Lowest, smallest

For years now, we Filipinos’ national ego has been battered, “bugbog-sarado” in Filipino, with all these international surveys showing us to be among the lowest for all kinds of indicators, from the livability of cities (Manila was 136th out of 173 cities surveyed) to the Programme for International Student Assessment (Pisa), 77th out of 81 countries in 2022. Hey, cheer up; we were 78th out of 78 countries in 2018.

Often cited, too, has been the “persistent stunting” in the Philippines, with about a third of our children found to be stunted.

The Filipino word is brutal: “bansot,” in English, the runt, referring to the smallest in a litter of puppies, kittens, or piglets. The stunting has many consequences, including frequent chronic diseases and difficulties with learning in school. I would not be surprised if our poor performance in Pisa is partly linked to the stunting.

The adverse effects of stunting carry into adulthood, with under-height women more at risk for difficulties during childbirth and, for both women and men, continuing vulnerabilities to chronic diseases throughout life.

In 2016, an international study led by Imperial College London was published, literally a “lowest, smallest” study. The study compared height figures over a century (from 1896 to 1996). The Philippines crawled along, with such slow progress improving our heights so that by 1996, our females ranked second to the lowest among 200 countries. Males did only slightly better, ranking 192nd.

The website of the research group, the Non-Communicable Disease Risk Factor Collaboration, has since continued to post granular statistics for the countries, giving average heights of youth by age. To dramatize the gaps, let me just cite figures in 2019 (the latest ones posted) for 19-year-olds in the Philippines and South Korea, the latter because they had the most dramatic improvements in height over the last century.

In 2019, the average height of Filipino 19-year-old girls was about 5 feet, roughly equivalent to the average for 12-year-old South Korean girls. For that same year, the average height of Filipino 19-year-old boys was about 5 feet 5 inches, roughly the average height for 13-year-old South Korean boys.

We Filipinos do know we are “maliit,” small, but almost think it’s normal because we are surrounded by low heights. The Imperial College London-led study was a wake-up call. Since reading its publication, I’ve been more conscious about the heights of my college students, at times amazed at how many of them are barely 5 feet.

I’ve also become more conscious of the class divide, the smaller ones tending to come from rural areas, and from poorer families while the upper-class students range from 5 feet 7 inches and up.

Through the years, I have wondered if there are more complex interactions between genetics, nutrition, and society. I think of former president Gloria Macapagal Arroyo, who wasn’t even 5 feet, despite coming from a very wealthy family. She did get a Ph.D. and became president. (Okay, okay, I can hear you reacting to the point about intelligence and being presidentiable and I’m thinking of the United States right now.)

I’ve also wondered: have we been that incompetent with our food and nutrition programs over the last hundred years—despite our leading the way with agricultural innovations and nutrition interventions—to stay stunted with our stunting?

I was thrilled to read a few days ago that the Department of Science and Technology’s Food and Nutrition Research Institute is starting a new nutrigenomics study that looks into genetics and nutrition. The research will track the development of Eastern Visayas birth cohorts (those born in a particular period) from the womb through the first 1,000 years of life, seeking explanations for Filipino height and build. Gonzales’ research background is impressive, including a project looking into the microbiome or bacterial communities in our gut, which may play a role in the way we metabolize food and, ultimately, our growth and development.

The project is a collaboration with the Dutch Wageningen University and Research and the Univesiteit Gent in Belgium, with Filipino lead researcher Gerard Bryan Gonzales, who is mentoring a Filipino doctoral student Jacus Nacis.

I’m glad the Dutch are involved considering they are among the tallest people on earth, six-footers being very common. But maybe closer to home, we might want to look, too, at the South Korean experience, the gains especially dramatic with the girls.

Of interest too for Filipinos: might there be a link between the gains in South Koreans’ heights and their “hallyu,” the wave of impressive gains in their creative industries?

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mtan@inquirer.com.ph