A Prospective Study in Guatemala
 
Arch Pediatr Adolesc Med. 2008;162(7):612-618.
Objective  To  estimate the association of improved nutrition in early life with  adult intellectual functioning, controlling for years of  schooling.   Design  Prospective cohort study.   Setting  Four villages in Guatemala, as well as locations  within Guatemala to which cohort members migrated.   Participants  Individuals who had participated as children  in a nutrition supplementation intervention trial from March 1,  1969, through February 28, 1977 (N = 2392). From May 1,  2002, through April 30, 2004, adequate information for analysis was  obtained from 1448 of 2118 individuals (68.4%) not known to have  died.   Interventions  Individuals exposed to atole (a protein-rich  enhanced nutrition supplement) at birth through age 24 months  were compared with those exposed to the supplement at other  ages or to fresco, a sugar-sweetened beverage. We measured years  of schooling by interview.   Main Outcome Measures  Scores on the Serie  Interamericana (InterAmerican Series) tests of reading  comprehension and the Raven Progressive Matrices, obtained from May  1, 2002, through April 30, 2004.   Results  In models controlling for years of schooling and  other predictors of intellectual functioning, exposure to atole  at birth to age 24 months was associated with an increase of  3.46 points (95% confidence interval, 1.26 to 8.18) and 1.74  points (95% confidence interval, 0.53-2.95) on the InterAmerican  Series and Raven Progressive Matrices tests, respectively. There  was no statistical interaction between exposure to atole at  birth to age 24 months and years of schooling on either outcome  (P = .24 and P = .60,  respectively).   Conclusion  Improved early-life nutrition is associated  with increased intellectual functioning in adulthood after taking  into account the effect of schooling. 
Author Affiliations:  Hubert Department of Global Health, Rollins School of Public Health, Emory  University, Atlanta, Georgia (Drs Stein, DiGirolamo, Ramakrishnan, Yount, and  Martorell and Ms Wang); and Unit of Public Policies, Institute of Nutrition of  Central America and Panama, Guatemala City, Guatemala (Drs Grajeda and  Ramirez-Zea). 
 
 
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