American teens are discovering that poor health habits can equal poor grades, as those who are at the top of the class tend to have fewer unhealthy behaviors, including drug use.

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The survey was conducted by the U.S. Centers for Disease Control and Prevention, and shows a strong link between the health habits of teens and their academic achievement.

“As our nation’s children embark on another school year, it’s important to remember that health and academic performance are not mutually exclusive,” said the CDC’s director, Dr. Brenda Fitzgerald.

Researchers analyzed data from a 2015 government survey and found that students with mostly D’s and F’s were more likely to have engaged in behaviors such as injecting illegal drugs, skipping school due to safety concerns, or having multiple sexual partners. The students who maintained A averages were twice as likely to eat breakfast every day and also maintained physical activity of at least 60 minutes a day five or more days a week.

There is no direct cause and effect relationship, but Fitzgerald says that there is a connection between student health and academic achievement.

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