LabDiet, Your World of Nutritional Answers
J. Nutr. First published December 9, 2009; doi:10.3945/jn.109.112300
 Journal of Nutrition, doi:10.3945/jn.109.112300
Vol. 140, No. 2, 348-354, February 2010
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© 2010 American Society for Nutrition

Community and International Nutrition

Weight Gain in the First Two Years of Life Is an Important Predictor of Schooling Outcomes in Pooled Analyses from Five Birth Cohorts from Low- and Middle-Income Countries1,2

Reynaldo Martorell3,*, Bernardo L. Horta4, Linda S. Adair5, Aryeh D. Stein3, Linda Richter6, Caroline H. D. Fall7, Santosh K. Bhargava8, S. K. Dey Biswas9, Lorna Perez10, Fernando C. Barros4, Cesar G. Victora4 Consortium on Health Orientated Research in Transitional Societies Group11

3 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322; 4 Universidade Federal de Pelotas, Pelotas 96090-790, Brazil; 5 Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27516-2524; 6 Birth to Twenty Research Programme, University of the Witwatersrand and the Human Sciences Research Council, Durban 4014, South Africa; 7 MRC Epidemiology Resource Centre, University of Southampton, Southampton S016 6YD, UK; 8 S.L. Jain Hospital, Delhi 464551, India; 9 Indian Council of Medical Research, New Delhi 138648, India; 10 Office of Population Studies Foundation, University of San Carlos, Cebu 6000, Philippines

Schooling predicts better reproductive outcomes, better long-term health, and increased lifetime earnings. We used data from 5 cohorts (Brazil, Guatemala, India, the Philippines, and South Africa) to explore the relative importance of birthweight and postnatal weight gain for schooling in pooled analyses (n = 7945) that used appropriate statistical methods [conditional weight (CW) gain measures that are uncorrelated with prior weights] and controlled for confounding. One SD increase in birthweight, ~0.5 kg, was associated with 0.21 y more schooling and 8% decreased risk of grade failure. One SD increase in CW gain between 0 and 2 y, ~0.7 kg, was associated with higher estimates, 0.43 y more schooling, and 12% decreased risk of failure. One SD increase of CW gain between 2 and 4 y, ~0.9 kg, was associated with only 0.07 y more schooling but not with failure. Also, in children born in the lowest tertile of birthweight, 1 SD increase of CW between 0 and 2 y was associated with 0.52 y more schooling compared with 0.30 y in those in the upper tertile. Relationships with age at school entry were inconsistent. In conclusion, weight gain during the first 2 y of life had the strongest associations with schooling followed by birthweight; weight gain between 2 and 4 y had little relationship to schooling. Catch-up growth in smaller babies benefited schooling. Nutrition interventions aimed at women and children under 2 y are among the key strategies for achieving the millennium development goal of universal primary education by 2015.

* To whom correspondence should be addressed. E-mail: rmart77{at}emory.edu.

Manuscript received 28 July 2009. Initial review completed 15 September 2009. Revision accepted 7 November 2009.

Published online 9 December 2009.