Results and implications of the INCAP follow-up study

This article is a critical synthesis of 12 papers included in this supplement. The set deals with the short- and long-term effects of improving nutrition in Guatemalan villages characterized by deficient diets, high rates of infection and pronounced growth retardation in the first 3 y of life. The data reviewed come from two studies carried out over two decades: the Institute of Nutrition of Central America and Panama (INCAP) longitudinal study (1966-1977) and its follow-up (1988-1989). The longitudinal study included a nutrition intervention that improved the energy and nutrient intakes of women and preschool children. Its effects included improved birthweights, reduced infant mortality rates and improved growth rates in children < 3 y of age. Growth rates from 3 to 7 y of age, similar to those of well-nourished children, were not affected by the intervention. The follow-up study was conducted when the subjects were 11-27 y old. Among the long-term effects found were greater stature and fat-free mass, particularly in females, improved work capacity in males and enhanced intellectual performance in both genders. The nutrition intervention did not, on the other hand, accelerate maturation during adolescence, as measured by skeletal age or age at menarche. It is concluded that improved nutrition in early childhood has important long-term effects in the adolescent and adult.