PRB

• This interview also in video (10 minutes)

(February 2008) Experts agree that nutrition has a significant impact on child health, growth, and development in the first two years of a child’s life. A recently published Lancet article highlights the effect of early childhood nutrition on not only the health of children, but also on their productivity as adults.¹

At a recent Population Reference Bureau policy seminar sponsored in part by the National Institute of Child Health and Human Development, Reynaldo Martorell, one of the co-authors of the article, discussed the effect of a nutrition intervention during early childhood on human capital (personal attributes such as knowledge, skills, health, and values, that increase individual productivity) formation and on the economic productivity of Guatemalan adults. Martorell is the Robert W. Woodruff professor of international nutrition at Emory University’s Rollins School of Public Health.²

Nutrition’s Effect on Child Growth and Human Capital

From 1969 to 1977, the Institute of Nutrition of Central America and Panama (INCAP) compared the effect of consuming more protein on the physical and mental development of children from four villages in Guatemala. Children in two villages were given atole, a drink made from a vegetable protein mixture, dry skim milk, and sugar. It offered more protein and energy than fresco, a less nutritious drink given to children in the other two villages.

The atole supplement improved child growth rates, increasing their height by 3 centimeters, but only for children younger than 3 years old. The beneficial effects of the atole on growth stopped once children reached age 3.³

Following a process that is not common in research on health and nutrition, researchers between 2002 and 2004 returned for a follow-up survey of the children who had received each of the two types of supplements in the 1960s and 1970s. The aim of this follow-up was to examine the longer-term impacts of the supplements that had been given to young children on later nutrition, health, and productivity.

At the time of the follow-up, those who had participated in the original study were about 32 years old. Those who had consumed the higher protein drink when they were younger than 3 seemed to fare better than those who had consumed fresco. For example, women from the atole villages had 1.2 more years of schooling. In addition, both men and women from the atole group tested 8 percent higher on intelligence tests and 17 percent higher on reading than those who hadn’t gotten the nutritional supplement.

These findings are consistent with another recent study that noted that undernutrition in the first two years of life is associated with lower adult human capital.⁴

What’s more, improved childhood nutrition was also associated with higher hourly wages for Guatemalan men. Better nutrition from ages 0 to 2 had the highest impact. Those who got the atole at those ages earned up to 67 cents per hour, or 46 percent higher wages, than those who got fresco. Their annual incomes were boosted by US$914, or one-third, over the men who had the less-nutritious drink.

Driving Poverty Reduction and Economic Growth by Investing in Nutrition

With 178 million stunted children under age 5 worldwide, Martorell says the need to target children during a child’s first two years is all the more pressing.

Martorell noted that direct investment in health and nutrition is needed to benefit the poor. Often, investments in economic growth outpace improvements in health. In India, for example, the economy has grown at least 6 percent a year over the past seven years. Yet the prevalence of underweight children under age 5 barely changed, dropping from 47 percent to 46 percent.

If undernutrition can lead to lower human capital, preventing it could bring about not only health, but also educational and economic benefits, said Martorell. Programs in health and nutrition aimed at women and young children could promote better growth and development, which would improve human capital and by extension increase economic productivity many years later.

In his talk, Martorell noted that the World Bank has positioned nutrition as not only a matter of human rights, but also as an economic investment and an engine for economic growth. “Investments in health and nutrition,” he said, “should be seen as a long-term human investment.”

Sandra Yin is editor at the Population Reference Bureau.

References

1. John Hoddinott et al., “Effect of a Nutrition Intervention During Early Childhood on Economic Productivity in Guatemalan Adults,” The Lancet 371, no. 9610 (2008): 411-16.
2. Reynaldo Martorell, “Early Childhood Nutrition, Human Capital and Economic Productivity,” presentation made at the Population Reference Bureau Policy Seminar Series, Washington, DC, Jan. 23, 2008. Reynaldo Martorell is also chairman in the Hubert Department of Public Health at Emory, vice-chairman of the Pan American Health and Education Foundation Leadership, and adviser to UNICEF, to the World Health Organization, and to the World Bank.
3. Hoddinott et al., “Effect of a Nutrition Intervention”; and Dirk J. Schroeder et al., “Age Differences in the Impact of Nutritional Supplementation on Growth,” Journal of Nutrition 125, no. 4 (1995): 1051-59.
4. Cesar G. Victora et al., “Maternal and Child Undernutrition 2: Consequences for Adult Health and Human Capital,” The Lancet 371, no. 9610 (2008): 340-71.