The Institute of Nutrition of Central America and Panama (INCAP) was created 25 years ago as a research and advisory organization in the field of human nutrition to serve the countries of the Central American Isthmus.
Our first efforts in defining the nutritional problems of the population were directed primarily at school-age children. It took us a few years to realize that at that age most of the effects of malnutrition have already taken place and were irreversible. Hence, our studies were reoriented to preschool children from 1 to 4 years of age. Working primarily with overt clinical cases of severe malnutrition, we learned that the critical age was the first two years of life; that inadequate diet interacting with frequent infections was the important mechanism responsible for malnutrition, and that overt clinical cases of severe malnutrition were only the readily visible part of a much greater problem. Although death