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Pebbles and diamonds

/ 11:11 PM December 19, 2011

“This is a real treasure,” Northwestern University’s Christopher Kuzawa told the Inquirer. The anthropologist meant a research project that tracked 3,327 Filipinas and their 3,080 children in 33 Metro Cebu barangay for over 28 years now.

Fr. Wilhelm Flieger, SVD, of the University of San Carlos and the Nutrition Center’s Florentino Solon launched the Cebu Longitudinal Health and Nutrition Survey (CLHNS) in 1983. USC’s Office of Population Studies thereafter built a data base, ranging from birth weight and vaccinations to IQ tests at age 10 for school dropouts.

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No national project matches that sustained—and still-ongoing—research program. Only South Africa, Brazil, India and Guatemala have bragging rights to similar programs. The  span makes intergenerational analysis possible.

Since then, this research lode anchored scores of programs, from Unicef’s breastfeeding projects to childhood malnutrition in Zimbabwe and Tanzania. Russian demographers used CLHNS data to assess married women’s resource position. The Asian Development Bank used the data in funding early childhood projects.

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Protein energy malnutrition sends more pre-school children to premature graves in the Philippines than in Bangladesh, India or Pakistan, the World and Asian Development Bank said in their joint report, “Early Childhood Development.”

Lack of micro-nutrients sap intelligence quotients. IQs of ill-fed kids can be whittled down by 10 to 14 percent, an ADB study says.

This loss is irreversible. “Their elevators will never go to the top floor,” Viewpoint noted. “That’s layman lingo for permanently impaired lives.”

Using CLHNS data, Harvard University researchers estimated that the economic returns from health, safeguarded by vaccinations, ranged from 13 percent to 18 percent. The Harvard  study backstopped the $13-billion Global Alliance for Vaccines and Immunization. The group seeks to inoculate children in 75 poorest countries, against a range of childhood diseases. “The dispassionate economic case for vaccination looks as strong as the compassionate medical one,” noted The Economist.

Almost three decades of CLHNS studies make it possible to ask in 2011 questions that span generations, Kuzawa told a USC forum. What policies are needed so that the next generation of adults can tamp down the rising incidence of high blood pressure as well as risk for diabetes and heart disease? Birth and growth records of 3,080 survey kids may provide answers.

To determine links between low birth weight and vital C-reactive protein, Northwestern University’s biological anthropologist Thomas McDade studied 1,461 CLHNS babies now grown up.

Increased susceptibility to diabetes and heart disease in adult years, as in Scotland, stems from CRP concentration. In Bangladesh, effects emerge even in children as young as 5. The same pattern emerges in Cebu, McDade found.

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Scientists assumed the potential for catch-up growth after age 2 in stunted babies was limited. “From Cebu, we’ve learned there is a large potential in catch-up growth in pre-adolescent years,” wrote North Carolina University’s Linda Adair.

Cebu data also “reinforce evidence that exclusive breastfeeding up to six months of age benefits infants,” Office of Population Studies  deputy director Judith Borja told a Singapore conference. Complementary foods should not be introduced earlier than six months. Continued breastfeeding until the first two years of life is beneficial.

UP Population Institute’s Josefina Cabigon  crafted with Father Flieger infant and child mortality tables. She analyzed Cebu data and concluded: “Other countries have undergone dramatic rises in survival and economic (growth). The Philippines faltered and there was a plateau in infant and child mortality levels.”

CLHNS revealed diarrhea and respiratory illnesses during infancy lowered scores in math and English in the first two years in school. Children stunted by malnutrition at age 2 often ended up with a lower number of years of schooling. For females, it whittled down the “likelihood of completing high school and college.”

Those who had high height-for-age scores as children tended to have higher labor productivity, an analysis of 1,888 CLHNS adults entering the labor force found. “What happens early in life has an effect on later life.”

“The first two years of life are a window of opportunity when nutrition programs have an enormous impact on a child’s development with life-long benefits,” the International Food Policy Research Institute notes. After age 3, economic benefits as adults dwindled to zero.

A massive stroke cut down Father Flieger in 1999. Cebu’s “elite” didn’t notice his passing. In contrast, Harvard University’s professor emeritus Nathan Keyfitz wrote: “He was the student and later the associate of whom I was proudest… Of all my students, he went far beyond his teacher.”

Despite his workload, this priest  “found a parish that lacked a pastor. Twice a week, he got into his little Volkswagen and drove to a village near Chicago’s O’Hare Airport where he ministered to a congregation that saw (the) purposefulness of his work.”

Cebu officials never grasped the significance or value of CLHNS. Officials instead fiddled with vigilante-style summary executions, buying handguns for barangay chieftains, fudging yen loans, etc. Then Mayor Tomas Osmeña saw to it his bodyguard, garlanded by three murder charges, was honored with a Cebu City Charter Day award.

“Not so for Father Flieger or CLHNS,” the Cebu Daily News said. “The blind see no difference between pebbles and diamonds.”

In  2011, they still don’t see.

(Email: [email protected] )

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TAGS: Cebu Longitudinal Health and Nutrition Survey (CLHNS), children, health, Juan L. Mercado, malnutrition, nutrition, opinion, research, Viewpoint
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