How to stunt a child with data

The World Health Organization believes there is a standard model human being and sets global standards for their body and health. Illustration by C Y Gopinath using AI

We all have defining numbers. Your height, weight, age, remaining vaccine shots and number of teeth, for instance. Your numbers are either normal or abnormal. If the latter, they can either be fixed or not.

If you didn't take your first steps between nine and 18 months, you can't fix that. If your BMI is 32, though, you could bring it down to 22. The question bedeviling me is: who decided which numbers are normal and which ones are not?

Let's talk about human lifespans. The global life expectancy is about 73 years, and the maximum human lifespan can range between 115 and 123. Jeanne Calment of France, dying in 1997 at age 122, is the longest-lived human. The world's oldest man is listed as Japanese Jiroemon Kimura, who died in 2013 at age 116.

But there is a bewilderingly long list of oldest men and women. On Novem-ber 16 last year, the Guinness Book of Records solemnly announced that "the world's oldest man" - John Tinniswood - born the year the Titanic sank, had died in a care home - at age 112. But some people say one Henry Jenkins lived to 169 years. It's a controversy. The title is currently held by Brazilian Joáo Marinho Neto, alive at 112. Though the previous titleholder lived 114 years.

When asked, all of them attribute their long lives to eating small quantities of food and living an active life.

Let's talk about Bombai. Click the QR code above to join my WhatsApp group to share your Bombai stories for my book - and perhaps answer some of my Bombai questions.

Who decides the numbers that rule our lives? Turns out it's WHO. The World Health Organization believes there is a standard model human being and sets global standards for their body and health. Once these ‘scientific' benchmarks are defined and accepted, they influence global funding priorities; insurance risk calculations of heart disease, life expectancy and other disorders; social policies; and sweeping claims about human health.

Any significant deviation from WHO's norms would be labelled defective, requiring special attention. If a child hasn't reached a certain weight or height by age five, the WHO will start using words like malnourished, wasted and stunted. The Global Nutrition Report, following WHO's tables, reported that 45.4 million children under 5 are ‘wasted'. The WHO says nearly one in six African children is underweight.

Some will nod their heads and think Sounds about right. That's why they call it Africa.

Based on WHO's charts, the Dassanach children of Kenya were declared to be malnourished by charity workers. But Herman Pontzer, an evolutionary biologist from Duke University, saw active, happy kids playing like kids everywhere though they were slim and lanky, as many East African pastoral tribes tend to be. "They didn't seem low on energy, particularly short or ‘stunted'," he said.

Pontzer found that at age two, Dassanach children grow taller at rates you don't see anywhere else in the world, though they gain weight slowly. By five, they're taller than chubby, well-fed European and American children but with a weight that WHO didn't like. They concluded they were malnourished, probably because of a dietary deficiency. But to Pontzer, their metrics were a sign that they had adapted uniquely, like most human communities.

Eskimos are rounder, usually overweight and shorter compared to, say, Masais, and live happily with cholesterol levels that would alarm most cardiologists. Based on WHO global standards, nearly a quarter of children in the Asia-Pacific are stunted. About 17 per cent of humans - about a billion, are zinc deficient.

How does the WHO decide these metrics that define the standard model human? Turns out, unsurprisingly, that their earliest tables were based on white, Caucasian populations. One of the earliest WHO global paediatric health standards was based on data from a single American community in Yellow Springs, Ohio.

To rectify this, new standards were released in 2006 using data from dis-persed locations like Norway, Oman, Brazil, India, Ghana and California. Because the study left out Pacific Islanders, Indigenous Americans, and East and Southeast Asians, now seven per cent of Japanese children are labelled as ‘stunted', compared to one per cent in the Netherlands. Both are rich countries with excellent nutrition and health care.

The Body Mass Index (BMI) used to define obesity mistakenly classifies stocky Pacific Islanders as fat and misses obesity in leaner South Asians. More than half of Indian children are classified by WHO as malnourished.

My mind wanders. I look at WHO's numbers on ‘normal' blood pressure, blood sugar, and even diet, and wonder who influences them. Why is 120/80 normal, and who is it normal for, and at what age? How do the Yanomami people of the Amazon eat inordinate amounts of salt without experiencing hypertension or heart disease, while Numidian nomads never eat salt without any health issues?

WHO claims that 90 per cent of India, where we live in direct, scorching sunlight most of the year, are Vitamin D deficient, based on research gathered from Europeans and Americans.

Which brings me back to humankind's great zinc deficiency, mentioned earlier. The next time someone talks about the planet's billion zinc-deficient people, remind yourself that WHO's data for asserting this was collected by the International Zinc Nutrition Consultative Group between 1976 and 1980, nearly half a century ago.

All the study participants were Americans.

You can reach C Y Gopinath at cygopi@gmail.com
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