Objective: To examine the association between nutrition, physical activity, lifestyle, the combined behavior e"ect, and the schoolchildren's academic achievement. Design: Observational and cross-sectional study. Setting: West Bank, Palestine. Participants: A group of schoolchildren (n=1945) in grades 5-9 (11-16 years). Measurements: Students were surveyed about the their ’dietary, physical activity (PA), leisure time activity, and academic achievement. Academic achievement was measured using students' marks in Arabic, English, math, science courses, and the total average score. The linear regression model was conducted to analyze the relationship between dietary, PA, combined behavior, and academic achievement, while adjusted for demographic confounders; body mass index (BMI), and parental education. Results: Findings indicated that healthy nutrition and adequate levels of PA significantly predict achievement scores. In both boys and girls, high academic achievement was associated with a high intake of fruits and vegetables (AOR: 1.1 (0.72-1.68); 1.18(0.81-1.7), and (AOR: 1.21(0.8-1.82); 1.33(0.93-1.91), respectively. In both girls and boys, high academic achievement was associated with low intake of soft drink, beverages (juice with sugar) and energy drink (AOR: (0.75(0.47-1.19), 0.85(0.58-1.27)); (0.99(0.63-1.57), 0.76(0.52-1.12)); (0.66(0.38-1.15), 0.49(0.27-0.89)), respectively. The active and healthy nutrition group scored higher on Arabic, English, math, science, and total average score. Conclusions: There is a strong relationship between healthy nutrition, acceptable PA, and the average academic achievement within schoolchildren. Findings emphasize the importance
of linking nutrition, school PA, and health policies for improving cognitive functions and academic performance of Palestinian schoolchildren. Thus, school-based healthy lifestyle educational, health behaviors policy, and recommendation programs may have a greater e"ect on students’ academic achievement.