title: The Association between Health Behaviours and Academic Performance in Canadian Elementary School Students: A Cross-Sectional Study.
abstract: BACKGROUND
  Establishing early healthy eating and physical activity behaviours is critical in supporting children's long-term health and well-being. The objective of the current paper was to examine the association between health behaviours and academic performance in elementary school students in a school board in Nova Scotia, Canada.
  
  
  METHODS
  Our population-based study included students in grades 4-6 across 18 schools in a rural school board. Diet and physical activity were assessed through validated instruments. Academic performance measures were obtained from the school board for Mathematics and English Language Arts (ELA). Associations between health behaviours and academic performance were assessed using multilevel logistic regression.
  
  
  RESULTS
  Students with unhealthy lifestyle behaviours were more likely to have poor academic performance for both ELA and Mathematics compared to students with healthy lifestyle behaviours; associations were statistically significant for diet quality, physical activity, sugar-sweetened beverage consumption for ELA; and breakfast skipping, not being physically active at morning recess, and not being physically active after school for Mathematics. The effects of diet and physical activity were independent of each other and there was no interaction between the two exposures.
  
  
  CONCLUSIONS
  Our findings suggest that support for healthy behaviours may help to improve academic outcomes of students.
authors.affiliation: Applied Research Collaborations for Health, School of Health and Human Performance, Dalhousie University, 1318 Robie Street, Halifax, NS B3H 4R2, Canada. jessie-lee.mcisaac@dal.ca.
authors.forename: Jessie-Lee D
authors.initials: JL
authors.lastname: McIsaac
authors.affiliation: Applied Research Collaborations for Health, School of Health and Human Performance, Dalhousie University, 1318 Robie Street, Halifax, NS B3H 4R2, Canada. sara.kirk@dal.ca.
authors.forename: Sara F L
authors.initials: SF
authors.lastname: Kirk
authors.affiliation: Perinatal Epidemiology Research Unit, Departments of Pediatrics and Obstetrics & Gynaecology, Dalhousie University, 5980 University Avenue, Halifax, NS B3K 6R8, Canada. stefan.kuhle@dal.ca.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kuhle
mesh_terms: D002170:Canada; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D004521:Educational Measurement; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D009674:Nova Scotia; D013334:Students / Q000523:psychology / Q000706:statistics & numerical data*
keywords: Canada; academic performance; child; diet; physical activity