Tuesday, December 22, 2009

Feeding the mind

published 22 December 2009, MST

That mental ability is a joint function of nature and nurture is obvious. A mixture of genetic and non-genetic factors shapes the level of a person’s IQ, define his thinking process and even determine how he behaves and reacts to different events. We really can’t do much about the things we inherit from our parents; we can only wish we take after their better qualities—a strong artistic inclination, for instance, a calm and reasonable demeanor, an analytical mind, even a photographic memory.

But beyond genetics, there is a world of a difference between nourished individuals and malnourished ones. In a paper on nutrition and brain development, Aida Mendoza-Salonga, professor and chairman of the Department of Neurosciences in UP Diliman, says the crucial months for mental nutrition starts from the womb until the first few years of life. This is shown perhaps by the plethora of milk formulas in the market. They flood the supermarket shelves, each claiming to give “the proper nutrients for your baby’s superior development.” Why, at one point, a company was able to equate its brand with producing gifted children. I say that’s genius—not the babies, but the marketing blitz.

Of course there are other factors that affect a child’s mental nourishment in those crucial years: the home environment, exposure to media and other enrichment activities and eventually the school where the parents send the child.

The goal is for the child to realize his full potential. But that’s assuming that all parents have the capability to nourish their child practically from the moment of conception by having the mother have the best pre-natal care, encouraging her to breastfeed her baby, choosing from the many available supplements,buying the best educational toys and sending the child to the best schools.

But we know this is not the case for every Filipino family—not even most Filipino families.

The fact is that children during this stage need key nutrients—iodine, folic acid, iron, zinc, vitamin B6 and vitamin A, deficiency in which “can cause cognitive and behavioral deficits over a lifetime,” Mendoza-Salonga says.

To be more dramatic about the whole thing, think how in a few decades, malnourished children with their could-be-better brains will comprise the generation we have been counting on to get the nation out of this rut. What will happen to the quality of decisions made at the family, community, industrial (or corporate) and government levels?

***

Yvonette Duque, a community doctor, is with the health mission of World Vision Foundation Philippines. Duque has personally seen both sides of the spectrum in her professional practice. She used to work with organizations that charged their patients exorbitant amounts. Then she decided to become a doctor to the barrios, traveling to far-flung barrios in the country and even spending a year in Africa. Now she says the joys of her profession are not found in donning an immaculate white suit and collecting big professional fees.

At a Sulo hotel media forum on the United Nations Convention on the Rights of the Child, Duque delivered a presentation on health issues confronting children. She started her talk by showing two scanned images of brains of two children, both below five years old. This was a study conducted by professor Ascobat Gani of Indonesia, she said. What’s the difference between the two brains?

The left image showed a big black area at the center of the brain. In the right, the black spot was much smaller. According to Duque, the one on the left was the brain of an undernourished child. There was literally nothing much inside the head—a tragedy because an empty brain is permanent. “There is an irreversible loss of opportunity,” Duque said. “This child will end up being a burden to his family and to society.”

The image on the right was the brain of a nourished child—and crucial nourishment should be given nine months before the child is born and 36 months after birth. This child will be quality human resource later on and is more likely to obtain higher income for his contributions.

If only bridging this gap were that easy. Actually, malnutrition is a vicious cycle that begins with having healthy parents. “If the father takes drugs and alcohol, smokes, and is himself malnourished, what kind of genes will he pass on to the child which he sires?” And of course, maternal health is a prime concern. If a mother is herself unhealthy, the quality of her egg cells, the conditions in her body that houses her child in the nine months before it is born, her ability to deliver the baby under normal circumstances, and her capacity to care for it well are all compromised.

And what if the child turns out to be a girl, subject to the same poor conditions growing up? She herself will not be a healthy child and a healthy adolescent, and her pregnancy and motherhood will be attended by the same difficulties that hounded her mother before her.

In the meantime, as these people struggle to meet their basic daily necessities, the attention on education and other means to improve mental health are relegated to the background.

Clearly there has to be intervention. But whose job is it to intervene?

Duque says that her work at the foundation has made her realize that World Vision and other organizations that go to the communities can, at best, only provide complementing services to existing efforts by the government. Even the national government, through the Health Department only plays supporting role.

The real decision makers who do make a difference at the grassroots level are the local government officials, according to Duque. It is they who decide whether a project is worth pursuing—not just starting, only to lose steam later on.

World Vision, for instance, can only adopt communities under its Nutrition Jumpstart program and prescribe the 7-11 intervention method. The method has seven points for pregnant women: adequate diet, iron and folate supplements, tetanus toxoid immunization, malaria prevention, healthy timing and spacing of birth, de-worming and access to maternal health service. It also has 11 points for children 36 months and below: appropriate breastfeeding, essential newborn care, hand washing, appropriate complementary feeding, adequate iron, vitamin A supplementation, oral rehydration therapy, care seeking for fever, full immunization, malaria prevention and de-worming.

Even the national government can only make sure that there are funds available when they need to be tapped.

So how can we make sure that good intentions do not get lost in politics?

Advocacy is key, Duque says. In turn, the people at the community must know the issues that must be tackled head on. To Duque’s mind, children’s nutrition during the crucial 45 months—with its implications on the IQ level, cognitive ability and behavior of the future generation—should be a priority, and a long-term one.

Christmas is the season for children and for hope. Would it not be easy if we can take the gift of good nutrition for every Filipino child, put it in a box and wrap it with bright paper? Since we cannot, let’s do the next best thing and not allow these real issues to wax and wane with what goes on in politics. We should demand that candidates, especially local ones, seeking our vote in the coming elections know their priorities and are prepared to see them through.

A blessed Christmas to all.

**

Readers' comments

Adelle,

I read your article, "Feeding the Mind". I think along the same lines, and wrote a book I believe you would enjoy, called NUTRITION AND YOUR CHILD'S SOUL. You may read about it on my website, www.dolevgilmore.com. Should you decide you'd like to order the book, contact me through the form on the website, and I can send you a PayPal invoice in any currency, and I'll pay half of the shipping cost. It would be a great honor to send a book to your country.

All the best,
Dolev Gilmore
(Israel)

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