Researchers in Nepal discovered something surprising: some schoolchildren don’t have enough food to eat and grow properly, while others eat too much and gain too much weight. This “double burden” is happening in the same schools and even in some of the same kids. Scientists studied nearly 12,000 students aged 6-18 and found that poor kids in rural areas tend to be too thin, while wealthier kids in cities tend to be overweight. This creates a unique challenge because schools need different nutrition programs for different groups of students. The study shows that Nepal needs special food and health programs designed for each type of school to help all children grow up healthy.

The Quick Take

  • What they studied: How many schoolchildren in Nepal are too thin, too heavy, or have stunted growth, and whether some kids experience both problems at the same time.
  • Who participated: 11,782 students between ages 6 and 18 from 111 different schools in Kaski, Nepal. The schools included both public and private schools in rural and urban areas.
  • Key finding: About 1 in 6 students (15.8%) had stunted growth from not eating enough, while 1 in 10 (10.7%) were overweight and 1 in 30 (3.3%) were obese. Surprisingly, 1% of students had both stunted growth AND were overweight at the same time.
  • What it means for you: If you live in or care about Nepal, this shows that nutrition problems are complex and different in different areas. Rural and public schools need help fighting hunger and poor growth, while urban and private schools need help preventing obesity. One-size-fits-all solutions won’t work.

The Research Details

Scientists took a snapshot of nutrition in Nepalese schools by measuring and weighing nearly 12,000 students at one point in time. This type of study is called “cross-sectional” because it captures information from many different groups all at once, rather than following the same kids over months or years.

The researchers randomly picked 111 schools across Kaski, Nepal to make sure their results would represent the whole region fairly. They trained people to measure each student’s height and weight using the same methods, which helps ensure the measurements were accurate. They also asked students questions about their families and backgrounds to understand if where they lived (city or countryside) or what type of school they attended (public or private) made a difference.

The scientists used official growth standards from the World Health Organization (WHO) to decide if each student was too short for their age (stunted), too light (underweight), too heavy (overweight), or very overweight (obese). Then they used math to compare the numbers between different groups.

This research approach is important because it quickly shows what nutrition problems exist right now in schools, which helps leaders decide where to focus help first. By comparing rural versus urban schools and public versus private schools, the study reveals that different communities face different challenges. This information is crucial for creating targeted programs rather than wasting resources on solutions that don’t fit the actual problem.

The study’s strengths include a large sample size (nearly 12,000 students), random selection of schools to reduce bias, trained researchers taking measurements the same way each time, and use of international standards for comparison. However, because this is a snapshot in time, we can’t know if these problems are getting better or worse. The study only looked at one region of Nepal, so results might be different in other parts of the country. Also, the researchers couldn’t measure other important factors like what students actually eat or their family income levels, which might explain some of the differences they found.

What the Results Show

The study found that malnutrition in Nepal takes different forms depending on where students live and what type of school they attend. In rural areas, the main problem is students being too short for their age (stunting) at 20.5%, compared to 15.1% in cities. This suggests that rural students often don’t get enough food to grow properly. In contrast, urban areas have more overweight (11.2% vs. 7.1%) and obese (3.6% vs. 1.5%) students, suggesting that city students have access to plenty of food but sometimes too much of the wrong kinds.

When comparing public and private schools, the pattern was even more striking. Public school students were more likely to be stunted (18.2% vs. 13.2%) and underweight (6.7% vs. 5.4%), while private school students were more likely to be overweight (13.3% vs. 8.2%) and obese (5.0% vs. 1.7%). This suggests that wealthier families who send kids to private schools can afford more food, but poorer families in public schools struggle to provide enough nutrition.

Perhaps most surprising, about 1% of students showed signs of both problems: they were stunted (too short) but also overweight or obese. This unusual combination happens when kids don’t get enough of the right nutrients early in life, stunting their growth, but then later eat too much food that’s high in calories but low in nutrition.

The study also found that underweight (too light for age) affected 6.1% of students overall, with higher rates in public schools (6.7%) than private schools (5.4%). This suggests that some students aren’t just short, but also weigh too little, indicating serious nutritional gaps. The fact that these problems cluster by school type and location shows that poverty and access to food are major factors driving these nutrition issues.

This research adds to growing evidence that low- and middle-income countries like Nepal face a unique challenge: they’re dealing with both too little nutrition and too much at the same time. Previous studies in other countries have shown similar patterns, but this is one of the first large studies to document how common it is for the same school—or even the same child—to experience both problems. The findings support what global health experts have been warning about: that simply having “enough food” isn’t enough; the food needs to be nutritious.

The study only looked at one region of Nepal (Kaski), so we don’t know if these patterns are the same everywhere in the country. Because measurements were taken at just one point in time, we can’t tell if these problems are getting better or worse. The study didn’t collect information about what students actually eat, their family income, or other health conditions that might explain the results. Additionally, the study couldn’t measure whether students had access to clean water, sanitation, or healthcare, which all affect nutrition. Finally, private schools might have different types of students (wealthier families) compared to public schools, which could explain some differences beyond just the school type itself.

The Bottom Line

Based on this research, Nepal should create different nutrition programs for different areas: (1) Rural and public schools need programs focused on providing enough food and teaching families how to grow nutritious foods. This recommendation has strong support from the data. (2) Urban and private schools need programs focused on teaching healthy eating habits and physical activity to prevent obesity. This also has strong support. (3) All schools should screen students for nutrition problems so they can get help early. This is a practical recommendation based on the findings. Parents and teachers should be aware that nutrition problems look different in different communities and require different solutions.

School administrators, teachers, and health workers in Nepal should definitely pay attention to these findings. Parents in both rural and urban areas should care because the study shows their children may face nutrition problems, just different ones depending on where they live. Government officials making health policy should use this information to design programs. However, people outside of Nepal should be cautious about assuming these exact patterns apply to their own countries, since nutrition problems vary by region and culture.

If schools implement targeted nutrition programs based on these findings, improvements in student health and growth could be seen within 6-12 months for some measures (like weight gain or loss), but improvements in stunting (height) take longer because children grow slowly. Real, lasting changes in community nutrition would likely take 2-3 years to become obvious.

Want to Apply This Research?

  • Users in Nepal or similar regions should track their child’s height and weight monthly using a simple chart, comparing measurements to WHO growth standards. This helps identify whether a child is growing normally, falling behind, or gaining weight too quickly.
  • For rural/public school families: Focus on adding more protein-rich foods (beans, eggs, fish) and vegetables to meals, even in small amounts. For urban/private school families: Increase physical activity to 60 minutes daily and reduce sugary drinks and processed snacks. All families should track what their child eats for one week to identify nutrition gaps.
  • Set a monthly reminder to measure height and weight, record it in the app, and compare to previous months. If a child isn’t growing as expected or is gaining weight too quickly, share the data with a school nurse or doctor. Track which foods the child eats most often and adjust based on nutrition goals.

This study provides important information about nutrition patterns in Nepalese schools but should not be used for individual medical diagnosis. If you’re concerned about a child’s growth or weight, consult with a healthcare provider who can evaluate that specific child’s health. The findings apply specifically to the Kaski region of Nepal and may not represent other areas. This research is observational and cannot prove that location or school type causes nutrition problems, only that they’re associated. Always seek professional medical advice before making significant changes to a child’s diet or health routine.