UNDER THE MICROSCOPE
Dr. Raymund W. Lo
Childhood nutrition, scholastic performance, world educational rankings, disinformation, poverty, elections, feudalism, national development, and corruption — how are they connected? Let’s try to dissect these and see how they relate to one another in the grand scheme of things.
Childhood nutrition is the starting point. A newborn’s brain is an undeveloped organ. It starts as a blank slate and at the same time has to develop properly to achieve its full potential. But to develop properly, it needs proper nutrition from the second half of pregnancy up to around age two at the very least. Failure to supply the proper nutrients will not allow the brain to form the networks that interconnect the various parts — neurons, white matter, and the nerves and synapses that form communication lines with each other to enable thought processes and decision making. This results in lower IQ scores, slower language and motor development, as well as poorer school performance.
Studies have shown that malnourished (stunted) children perform poorly in tests of attention, working memory, and learning visuospatial ability. In addition, age-related improvement is not seen in tests of attention, visual perception, and verbal comprehension. In other words, even as these stunted children get older, their intellectual ability does not improve.
The nutrients needed for proper brain development include protein and fat; the latter is crucial for proper nerve development, since fat is the main ingredient for nerves (myelin is the sheath that covers nerves as insulation and is made up mainly of fat). In addition, iron needs to be introduced at six months of age to prevent anemia, which reduces the oxygen- carrying capacity of red blood cells to the brain. This, in turn, reduces the cognitive ability in children.
In the Philippines, malnutrition and stunting is a big problem. Every day, 95 children die from malnutrition. The rate of stunting among Filipino children under five years of age was 28.8 percent in 2019. This has not changed much from 30 years ago. The WHO considers the stunting of children in the Philippines of very high public health significance, placing it among the top 10 countries with stunted children globally.
“Undernutrition robs Filipino children of their chance of a bright future.” (‘Undernutrition in the Philippines,’ April 30, 2021). It further states that the country loses US$4.4 billion or 1.5 percent of the country’s GDP annually. The prevalence of stunting approaches 80 percent in the bottom 20 percent socio-economic status (‘Breaking the Curse: Addressing Chronic Malnutrition in the Philippines Using a Health System Lens,’ Valerie Gilbert T. Ulep, December 2021)
Sadly, efforts by the Philippine government have not had a significant impact on the problem. It will fall on non-governmental organizations to help out those in the bottom 20 percent that are most in need of upliftment. These truly are the people in the margins of our society, the so-called “laylayan.”
I will propose that efforts be concentrated on this area by the Angat Buhay Foundation when it launches in July. The project will necessarily be long-term, for the effects will only be felt decades later when these children achieve their full potential in their education and economic potential. What’s even more important is that they be equipped with the proper mental capacity to think critically and not be misled by disinformation easily. Otherwise, efforts at combatting fake news will be for nothing, since they can’t process information properly.
What will it entail? A lot. Maternity clinics need to be set up in the areas to be identified as having the most child stunting. The needs of expectant mothers — primarily anemia and improper nutrition during pregnancy — will have to be addressed. The most crucial step in laying the proper groundwork for mental-capacity building is the provision of proper nutrition for pregnant women, besides attending to their other health issues. This will take care of the pre-natal factor in stunting.
We need doctors to man these clinics as well as the nurses to assist in maternity care. The laboratory workups can be done via simple on-site testing or networking with nearby laboratories that can offer the simple services of bloodwork for anemia and chemistry. Mobile clinics will be most helpful in far-flung areas, since these have no access to health care at all.
The aim is to produce healthy newborn babies with no issues stemming from a problematic pregnancy. This will be a very good start for the program. Is it doable? Yes, but it will take planning and resource allocations.
Next, we look at how we can support these newborn babies with proper nutrition and prevention of communicable diseases.