boys, in the Sistani ethnic group 1.82 times more than Fars-native ethnic group, and in low-income families 2.01 times more than high-income families. Thinness was significantly higher in public schools than in private schools. There was a statistically significant relationship between the consumption of snacks and the wasting of schoolchildren. Birth weight, parental education, father’s height, father’s job, family income, and maternal age were the main contributing factors to malnutrition in schoolchildren (p<0.05).
Conclusion: The prevalence of malnutrition in Iranian schoolchildren in the Sistan and Balochistan, Kerman, and Kurdistan provinces was relatively high in terms of wasting, stunting, and being underweight. The risk of malnutrition was high in rural areas, girls, Sistani ethnic groups, and low-income families.