Better childhood nutrition increases productivity

Feeding very young children a high-energy, high-protein supplement leads to increased economic productivity in adulthood, especially for men, according to a study by Emory University public health researcher Reynaldo Martorell, PhD, and a team of economists.

The study, published in the Feb. 2, 2008 issue of the Lancet, is the first to show that improving nutrition in early childhood leads to significantly higher incomes in adulthood.

Boys who received the supplement, known as atole, in the first two years of life earned on average 46 percent higher wages as adults, while boys who received atole in their first three years earned 37 percent higher wages on average. Those who first received the supplement after age three did not gain any economic benefits as adults.

The research was conducted in Guatemala by Dr. Martorell, principal investigator, and colleagues at Emory University, the International Food Policy Research Institute (IFPRI), the Institute of Nutrition of Central America and Panama, the University of Pennsylvania, and Middlebury College. The study was funded by the Fogarty International Center of the National Institutes of Health. "The study confirms that the first two years of life are the window of opportunity when nutrition programs have an enormous impact on a child’s development, with lifelong benefits," says Dr. Martorell, Woodruff Professor and chair of the Hubert Department of Global Health at Emory’s Rollins School of Public Health.

From 1969 to 1977, four rural communities in Guatemala participated in a food supplementation study in which children received one of two supplements fortified equally with micronutrients. The first, atole, was high in protein and energy; the second contained no protein and was low in energy. The atole improved child growth but only in the first three years of life. During 2002 to 2004, researchers returned to Guatemala to interview individuals who had participated in the nutrition supplement program as children. They collected information about all income-generating activities, including type of work; hours, days, and months worked; and fringe benefits received.

"This research demonstrates that improving early childhood nutrition in developing countries is not only crucial for the physical growth of children, but is also a wise, long-term economic investment," says Dr. Martorell, who also was one of the researchers who conducted the original study in Guatemala.

"Just as we need to invest in infrastructure, we need to invest in children," says Dr. Martorell. "Improving maternal nutrition during pregnancy, promoting exclusive breastfeeding for the first four to six months, and improving what children are fed from six to 24 months to complement breast milk, along with preventive care and adequate sanitation are key public health interventions to ensure a healthy start in life."

The Guatemala study is part of an ongoing focus by the Lancet on maternal and child under nutrition and a featured article in the current issue.

"We have long known that nutrition interventions can provide significant benefits in terms of a child’s health, growth and mental and physical development," says John Hoddinott, lead author of The Lancet article and IFPRI senior research fellow. "This study in Guatemala is important because it shows that improving nutrition in early childhood can also be a driver of economic growth for developing countries and a pathway out of poverty for poor households."

(Source: Lancet: Ashante Dobbs: Emory University: February 2008)