A comprehensive approach to preventing and treating
malnutrition means expanding programs to the scale needed
and linking current U.S. nutrition activities with broader investments in related sectors, including agriculture, food security, and rural infrastructure. Focusing on nutrition is one of
the best investments the United States and the international
community can make to reduce hunger and poverty and promote development.
The first two years of life are a critical window of
opportunity to make sure children live healthy, productive
lives. A long-term study in Guatemala following individuals
from infancy into adulthood provides some of the best
evidence yet of the economic benefits of good nutrition.9
In 1969, young Guatemalan children in two communities
were chosen to participate in a nutrition supplementation
program that provided them with a nutritious drink twice
a day. One group of children received a drink called Fresco,
the other a drink called Atole, which contained more calories
and protein than Fresco.
The nutrition intervention had a profound impact.
Those who received Atole grew on average an additional
2.4 centimeters taller than those who received Fresco. This
small difference resulted in a 20 percent reduction in
severe stunting in the Atole group. Virtually no reduction in
stunting was found for children who received Fresco.10 Followup monitoring of the children in these two communities
25 years later showed that individuals who received Atole
had a greater likelihood of completing primary and some
secondary school, higher scores on reading comprehension
and cognitive tests, and, among women, completion of more
grades in school.11
The impact of greater height and more schooling in the
Atole group has economic consequences as well. As adults,
children who received Atole during the first two years of life
earned an average of $870 more annually than individuals
who received Fresco. In a country where annual per capita
income is just $2,440, this represents a significant gain
for adults who were properly nourished in childhood.12 In
Guatemala and other countries where malnutrition persists,
the economic loss can be as high as 2 to 3 percent of GDP.13
These direct costs are compounded by indirect costs—for
example, from increased healthcare expenses and lost labor
hours resulting from increased susceptibility to illness.
Malnutrition Remains Pervasive
The dual crises of high food prices and a deep economic
recession in the last few years have reversed progress against
hunger. In many countries, child malnutrition rates are
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Todd Post
Nutrition is Critical for Development
steadily rising. For children suffering malnutrition, the effects will be long-term, even intergenerational. A woman
who has been malnourished in childhood is likely to deliver
a smaller baby with poor fetal growth and a greater likelihood of suffering stunting.14
A number of factors, including poverty, contribute to
malnutrition. During the first six months of life, breast
milk contains all of the nutrients a growing infant needs to
maintain health, but exclusive breastfeeding rates remain
very low. In a survey of 82 developing countries, less than
50 percent of mothers exclusively breastfed their children.
Suboptimal breastfeeding results in the death of 1.4 million
young children each year.15
Healthy children become malnourished if they do not
get enough to eat or if they eat food of limited nutritional
value, as often happens when diets consist mainly of a staple
grain such as corn or rice. Poor diets are themselves often
the result of poverty or lack of availability of food. Save the
Children found that at average wages, a rural family of five
in Ethiopia would have to work for four months simply to be
able to afford one month’s worth of healthy food.16 In Niger
and other countries, severe malnutrition increases during
the so-called hunger season before crops are harvested.17
(See Fig. 1 on next page)
Even if food availability is not a barrier, mothers may not
have good information about what, how much or how often
Bread for the World Institute 3