Investigation of the nutrition problems of Central America and Panama

From its earliest years, INCAP gave a high priority to a multidisciplinary effort to learn as much as possible about the dietary habits, nutritional status, and their consequences in the populations of Central America and Panama. Most of the papers in this Special Issue contain some of this information. The first studies were in schoolchildren but were soon extended to preschool children, pregnant and lactating women, and other adults. This paper describes the principal findings of the initial dietary, biochemical, and clinical community-based studies. From 1965-67, very extensive studies were carried out in all six countries including dietary, biochemical, clinical, and anthological studies were carried out in all six countries, the results of which are summarized.

Nutrition, poverty alleviation, and development in Central America and Panama

This paper reviews research with policy relevance for food and nutrition in Central America and similar areas. The research was conducted by the Institute of Nutrition of Central America and Panama (INCAP) during the last three decades of the past millennium (1970-99). Six policy areas were selected for this review: agricultural commercialization and rural development; wage and price policies; human resource development; social safety nets, particularly complementary food programs; multi-sectoral nutrition planning; and food and nutrition monitoring for policy formulation. The contents and major conclusions of the work are described, as well as their public policy implications.

Reflections on the legacy of INCAP

The second Director of the Institute of Nutrition of Central America and Panama (INCAP) reminisces about the productive program of valuable and practical research at the highest level developed with local personnel in a small and poor developing region. The same was true for the world-class advanced training program that contributed many hundreds of professionals, not only to the region, but to all of Latin America and to other countries. The major contributions of INCAP in its first 25 years are cited along with reasons for its success.

INCAP Studies of Kwashiorkor and Marasmus

This article summarizes thirty years of intensive clinical metabolic and therapeutic studies of the consequences of severe protein deficiency relative to calories, which results in kwashiorkor, and of a balanced deficiency of protein and calories that results in marasmus. Evidence is provided that these are two different metabolic diseases, but kwashiorkor is usually superimposed on some degree of chronic marasmus and hence most cases studied were marasmic kwashiorkor. The value of the creatinine/height index to indicate the degree of lean body cell mass with any disease is demonstrated.

Diet and Chronic Diseases: INCAP Studies of Atherosclerosis and Coronary Heart Disease

This paper describes early INCAP studies showing that cholesterol and lipoprotein levels were much lower in the low-income populations of Central America than values that were just beginning to emerge from industrialized countries. These led to the collection of aortas and coronary vessels from 14,610 males and 7,906 females from serial autopsies from 12 public general hospitals in developing countries, mostly in Latin America and in New Orleans and Oslo. The severity of atherosclerotic lesions in the samples was evaluated independently by four pathologists after the samples were randomized, who determined that the severity of atherosclerosis progressed so slowly in the developing country samples that it rarely became clinically significant. The strongest correlation with the severity of lesions was the fat content of the diet.