A ‘model’ of stunting

If “stunting” were simply a matter of stature or height, then Carlos Yulo might well be considered a “model” of stunting. At 4’9”, he is certainly short, but there is no shortchanging his feat of being the first Filipino (and Southeast Asian) to win gold in an event in an international gymnastic competition.

There may be many reasons for Yulo’s height — genetics might well figure in his lack of physical stature — but he has become a model for Filipinos for whom stunting has become a common condition.

And it’s not just height. The annual The State of the World’s Children report for this year — prepared by Unicef, the United Nations’ agency for children — laid bare the “triple burden” that poor nutrition imposes on Filipino children. These burdens are: undernutrition, which is caused not just by lack of food but also by unhealthy and irregular diets and resulting in stunting, among other effects; “hidden” hunger, or the lack or absence of micronutrients crucial for healthy development; and, ironically, overweight or obesity.

“The undernutrition facts in the Philippines are disturbing,” asserted Unicef Philippines representative Oyun Dendevnorov at the report’s launch last week. “One in three 12-23-month-old children suffer from anemia while one in three children are irreversibly stunted by age 2.” Stunting, it was pointed out, results not just in lack of height but also in poor mental development and physical ability. On the other hand, said Dendevnorov, “1 in 10 adolescents are obese from wrong eating habits.”

The problem, said Dr. Rene Galera, nutrition specialist with Unicef, “is not just food but also diet.” Many parents, apparently, feel that as long as a child leaves the table feeling sated or “full,” then he or she has been adequately fed. But in reality, said Galera, family meals and snacks are heavy in sugar, salt and fat which can be harmful. “We should place children at the center of food systems,” Galera said, adding that “the right to food and nutrition is a human right.”

There is good news and bad news on the nutrition front, said Dr. Azucena Dayanghirang, executive director of the National Nutrition Council. Based on last year’s Expanded National Nutrition Survey, she said there is “high possibility of meeting the 2022 targets,” with key indicators showing improvements in nutrition levels, including rising breastfeeding levels.

But stunting remains a problem, said Dayanghirang, since addressing it needs to take place within the “first 1,000 days,” which cover a mother’s pregnancy and the first six months of a newborn’s life.

Urgent, indeed, is the need to “build a healthy food environment” for children, according to Dr. Anthony Calibo of the Department of Health. Stunting, once it takes hold, is irreversible, he said, and
it must begin with full and exclusive breastfeeding at least for six months. But again, it is not just feeding, but also, said Julia Rees, deputy Unicef representative, “comfort, care, human contact and interaction and a stimulating environment.”

The country needs at least $1 billion to address malnutrition, said the panelists, but while the cost may be steep, ignoring the problem is far more costly. Based on established international studies, said Rees, the costs tied to malnutrition could reach $4.5 billion or P230 billion, broken down into health costs such as hospitalization and long-term illnesses, poor educational outcomes, even unproductive workers.

Dayanghirang said that nutritional supplements have already been developed for distribution to impoverished families who cannot afford or are heedless of the need to give children adequate and good-quality meals. But local government units need to get involved, too, including giving orientation or training to parents and community groups. One strategy mentioned was organizing urban poor couples to establish community vegetable gardens or communal poultries, pigpens or goat herds to supplement the meager diets of urban poor families.

Food manufacturers and marketers also need to join the bandwagon, empowering consumers with the right choices of food that are also health-giving and free from harmful ingredients, giving children the promise and possibility of healthy lives.

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