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This study aims to enhance understanding of malnutrition's effect on academic achievement of primary school students.

This is a descriptive, cross-sectional design built on Roy's adaptation model (RAM). This study uses a random cluster sample, consisting of 453 primary school students. Contextual stimuli (mother's educational level, income and child’s breakfast eating) and focal stimuli (wasting, thinness, body mass index and stunting) were examined regarding adaptive responses to student’s academic achievement.

The investigation revealed that Model 1, which took into account factors of age, gender, the frequency of breakfast, income, the number of family members and the education of mothers, explained 12% (R² = 0.12) of the variance in academic achievement. Stuntedness (β = −3.2 and p < 0.01), BMI (β = 0.94 and p < 0.001), family income per month (β = 5.60 and p < 0.001) and mother's education (β = 2.79 and p < 0.001) were the significant predictors in Model 2.

This study provides evidence that malnutrition is associated with ineffective academic achievement. Moreover, variables such as the mother's level of education, family income and the child’s breakfast consumption have a significant impact on academic achievements.

RAM is a useful framework for determining factors affecting people's reactions to difficult circumstances.