Abstract: Objective To understand the nutritional status and influencing factors among primary and secondary school students in rural areas of four counties in Guangdong Province, and to provide a basis for formulating nutritional intervention measures. Methods A multi-stage stratified cluster random sampling method was used to select students aged 6-16 years from rural compulsory education areas under the Student Nutrition Improvement Program in Guangdong Province in 2021. Questionnaire surveys and physical examinations were conducted, and the influencing factors of nutritional status were analyzed using a multinomial logistic regression model. Results Among the 501 rural primary and secondary school students in four counties of Guangdong Province, the undernutrition rate was 11.60%, and the overweight/obesity rate was 9.40%. Multinomial logistic regression analysis showed that, compared with students with normal nutritional status, students from pilot counties (OR=0.167) and those with good lung capacity (OR=0.292) had a lower risk of malnutrition (all P<0.05), while students who sometimes exhibited picky eating habits (OR=3.439) had a higher risk of undernutrition (P<0.05). Students who consumed beverages 3-6 times per week had a significantly higher risk of overweight/obesity compared to those who consumed beverages ≤ 2 times per week (OR=3.959, P<0.05). Conclusions Undernutrition and overweight/obesity are prominent issues among rural students in the four counties of Guangdong Province. Targeted nutritional interventions should be strengthened, with a focus on dietary behaviors and physical fitness, to improve students' nutritional health levels.

Key words: Rural area, Primary and secondary school students, Nutritional status, Influencing factors