STARHEALTH, SUNDAY 26 MAY 2019
Nature vs nurture
By TAN SHIOW CHIN
starhealth@thestar.com.my
HUMANS are the dominant spe-
cies on Earth because of our supe-
rior intelligence, compared to the
other living beings on this planet.
Our intelligence evolved, not so
much due to the size of our brain,
but because of the ratio of our
brain’s weight to the weight of our
body.
Of all creatures, humans have
the largest brain to body weight
ratio, meaning that we have rela-
tively heavy brains for our body
size.
In addition, the cerebral cortex
in humans is the largest, relative to
body weight, among all the mam-
mals, which are the only living
beings to have a cerebral cortex.
This area is crucial to our intelli-
gence as part of the cerebrum,
which is responsible for our think-
ing, judgement, memory and com-
munication skills, among others.
According to consultant paedia-
tric neurologist Prof Dr Wong Chee
Piau, there are three major stages
in the development of a normal
brain.
“When we talk about brain
development, we look at three
major events.
“First, obviously, you have to
form the brain, which is called
neurogenesis.
“Once you have formed the
brain, then you have to connect the
brain, which is called synaptogene-
sis.
“Then the third thing is to speed
up the processing, which is called
myelination,” he explains.
Forming our brain
For such an essential organ, our
brain actually reaches its full deve-
lopment when we are about 25
years of age.
After that, it plateaus, and even-
tually starts to decline as we hit
our senior years.
Says Prof Wong: “In the womb,
neurogenesis, or the formation of
the brain’s structures, occurs as
early as six weeks into the preg-
nancy.
“Very simply put, it starts with a
few neural cells, then it forms a
sheet, then it forms a tube, then it
forms a ball, then the ball eventual-
ly divides into two halves (the left
and right hemispheres), and
towards the end, the two halves
become wavy (with grooves and
bumps) as per the familiar appea-
rance of the brain.
“And all this forms before we are
born.”
Although the brain develops
until young adulthood, the most
active period of development starts
from conception until about two
years of age.
“That is probably the most
intense period (of brain develop-
ment) – some people call it the exu-
berant period,” he adds.
Prof Wong notes that we are
actually born with more brain cells
than what we end up with when
the brain completes its develop-
ment.
“It’s almost like saying when you
build a house, you buy a lot of
bricks; then, when you finish build-
ing the house, there are some
bricks left over and those bricks get
thrown away.”
This is because the next part of
brain development – synaptogene-
sis – is crucial in making the brain
work.
“There are a lot of brain cells.
Some will connect, and those will
remain because they become func-
tional.
“Those that do not connect are
not functional and will disappear,”
he explains.
He adds that the latter process is
known as synaptic pruning, which
The journey to maximising your child’s brainpower starts as
soon as you get pregnant, when nurturing their potential comes
into play.
A computer monitor displays a colourful array of brain connections at a University of Washington research lab
in Seattle, United States. Building these connections is the second stage of our brain development. — TNS
maximum potential.”
For example, as we have the
ability to learn how to walk, we
can eventually learn how to run
fast.
But no matter how fast we can
run, we will never be able to run
beyond a certain speed – say, for
example, faster than the speed of
sound (343 metres per second) – as
it is not within our physical ability
to do so.
Meanwhile, nurture helps to
maximise a person’s potential and
is the part that we can affect for
our children and ourselves.
“The nurture part is obviously
multi-factorial and very complex.
“For example, nutrition definite-
ly plays a big part – if children
don’t eat well, their brains won’t
grow well.
“Putting them into an enriching
environment where they learn the
right things is important (i.e. stimu-
lation).
“And giving them tender loving
care – a caring environment – is
also very important,” says Prof
According to Prof Wong, we are born with a certain amount of natural Wong.
ability and nurturing this ability will help us make the most of it. — He gives the example of a child
KAMARUL ARIFFIN/The Star brought up in an orphanage, who
has the same potential (nature) and
helps improve the brain’s connec- tant function of substantially nutrition as one who lives in a sta-
tions, similar to how pruning a speeding up the transmission of ble, loving home.
bonsai tree improves its growth electrical impulses in our brain.” The first child is less likely to
and appearance. This enables us to think and achieve as much as the second one,
The final part of brain develop- react quickly, and may influence due to a less enriching and loving
ment is to speed up the connec- our learning ability, as it speeds up environment.
tions between our brain cells the processing of information. “Even with maximum potential,
through myelination. there is a lack of nurturing to push
“Myelination is the maturing them to the max, and that is quite
process of the brain connections,”
Nature and nurture important,” he says.
says Prof Wong. Now, the million-ringgit ques- As for us adults, the bad news is
“In our brain cells, we have a tion, of course, is if there is any that our number of brain cells is
cord called an axon, which is like way to make yourself or your child fixed, and will probably decrease
the central metal cable in wiring. more intelligent. as we age due to natural cell death.
“The myelin will form a sheath This is where both nature and However, don’t despair, the key
covering the axon – that is the pro- nurture come into play. to maximising what we do have is
cess of myelination.” Says Prof Wong: “You are born to ensure we continually stimulate
He adds: “While we say that the with a certain amount of ability and use our brains throughout our
covering of wiring is for protection, and I think it’s quite difficult to go lives.
myelin is not only for protection, beyond what you have. As Prof Wong says, “You have to
but it also serves the very impor- “Nature is such that it limits your use it or lose it.”
Child Health 3
Maximising potential
So, what can parents do to
maximise their child’s potential?
It all starts even before concep-
tion.
According to Prof Wong, nutri-
tion is very important for women
who are ready to try for a baby.
Aside from ensuring that you
are eating a balanced diet, he
advises mums-to-be to start taking
folate, also called folic acid, sup-
plements.
Parents are probably aware
that folate is one of the required
supplements – along with iron –
that mothers have to take during
their pregnancy.
This is because folate is known
to help prevent neural tube
defects that can result in condi-
tions like spinal bifida and anen-
cephaly (where a large part of the
brain and skull is absent).
As neural tube defects are most
likely to form during the first few
weeks of pregnancy when most
women might not even know they
are pregnant, it is ideal to start
taking folate supplements as soon
as you are ready to try conceiving.
“The second thing is stress –
maternal stress does affect the
formation of the fetus,” he says.
He notes that extreme physical
stress like running a marathon
already stretches a person’s physi-
cal limits, what more if that per-
son is carrying another person
within her.
“So, I would say moderate phy-
sical activity is welcome, but
extreme physical activity is not.”
As for mental stress. Prof Wong
says that it can result in three
things that may affect the baby’s
development: lack of sleep or
insomnia, hormonal changes and
substance abuse, which is a prob-
lem on its own.
He notes that substances like
alcohol, cannabis and heroin,
when taken by mum during preg-
nancy can also adversely affect
her baby.
“For example, if mum drinks a
lot of alcohol, her baby will end
up with fetal alcohol syndrome.
“This is bad news for the child’s
brain – the child will have a lot of
learning difficulties, a lot of
behavioural problems, etc.”
He also notes that if mum-to-be
is on any medications, particular-
ly long-term ones, she should see
her doctor to ensure that the
medication will not adversely
affect her future baby.
“For example, women with epi-
lepsy who take sodium valproate
might want to see if it is possible
to either reduce their dose, or bet-
ter still, change to another anti-
epileptic drug, as sodium val-
proate affects the baby’s develop-
ment, resulting in fetal valproate
syndrome,” he explains.
For both parents-to-be, advanc-
ing age is also an important issue.
Says Prof Wong: “What happens
is that our body constantly gets
injured and we constantly repair
ourselves.
“Same thing with our genetic
material – it constantly gets
damaged and repaired.
“When we are young, the repair
efficiency is much better.
“As we grow older, we find that
the gene repair is not as good and
it can be faulty, and if you pass
that faulty gene on to your baby,
you might have a problem.”
An example of this is Down syn-
drome, which is associated with
advancing maternal age.
“We know that advanced pater-
nal age is also associated with
subtle problems in the baby – not
as clearly linked as Down syn-
drome is with maternal age, but
we do know that certain syn-
dromes are associated with
advanced paternal age,” says Prof
Wong.