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82   Evidence Links Poor Diet
     To Forever-Stunted Minds
     The Washington Post   Saturday, January 27, 1968

     "New evidence suggesting a relationship between malnutrition and
mental retardation should be cause  for major policy concern in a 
number of world capitals.  The recognition that malnourished children 
may emerge from childhood lacking the ability to reach their full 
genetic intellectual potential introduces a new and perhaps frightening
note into theories of national development." The quotation introduces an
article on "Malnutrition and National Development" which appeared 
recently in Foreign Affairs magazine.  It was written by Alan D. Berg
of the U.S. Agency for International Development.  He is stationed in
New Delhi.
      
     The geopolitical impact of this facet of nutritional science
comes from the vicious cycle of malnutrition, mental retardation,
indolence and unemployability--a vicious cycle that afflicts depressed
peoples throughout the world, be they have-not nations or have-not
ghettos.

     It has been known for a long time that stunted growth due to 
malnutrition in childhood is beyond the reach of an adequate diet in
later life.  A number of population studies in Latin America, reviewed
in pediatrics magazine by Dr. Joaquin Cravioto of Mexico City, 
indicate that the same might be true of mental development.

     In reviewing his own and other investigators' observations, Dr. 
Cravioto attributes I.Q. score deficits of 18 to 22 points to 
nutritional deprivations.  These deficits could sometimes be remedied--
if the undernourishment was not too long standing and the child not too
old when brought under care.

     There are of course great difficulties in seeking rigorous proofs
of such effects in man.  First, we do not ordinarily condone experiments
in human malnutrition, least of all those that might irreversibly
damage children.  Second, malnutrition is usually associated 
with social disruption, poverty, superstition, illiteracy, crowding
and poor sanitation.  Underfed children are likely to be neglected in
many other ways, exposed to infectious disease and parasites and 
weakened so as to be more vulnerable to them.

     It is hardly possible from these, or any other easily imaginable
observations, to isolate malnutrition as the crucial factor for the
psychological disabilities of the children.

     There is, however, plenty of indirect evidence that the 
pre-school years are a critical period for brain development, and animal
studies corroborate the view that nutritional imbalance can impair the
development of cellular structures in the growing brain.  The evidence
for a crucial impact of good early nutrition on intellectual 
development is at least as strong as it is for the importance of early 
intellectual stimulation and emotional rapport.

     The political question is the priority that should be afforded to
investment in nutrition--particularly child nutrition--compared to the
capitalization of agricultural, light and heavy industry and education.
Fortunately the technical costs of improving child nutrition
are relatively low, but it remains extraordinarily difficult to teach
good dietary habits to an unschooled population. 

     The question is not confined to Latin America, Africa and India.
Many physicians believe that the most important benefits of the Head
Start program in the U.S. urban slums is its incidental exposure of
the children to higher standards of health care and nutrition.

     It is hard to convey how little we really know about the most
important scientific questions in this field.  Even if "malnutrition"
is accepted as a proven source of mental lag, we still have no 
evidence of specificity. Just which amino acids are crucial, and in what
circumstances?

     There is some theoretical reason to believe that a specific 
imbalance in one amino acid is more damaging than a general lack of
nutrient.  General malnutrition may give rise to an over-all 
depression of growth, but lack of a specific amino acid may produce an 
unbalanced growth with some tissues maturing  out of phase with others
and result in a more distorted pattern.  (We have been doing just   
such experiments recently in the laboratory with bacteria.)  Cells
deprived of the amino tryptophane die rapidly, but only if the remaining
diet is adequate; if the over-all is less adequate, oddly enough,
these same cells simply go into suspended animation.

     Above all, we really do not know how to define the best diet.  It
is, after all, quite possible that a pattern of child nutrition that
has been designed to the criterion of fastest physical growth is 
irrelevant to the maturation of the brain.  Both foreign and domestic
policy are in urgent need of much more penetrating research on these
homely topics.

     Nevertheless, we surely do know enough to say that children must
be fed if they are to grow up.  Very little of our foreign policy
follows such simple logic, judging from the contradictions in
Congress's appropriations for technical assistance versus military
action  as our vehicles of support for the aspirations of the people
of Southeast Asia.

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