|Effects of Improved Nutrition in Early Childhood : The institute of Nutrition of Central America and Panama (INCAP) Follow-up Study; Proceedings of an IDECG workshop, July 1990, Bellagio, Italy, Supplement of The Journal of Nutrition (International Dietary Energy Consultative Group - IDECG, 1994, 198 pages)|
|Nutritional supplementation during the preschool years influences body size and composition of Guatemalan adolescents(¹,²)|
JUAN A. RIVERA,*³ REYNALDO MARTORELL, MARIE T. RUEL, JEAN - PIERRE HABICHT §AND JERK D. HAAS§
*Centro de Inuestigaciones en Salud Públics,
Instituto Nacional de Salud Pública, 62508 Cuernacaca, Morelos, Mexico,
Department of International Health, The Rollins School of Public Health
of Emory University, Atlanta, CA 30322, Division of Nutrition and Health,
Instituto de Nutritión de Centro America y Panama, Guatemala City, Guatemala,
and §Division of Nutritional Sciences Cornell University, Ithaca, NY
¹ Presented in the symposium on Nutrition in Early Childhood and its long-term Functional Significance, FASEB, April 6, 1992, Anaheim, CA. Published as a supplement to The Journal of Nutrition. Guest editors for this supplemental publication were Reynaldo Martorell, The Rollins School of Public Health of Emory University, Atlanta, GA, and Nevin Scrimshaw, The United Nations University, Boston, MA.
² Data analyses were supported by NIH Grant HD22440 and by grant 9202716-000 from the Pew C heritable Trusts.
³ To whom correspondence should be addressed: Centro de Investigaciones en Salud Pública, Instituto Nacional de Salud Pública, 62508 Cuernavaca, Morelos, Mexico.
Effects of supplementary feeding during early childhood on body size and composition at adolescence are examined in a population with marked growth failure in the first 3 y of life. The data came from a supplementation trial conducted in rural Guatemala from 1969 to 1977 and a 1988-89 follow-up study of the same subjects at adolescence. Two pairs of villages participated in the trial. One village from each pair received a high protein-energy supplement (Atole), which significantly improved dietary intakes, whereas the other village of the pair received a low-energy, no-protein supplement (Fresco), which did not impact appreciably on dietary intakes. Children from Atole villages grew better during the preschool period than children from Fresco villages. At adolescence, subjects from Atole villages were taller, weighed more and had greater fat-free masses than subjects from Fresco villages. Differences in height at adolescence were slightly reduced in magnitude relative to differences at 3 y of age. However, differences in weight were increased in adolescence relative to 3 y of age. J. Nutr. 125: 1068S-1077S,1995.
INDEXING KEY WORDS:
In a review of controlled supplementation trials, clear effects of supplementary feeding on growth were found in populations with evidence of growth retardation when the dietary intakes of young children were truly improved (Habicht and Butz 1979, Rivera 1988). On the other hand, the long-term effects of community-based supplementation programs during early childhood on the growth and body composition at adolescence or adulthood have not been studied.
This article examines effects of supplementary feeding during early childhood on body size and composition at adolescence in a population where effects of supplementation on growth rates were observed during the first 3 y of life but not from 3 to 7 y of age Martorell et al. 1982, Schroeder et al. 1995). It remains to be shown whether these improvements in growth persist into adolescence.
Tanner (1986) has described human growth as a target-seeking function. In his view, children have their own natural growth trajectories; when deviations occur, restoring forces develop to return children to their original growth curves. Growth after 3 y of age in rural Guatemala is not significantly constrained (Martorell et al. 1995b) and thus, it may be possible for the differences in size in favor of supplemented children observed at 3 y of age to be reduced through faster growth subsequently in nonsupplemented children. In addition, nonsupplemented children may have a greater potential for growth than supplemented children because of delayed maturation. Martorell et al. (1979) found that nonsupplemented children were less mature at 3 y of age than supplemented children in this population. Less mature children, in turn, may have a more prolonged subsequent growth period that could compensate for some of the growth failure incurred in early childhood.
The hypothesis tested in the present study is that effects of supplementation on growth at 3 y of age persist into adolescence and that differences in attained growth at: adolescence between supplemented and nonsupplemented groups are of similar magnitude as observed at 3 y of age. The data used in the analysis were collected during a supplementation trial of rural Guatemalan children conducted from 1969 to 1977 and from a follow-up study of the same subjects at adolescence. Results are presented for length and weight at 3 y of age and for height, weight and fat free mass (FFM) at adolescence and young adulthood.