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      Improved nutrition in the first 1000 days and adult human capital and health : MARTORELL

      American Journal of Human Biology
      Wiley

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          Abstract

          <div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d15137558e97">Objective</h5> <p id="P1">The aim of this article is to review why the first 1000 days of life are a vulnerable period of human development, and the long-term effects of a nutrition experiment carried out in Guatemala (1969–1977). </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d15137558e102">Methods</h5> <p id="P2">In 1969–77, a supplement called Atole, containing high quality protein, energy and micronutrients, was provided to women during pregnancy and lactation and to children &lt;7 years of age in two villages while in two control villages a low-energy drink called Fresco was provided. The villages were assigned at random to the treatment groups. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d15137558e107">Results</h5> <p id="P3">Several reasons explain the vulnerability of the first 1000 days: rapid growth and development, high nutritional requirements, greater susceptibility to infections, high sensitivity to programming effects and full dependence on others for care, nutrition, and social interaction. Compared to Fresco, Atole improved total nutrient intakes (protein, energy and micronutrients) and reduced stunting, but only in children &lt; 3 years of age. A study in 2002–2004 showed that schooling, reading, and intelligence were improved in Atole villages, but only in those who received Atole before the age of 3 years. Wages of men were increased by 46% in those provided Atole through the age of 2 years. Findings for cardiovascular disease risk factors were inconclusive, perhaps because of the young age of the sample. A new study focusing on chronic diseases is ongoing (ages 38–54 years). </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d15137558e112">Conclusions</h5> <p id="P4">The Guatemalan studies indicate that substantial improvement in adult human capital and economic productivity resulted from the nutrition intervention. This provides a powerful argument for promoting improvements in nutrition in pregnant women and young children in low income countries. </p> </div>

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          Most cited references15

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?

            The Lancet, 382(9890), 452-477
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              Effect of a nutrition intervention during early childhood on economic productivity in Guatemalan adults.

              Substantial, but indirect, evidence suggests that improving nutrition in early childhood in developing countries is a long-term economic investment. We investigated the direct effect of a nutrition intervention in early childhood on adult economic productivity. We obtained economic data from 1424 Guatemalan individuals (aged 25-42 years) between 2002 and 2004. They accounted for 60% of the 2392 children (aged 0-7 years) who had been enrolled in a nutrition intervention study during 1969-77. In this initial study, two villages were randomly assigned a nutritious supplement (atole) for all children and two villages a less nutritious one (fresco). We estimated annual income, hours worked, and average hourly wages from all economic activities. We used linear regression models, adjusting for potentially confounding factors, to assess the relation between economic variables and exposure to atole or fresco at specific ages between birth and 7 years. Exposure to atole before, but not after, age 3 years was associated with higher hourly wages, but only for men. For exposure to atole from 0 to 2 years, the increase was US$0.67 per hour (95% CI 0.16-1.17), which meant a 46% increase in average wages. There was a non-significant tendency for hours worked to be reduced and for annual incomes to be greater for those exposed to atole from 0 to 2 years. Improving nutrition in early childhood led to substantial increases in wage rates for men, which suggests that investments in early childhood nutrition can be long-term drivers of economic growth.
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                Author and article information

                Journal
                American Journal of Human Biology
                Am. J. Hum. Biol.
                Wiley
                10420533
                March 2017
                March 24 2017
                : 29
                : 2
                : e22952
                Article
                10.1002/ajhb.22952
                5761352
                28117514
                b8d6299a-eb27-4f79-a367-52194445a892
                © 2017

                http://doi.wiley.com/10.1002/tdm_license_1

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