DUMB AND DUMBER? Do lost vitamins and minerals translate to lost IQ points?
By Jin Paul S. de Guzman Associate Editor
Nearly a million public-high-school seniors took the National Achievement Test (NAT) administered by the Department of Education (DepEd) last year. Only about 20,000 went beyond the cut-off score of 75 percent. A number of things were blamed--poverty, the deteriorating quality of public and private education, the lure of television and online gaming--but malnutrition was specifically mentioned. The effect of malnutrition on literacy and performance at school so concerned observers, that it prompted Senator Manuel Villar to file Senate Bill 531, or "Hot Meals for Hungry Learners." The proposal aims to provide students with "hot meals," so they wouldn't have to learn on empty stomachs, because an empty stomach, Villar noted, is "a breeding ground for criminality." Once approved, the program aims to initiate the feeding in public elementary schools. The program also provides schools with capital to develop vegetable gardens and to raise poultry. It also aims to revive the practice of distributing "nutribuns," which was done in the 1960s and 1970s. Better or worse? Villar said that malnutrition among schoolchildren has "worsened": of the 3.4 million kids in elementary school, he said, 515,000 are suffering from "poverty-related health problems" and "varying levels of malnutrition." The sixth national nutrition survey (NNS), meanwhile, showed that the nutritional status of primary-school-age children has improved: if in 2001 33 out of every 100 primary-school-age children were underweight, in 2003 it has gone down to 26 out of 100. It may seem a good sign, but the World Bank finds this decline very slow. In a report released last year, the World Bank said that if the 0.6-percent annual decline in malnutrition would continue, the Philippines would not achieve its goal of halving the malnutrition problem by 2015. Being one of the 189 signatories to the United Nations-initiated Millennium Development Goals, the country should be reducing malnutrition rates by 2.7 percent. The slow decline in malnutrition rates affects many parts of the world as well, as demonstrated by a report released by the UN Standing Committee on Nutrition in March last year. Catherine Bertini, committee chair, called this "the scandal of malnutrition." She pointed out that despite the twofold growth of gross domestic product (GDP) worldwide in the last 20 years, the number of underweight children below five years has gone down by only 20 percent.
The link between nutrition and physical and mental development has long been established, in fact it is now taken for granted--bad nutrition, bad health. The lack of certain nutrients has been proved to lead to serious health problems that could arise anytime. From fetal stage to old age, one is never free from the threat of malnutrition-related conditions, whether they be congenital or degenerative. In addition, malnutrition makes one more susceptible to external threats, such as infectious agents. And so if malnutrition affects the body, it affects the mind as well. The Center for Hunger and Poverty based in Brandeis University (Massachusetts) published a statement on the link between nutrition and cognitive development in 1998. Pointing to current scientific evidence, it cited the following facts: o Undernutrition, as well as poverty-related environmental factors, can "permanently retard physical growth, brain development, and cognitive functioning." o The risk of cognitive impairment increases with the length of time a child's nutritional, emotional, and educational needs go unmet. o Iron-deficiency anemia may impair cognitive development. o "Poor children who attend school hungry perform significantly below nonhungry low-income peers on standardized test scores." o Children's growth and cognitive development have a "strong association" with family income. o Improvements made on nutrition and environmental conditions can alter the effects of early malnutrition. o Iron supplementation can enhance learning, attention, and memory. o Supplemental feeding programs may serve as effective interventions to learning difficulties associated with poor nutrition. o The long-term effects of undernutrition "may be reduced or eliminated by a combination of adequate food intake and environmental (home and school) support."
A study published by the American Journal of Psychiatry in November last year showed that aside from being associated with cognitive development, malnutrition may also have a few crucial behavioral effects. The study, spearheaded by Dr. Jianghong Liu of the University of Southern California, showed that malnutrition during the first few years after birth could be associated with antisocial and aggressive behavior through age 17. The nutritional, behavioral, and cognitive development of 1,000 children living in Mauritius were followed up for 14 years. At age three, the children were assessed for the following: deficiencies in vitamin B2, protein, zinc, and iron. They were then divided into two groups, depending on their nutritional scores. In addition, the children's intelligence level, as well as their families' overall living conditions (income, occupation, health status, education, and others), was taken into consideration. And then at ages eight, 11, and 17, the kids were followed up on how they were behaving at home and in school. It emerged that compared with the control group, the malnourished group showed a 41-percent rise in aggressive behavior at age eight, a 10-percent rise in aggression and delinquency at age 11, and a 51-percent rise in violent and antisocial behavior at age 17.
The United Nations Children's Fund (UNICEF) released Vitamin and Mineral Deficiency: A Global Progress Report last year. Carol Bellamy, UNICEF executive director, and Venkatesh Mannar, president of the Ottawa-based Micronutrient Initiative, said that the global problem of vitamin and mineral deficiency "means the impairment of hundreds of millions of growing minds and the lowering of national IQs; wholesale damage to immune systems, and the deaths of more than a million children a year; 250,000 birth defects annually, and the death of approximately 50,000 young women a year during pregnancy and childbirth; and the large-scale loss of national energies, intellects, productivity, and growth." The report points out that at the heart of the problem is diet. The traditional diets, mostly starch-based staples, hardly provide the nutrients necessary to health. The addition of more nutritious items already puts a strain to the resources of families in developing economies; one can just imagine how much more of a strain the requirements of eating right are to the least developed nations, where staving off hunger is more important than meeting one's recommended dietary allowance. The UNICEF recognizes that "improving and diversifying the food eaten by the poor… is the most fundamental approach toward controlling vitamin and mineral deficiency." However, the agency also recognizes that dietary improvement is "not comprehensive." And so the UNICEF is now more actively campaigning for governments and other concerned agencies to strengthen supplementation and food fortification programs. Fortification has worked well for many industrialized nations, the report says, and is way less expensive than other intervention strategies. In the Philippines, the issue of food fortification has been largely criticized for allowing food items considered as "junk" to carry the "Sangkap Pinoy Seal." Given by the Bureau of Food and Drugs, the seal requires that a certain food product provide at least a third of the RDA for certain micronutrients (vitamin A, iron, and iodine). The sixth NNS shows that the 99 percent of Filipino households use fortified food products, although only 16 percent are aware of the "Sangkap Pinoy Seal." This, the survey team explains, is because many of the products with the seal are readily available, and are being largely consumed even before they were given the seal. The survey points out that iron-deficiency anemia, while still a public-health concern, has gone down across populations between 1998 and 2003. Iodine levels have also improved, and based on international standards is "not a public-health problem." However, the NNS is as yet not capable of determining accurately how much of these improvements can be directly attributed to the "Sangkap Pinoy" Program.
Here's more alarming information that should put to rest that twisted logic behind the administration's spin on the results of the latest self-rated poverty surveys; and the vaunted "sense of sacrifice" that makes fewer Filipinos feel hungry simply because more of them are tightening their belts and scrimping on that most important item: food. An estimated 1.2 million Filipino children aged 6 to 12 years old have low intelligence quotient (IQ) level due to iodine deficiency, results of the 2003 National Nutrition Survey (NNS) said. There are 11 million children in that age group. This, even if iodine deficiency among children has declined from 36 percent in 2000 to 11 percent three years later, noted the NNS. The study took urine samples of 4,566 children aged 6-12 all over the country. Secretary Estrella Alabastro of the Department of Science and Technology (DOST) said children from this age group, as well as pregnant and lactating women, are the three most vulnerable groups to iron deficiency. The prevalence rate of iodine deficiency among pregnant women also went down from 28 percent in 2000 to 18 percent in 2003 while the rate for lactating women decreased from 35 percent to 25 percent also in the same period, noted the report. Over 200,000 pregnant and lactating women were covered by the study. Health secretary Manuel Dayrit said the government is targeting a zero-iodine deficiency by 2008 when all food products are expected to have complied with the 1995 ASIN law, or the salt-iodization law. Dayrit said children who lack iodine lose about 10 IQ points because "the brain lacks the nerve connections." Iodine deficiency also causes goiter, hypothyroidism, growth retardation and cretinism. The DOST said children need a daily intake of 120 micrograms of iodine while pregnant and lactating women require 200 micrograms. Dayrit noted while noniodized salt is only cheaper by a peso per kilogram, still many Filipinos buy it to save money. C. Jimenez/TODAY |
