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

Abstract

Objective 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). Methods 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 <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. Results 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 < 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). Conclusions 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.

Impact of an integrated nutrition, health, water sanitation and hygiene, psychosocial care and support intervention package delivered during the pre- and peri-conception period and/or during pregnancy and early childhood on linear growth of infants in the first two years of life, birth outcomes and nutritional status of mothers: study protocol of a factorial, individually randomized controlled trial in India

“…Evidence indicates that the first 1000 days of life i.e. from conception to two years of age are critical for optimal growth and brain development [3,4]. Linear growth and neurodevelopment are particularly interlinked in the first two years of life as the etiology of poor growth (stunting) and neurodevelopment, such as insufficient nutrition, repeated infections and sub-optimal care, are similar during this period [5][6][7].…”

Global country‐level estimates of associations between adult height and the distribution of income

“…Substantial evidence suggests that height is caused by material standard of living. For example, in a controlled experiment on nutritional supplements on growth and adult human capital, children under 3 years old randomized to receive an energy drink grew approximately three more centimeters by age three, and had 46% higher wages as adults, than those in the control group (Martorell, ). The literature on the “early origins hypothesis,” that adult health (and height) depend critically on the nutrition and disease environments experienced in utero and infancy, helps explains this causal relationship (see Almond and Currie () for a review of this literature.)…”

Nutrient supplementation during the first 1000 days and growth of infants born to pregnant adolescents

“…The RDNS was a cluster‐randomized effectiveness trial, designed to evaluate the impact of nutrition interventions during the “1000 days” window on nutritional status of pregnant and lactating women and on growth, nutritional status, and development of their children . We focused on the first 1000 days because nutritional insults and growth faltering during this time period are associated with serious long‐term adverse consequences . Of the pregnant women enrolled in the study, almost 40% were adolescents (<20 years of age).…”