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Nutritional supplementation in girls influences the growth of their children: prospective study in Guatemala^1,2,3,4

¹ From the Department of Economics and Population Studies Center (JRB), the Graduate Group in Demography (MCC), and the Department of Sociology and Population Studies Center (SHP), University of Pennsylvania, Philadelphia, PA; the International Food Policy Research Institute, Washington, DC (JH); and the Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA (RM and ADS).

² The funders of the study based on competitive peer-reviewed competitions had no role in the study design, data collection, data analysis, data interpretation, or writing of the report.

³ Supported by National Institutes of Health grants TW-05598 (PI Martorell; "Early Nutrition, Human Capital and Economic Productivity"), HD-046125 (PI Stein; "Education and Health Across the Life Course in Guatemala"), and HD045627 (PI Hoddinott; "Resource Flows Among Three Generations in Guatemala"); NSF/Economics grants SES 0136616 and SES 0211404 (PI Behrman; "Collaborative Research: Nutritional Investments in Children, Adult Human Capital and Adult Productivities"); and the National Science Foundation.

⁴ Address correspondence to JR Behrman, Economics Department, McNeil 160, 3718 Locust Walk, University of Pennsylvania, Philadelphia, PA 19104-6297. E-mail: jbehrman{at}econ.upenn.edu.

Background: Better early childhood nutrition improves schooling, adult health, skills, and wages, but there is little evidence regarding its effect on the next generation.

Objective: We assessed whether nutritional supplementation in children aged <7 to 15 y affected their children's nutritional status 29–38 y later.

Design: We studied 791 children 0–12 y who were offspring of 401 Guatemalan women who had participated as children in a nutritional supplementation trial in which 2 villages were randomly assigned to receive a nutritious supplement (atole) and 2 were assigned to receive a less-nutritious supplement (fresco). We compared anthropometric indicators between the offspring of mothers exposed to atole and the offspring of mothers exposed to fresco.

Results: Compared with the offspring of women exposed to fresco, the offspring of women exposed to atole had a 116-g (95% CI: 17, 215 g) higher birth weight, were 1.3-cm (0.4, 2.2 cm) taller, had a 0.6-cm (0.4, 0.9 cm) greater head circumference, had a 0.26 (0.09, 0.43) greater height-for-age z score, and had a 0.20 (0.02, 0.39) greater weight-for-age z score. The association for height differed by offspring sex. Sons of women exposed to atole were 2.0-cm (95% CI: 1.0, 3.1 cm) taller than the sons of women exposed to fresco. Supplementation was not associated with 6 other offspring anthropometric indicators that reflect measures of adiposity. Supplementation in boys did not affect their children's anthropometric measures.

Conclusion: Nutritional supplementation in girls is associated with substantial increases in their offsprings' (more for sons) birth weight, height, head circumference, height-for-age z score, and weight-for-age z score.