INCAP Longitudinal Study: 50 Years of History and Legacy

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Research snapshot¹

The INCAP Longitudinal Study is the longest followed cohort study since birth in a developing country. It is made up of people who, from conception or before they turned seven years of age, participated in a nutritional supplementation intervention between 1969 and 1977 in four rural villages in Guatemala and who, in the last follow up (2015-2017), were between 42 and 57 years of age.

Two villages received a high-protein, high-energy supplement (‘atole’) and another set of matched villages received a non-protein, low-energy supplement (‘fresco’). Both supplements contained the same amount of micronutrients. This community randomised nutrition intervention targeted pregnant and lactating women and their children from birth to seven years of age. In addition to the nutritional intervention, a health education programme and free primary healthcare were provided in all villages.

Since the study, seven follow-up investigations have been carried out, thus offering one of the richest sources of information in relation to the importance of nutrition for growth, development, wellbeing and human capital later in life. Reflecting on the findings over the last fifty years, a special supplement of the Food and Nutrition Bulletin aims to highlight the large body of evidence drawn from this cohort.

Articles in this supplement demonstrate an association between atole being given during the first 1,000 days and reductions in morbidity and improved physical growth in infancy and early childhood, as well as positive longer-term effects on anthropometry, skeletal maturation, physical work and intellectual development. Atole during the first 1,000 days was also associated with improvements in motor development and cognitive function during childhood and adolescence and adult cognitive skills and productivity. One follow up study noted the impact of atole on reducing the risk of diabetes but also on increasing the risk of overweight and obesity. Intergenerational effects were also found with impacts on the birth size, growth, body composition and wellbeing of the next generation.

The INCAP study has been instrumental in generating consensus on the importance of the first 1,000 day window with long-term impacts on human capital. The special supplement summarises the rich body of evidence to enable improved decision making, particularly in Latin America. Work to explore further findings within this cohort continues.  

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