Prospective study of protein-energy supplementation early in life and of growth in the subsequent generation in Guatemala

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Abstract
Background: The secular increase in height is assumed to result from long-term improvements in nutritional intakes and reductions in infectious disease burdens. Nutritional supplementation in early life reduces stunting in chronically undernourished populations. It is unknown whether these improvements can be transmitted to subsequent generations. Objective: Our objective was to estimate the intergenerational effect on offspring length of improved nutrition in the mother's childhood. Design: We studied 263 children born in 1996–1999 to 231 women who had received nutritional supplementation, ie, atole (high-protein, moderate-energy drink) or fresco (nonprotein, low-energy drink), prenatally and up to age 7 y as part of a community trial in Guatemala between 1969 and 1977. Child length was measured at different times to age 36 mo. Results: Children born to women who received the enhanced supplement were taller (age-adjusted difference: 0.80 cm; 95% CI: 0.16, 1.44 cm) than were children whose mothers received the low-energy supplement. This increment was independent of the children's birth weight or socioeconomic status but was substantially attenuated and no longer significant after adjustment for maternal height (adjusted difference: 0.43 cm; 95% CI: −0.10, 0.96 cm; P > 0.10). The effect of maternal nutritional supplementation was more pronounced in boys than in girls (P for interaction < 0.10) and in children born to women who received supplements at ages 3–7 y than in children born to women who received supplements at ages 0–3 y (P for interaction < 0.01). Conclusion: Nutritional supplementation in childhood has positive effects on both the supplemented persons and on the subsequent generation.