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Early Nutritional Supplementation and Skeletal Maturation in Guatemalan Adolescents^1,2,

Kate E. Pickett^*, Jere D. Haas^*,3, Scott Murdoch^*, Juan A. Rivera and Reynaldo Martorell

^* Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853 Centro de Investigaciones en Salud Pública, Instituto Nacional de Salud Pública, 62508 Cuernavaca, Morelos, México Department of International Health, The Rollins School of Public Health of Emory University, Atlanta, GA 30322

The effect of early childhood nutritional supplementation on skeletal maturation at adolescence was investigated in 663 rural Guatemalans, aged 11–18 y. Skeletal maturation was assessed by the Tanner-Whitehouse-2 method. The subjects were former participants in the Institute of Nutrition of Central America and Panama longitudinal study of growth and development (1969–77) residing in four villages (two large and two small) in eastern Guatemala. The villages were randomized within pairs to receive either a high energy, high protein supplement (Atole) or a low energy supplement with no protein (Fresco). Skeletal maturity was observed across all villages to be delayed significantly relative to a British reference for boys < 14 y of age, but not for older boys or for girls < 14 y of age. Delays in girls > 14 years could not be determined reliably because many had reached maturity. Girls < 14 years from Atole villages were more advanced in skeletal maturity than similar age girls from Fresco villages but these differences were found only in comparisons of the large villages. The relationship between early nutrition and biological maturation at adolescence may be obscured in this sample by the advanced age at which the subjects were examined in adolescence.

KEY WORDS: • protein-energy malnutrition • skeletal age • adolescence • childhood supplementation • Guatemala

¹ Published as a supplement to The Journal of Nutrition. Guest editors for this supplement publication were Reynaldo Martorell, The Rollins School of Public Health of Emory University, Atlanta, GA and Nevin Scrimshaw, The United Nations University, Boston, MA.

² Supported by NIH grant number RO1-HD22440.

³ To whom correspondence should be addressed: Division of Nutritional Sciences, 211 Savage Hall, Cornell University, Ithaca, NY 14853.