2018 Expanded National Nutrition Survey-ILOILO CITY

ii
2018 Expanded National Nutrition Survey

Monograph Series
The Food, Health and Nutrition

Situation of Iloilo City
iii
ISSN 2782-8964
ISBN 978-971-8769-69-0
This report provides data and information on the health and nutritional status of Iloilo City as a
result of the different assessments undertaken during the conduct of the Expanded National
Nutrition Survey by the Department of Science and Technology-Food and Nutrition Research
Institute (DOST-FNRI). This monograph series will be published every five years, in the next cycle
of the Expanded National Nutrition Survey.
Additional information about the survey could be obtained from the DOST-FNRI website https://
www.fnri.dost.gov.ph/ or at the DOST-FNRI Office located at the DOST Compound, Gen. Santos
Avenue, Bicutan, Taguig City, Metro Manila, Philippines 1631.
Tel. Numbers.: (632) 8837-20-71 local 2282/ 2296; (632) 8839-1846; (632) 8839-1839
Telefax: (632) 8837-2934; 8839-1843
Website: www.fnri.dost.gov.ph
Recommended Citation:
Department of Science and Technology - Food and Nutrition Research Institute (DOST-FNRI).
2020. 2018 Expanded National Nutrition Survey Monograph Series: The food, health and nutrition
situation of Iloilo City. FNRI Bldg., DOST Compound, Gen. Santos Avenue, Bicutan, Taguig City,
Metro Manila, Philippines.
The 2018 Expanded National Nutrition Survey Monograph Series is published by the Department of
Science and Technology-Food and Nutrition Research Institute (DOST-FNRI).
Table of Contents
Foreword i
The Project Team ii
Acknowledgments iii
List of Tables iv
List of Figures vii
Executive Summary 1
ENNS Results at a Glance 4
Introduction 17
Background and Rationale of the Expanded National Nutrition Survey (ENNS) 17
Objectives of the ENNS 18
Significance and Uses of ENNS 19
Methodology 20
Sampling Design 20
Data Collection, Processing, and Analysis 21
Ethics Review 30
Study Site 31
Profile of Iloilo City 31
Household and Individual Response Rates 32
Socio-demographic Profile of Households and Respondents 32
Food Security Status 34
Key Findings by Life Stage 36
Infants and Preschool Children (0 to 59 months old) 36
School-age Children (5 to 10 years old) 41
Adolescents (10 to 19 years old) 45
Women of Reproductive Age (15 to 49 years old) 50
Adults (20 to 59 years old) 54
Elderly (60 years old and above) 62
Conclusion and Recommendations 66
References 67
Annex 1. List of ENNS Booklets and Forms 69
Annex 2. ENNS Survey Team 71
Annex 3. Data Management Team 72
Annex 4. Biochemical Survey Team 73
vi
Foreword
Since its birth in 1947, the Department of Science and Technology - Food and Nutrition
Research Institute (DOST-FNRI) has consistently strived to fight malnutrition through accurate
data, correct information, and innovative technologies. Food and nutrition research is pertinent to
the needs of stakeholders like the policy makers, development program officers, program
implementers, local executives, government and non-government stakeholders, and other users
who are into program planning and development.
Over the years, the NNS has evolved from a focused assessment of the Filipino‟s
nutritional status to expanding its purpose and use to include tracking progress towards the
country‟s commitment to “end malnutrition in all its forms” as stipulated in the Sustainable
Development Goals (SDGs) and the Scaling-Up Nutrition (SUN) Movement. Since 1978 to 2013,
the survey was conducted every 5 years, however due to the importance of having empirical data,
policy makers and other users of the data deemed necessary to conduct the survey every year to
provide local- and national-level data. To scientifically do this, the DOST-FNRI has
resorted to a rolling survey or the Expanded National Nutrition Survey (ENNS) for three
years starting in 2018 until 2021 (not including 2020) to cover all the 81 provinces,
33 highly urbanized cities (HUCs) and three other special areas. Detailed description on the
coverage of the ENNS is presented in the methodology of this report.
This monograph presents the results of the 2018 ENNS reported by life stages of the
seven components: Anthropometry, Biochemical, Clinical and Health,
Socio-economic, Food Security, Infant and Young Child Feeding (IYCF) Practices, and Maternal
Health and Nutrition. The results of the food consumption survey at the household and individual
levels will be provided in another report.
This book is developed by the Nutritional Assessment and Monitoring Division of the
DOST-FNRI for use by our Local Chief Executives and development planners. We affirm that the
use of correct and accurate food and nutrition information is necessary towards ending all forms of
malnutrition. May this book generate fresh ideas and perspectives that shall be translated into
doable actions for the betterment of the quality of life of Filipinos.
MARIO V. CAPANZANA, Ph.D.

Director
i
The Project Team
THE EXPANDED NATIONAL NUTRITION SURVEY 2018 MANAGEMENT TEAM
Mario V. Capanzana, Ph.D.

Project Director
Imelda Angeles-Agdeppa, Ph.D.

Project Leader
SURVEY OPERATIONS DATA MANAGEMENT
Marina B. Vargas, Ph.D. † Charmaine A. Duante, MSc Epid (PH)

Head, Nutritional Assessment Team Head, Nutrition Statistics and
and Dietary Component Informatics Team
COMPONENT LEADERS
Ma. Lilibeth P. Dasco, MSAN, MDM Glen Melvin P. Gironella

Anthropometry Senior Statistician
and SES Component
Michael E. Serafico, MSc
Biochemical Component Ma. Lynell V. Maniego
Senior Statistician
Chona F. Patalen, MPH
Clinical and Health Component Mae Ann S.A. Javier
Programmer
Cristina G. Malabad, MSPH and Developer of e-DCS
Food Security Component
Eldridge B. Ferrer, MSAES
Mildred O. Guirindola, MPS-FNP Statistician
Maternal Health and Nutrition
and IYCF Components Apple Joy D. Ducay
Statistician
Eva A. Goyena, Ph.D.
Maternal Health and Nutrition Cheder D. Sumangue
and IYCF Components Statistician
Josie P. Desnacido, MSAN

Dietary Component
Charina A. Javier, MDE

Government Programs
Participation Component
FINAL REPORT WRITERS

Ma. Lilibeth P. Dasco, Apple Joy D. Ducay, and Charmaine A. Duante
EDITORS
Mario V. Capanzana, Ph.D.
Imelda Angeles-Agdeppa, Ph.D.
ii
Acknowledgments
Grateful acknowledgment and appreciation are due to the following:
The Department of Health (DOH), Disease Prevention and Control Bureau for the funding support
in the implementation of the ENNS;
The Philippine Statistics Authority (PSA) Board for approving the adoption of the ENNS survey
design and the PSA for approving the tools and questionnaires of the ENNS through the
Statistical Survey Review and Clearance System, and for providing the list of sample housing
units and sample households;
The Section of Cardiology, Department of Medicine of the Philippine General Hospital (PGH),
Philippine Heart Association (PHA) Baguio-Benguet Chapter, Western Visayas Medical
Center, Southern Philippines Medical Center, and Zamboanga City Health Office for sharing
their expertise during the Blood Pressure Certification Training;
The Department of Interior and Local Government (DILG), Local Government Units (LGUs), the
Governors, Mayors, Barangay Captains, and their constituents for providing direct assistance
in the field survey operations;
The National Nutrition Council of the Department of Health (NNC-DOH), through its Regional
Nutrition Program Coordinators (RNPCs) and Provincial/City and Municipal Nutrition Action
Officers (PNAOs/CNAOs and MNAOs), for sharing their untiring guidance and incessant
support during field data collection;
The Department of Science and Technology Regional Directors (RDs) and Provincial Science and
Technology Directors (PSTDs) for their support, especially during field data collection, training,
and pre-survey coordination in the regions, provinces and cities;
The Centers for Health Development (CHDs) - Department of Health (DOH) through its Regional
Directors, Chiefs of Hospitals, and the Provincial/City and Municipal Health Officers (PHOs/
CHOs and MHOs) for their assistance during training and field data collection;
Dr. Cecilia Cristina S. Acuin, former Chief SRS of the Nutritional Assessment and Monitoring
Division, DOST-FNRI, for the initial development of the new survey design, conduct of
stakeholders‟ consultations and pilot survey implementation;
Dr. Arturo Y. Pacificador, Jr., as statistics consultant, for the technical guidance in sampling design;
Ms. Mae Ann S.A. Javier, Mr. Chester G. Francisco, Mr. Efren P. Nacion, and Ms. Chona F.
Patalen for the layout and formatting of this monograph;
Ms. Mariele G. Siladan, for preparing the draft of this monograph;
Ms. Karla Denice A. Inso, for assisting in the review and revision of this monograph;
The FNRI Finance and Administrative Division (FAD) for their invaluable assistance in the financial
aspect of the survey;
All 45,957 households and 159,926 individuals for their indispensable participation and utmost
cooperation in the survey; and
All FNRI technical and non-technical staff, local researchers, local survey aides, and numerous
others who have provided their inputs, involvement, and contribution to the fruition of the 2018
ENNS.
iii
List of Tables
Table No. Title Page
1 WHO Child Growth Standards 2006 for infants and young children 22
(0-60 months) and WHO Growth Reference 2007 for school-age children
and adolescents (61-228 months) by indicators and age groups
2 Cut-off points used in classifying nutritional status of children, 23

0-10 years old (0-120 months), based on WHO CGS (2006) and WHO
Growth Reference (2007)
3 Cut-off points used in determining magnitude and severity of underweight 23

and stunting among children under-five years old (0 to <60 months) as a
public health problem (WHO, 1995)
4 Cut-off points used in determining magnitude and severity of wasting 23

among children under-five years old (0 to <60 months) as a public health
problem (WHO, 1995)
5 Cut-off points in classifying the nutritional status of adults and lactating 24

women,19.0 years and over (≥228 months), based on Body Mass Index
(WHO & NCHS, 1978)
6 Cut-off points in classifying the nutritional status of pregnant women 24

based on weight-for-height (Magbitang, et.al., 1988)
7 Cut-off points used in determining magnitude and severity of underweight 24

(BMI <18.5) among adults, 19.0 years old and over (≥228 months), as
8 Cut-off points for waist circumference and waist-hip ratio, by sex 25

(WHO, 2011b ; DOST-FNRI, 2010)
9 Hemoglobin concentrations below which anemia is likely to be present in 25

populations at sea level (WHO, 1972)
10 Classification of public health significance of anemia in populations on the 25

basis of prevalence estimated from blood levels of hemoglobin
(WHO, 2001)
11 Guidelines used for the interpretation of Serum Vitamin A level 26
(WHO/USAID, 1976; WHO/UNICEF/HKI/IVACG, 1982)
12 Prevalence cut-offs to define vitamin A deficiency in a population and its 26

level of public health significance (WHO, 1996; WHO, 2011a)
13 Epidemiological criteria for assessing iodine nutrition based on median 27

urinary iodine concentrations in school-age children
(WHO/UNICEF/ICCIDD, 2001)
14 Epidemiological criteria for assessing iodine nutrition based on urinary 27

iodine concentrations of pregnant women (WHO/UNICEF/ICCIDD, 2007)
iv
15 Blood pressure classification (NIH: JNC VII, 2004) 28
16 Cut-off points for fasting blood sugar 28
17 Target age or physiologic groups for specific variables 30
18 Household and individual eligibility and response rate in Iloilo City 32
19 Socio-demographic profile of households and household heads in 32

Iloilo City: ENNS, 2018
20 Percentage of households by food security status in Iloilo City: 34

ENNS, 2018
21 Prevalence of underweight, stunting, wasting, and overweight-for-height 38

among children, under-five years (0-59 months), in the Philippines and
22 Prevalence of anemia among preschool children, 6 months to 5 years old 39

(6-71 months), in the Philippine and Iloilo City: ENNS, 2018
23 Prevalence of vitamin A deficiency among preschool children, 39

6 months to 5 years old (6 - 71 months), in the Philippines and Iloilo City:
ENNS, 2018
24 Prevalence of underweight, stunting, wasting, and overweight/obesity 41

among children, 5 to 10 years old, in the Philippines and Iloilo City: ENNS,
2018
25 Prevalence of anemia among school-age children (6 to 12 years old) in 43

the Philippines and Iloilo City: ENNS, 2018
26 Median UIE and percent urinary iodine (UI) level of <50 µg/L among 43
school-age children (6 to 12 years old) in the Philippines and Iloilo City:
ENNS, 2018
27 Prevalence of stunting, wasting, and overweight/obesity among 45

adolescents (>10 to 19 years old) in the Philippines and Iloilo City:
ENNS, 2018
28 Prevalence of anemia among adolescents (13 to 19 years old) in the 46

Philippines and Iloilo City by sex: ENNS, 2018
29 Prevalence of chronic energy deficiency (CED) and overweight/obesity 50

among non-pregnant/non-lactating women of reproductive age
(15 - 49 years old) in the Philippines and Iloilo City: ENNS, 2018
30 Prevalence of anemia among non-pregnant/non-lactating women of 50

reproductive age (15 - 49 years old) in the Philippines and Iloilo City:
ENNS, 2018
v
31 Prevalence of vitamin A deficiency among non-pregnant/non-lactating 51

women of reproductive age (15 - 49 years old) in the Philippines and
non-pregnant/non-lactating women of reproductive age (15 - 49 years old)
in the Philippines and Iloilo City: ENNS, 2018
33 Prevalence of chronic energy deficiency (CED) and overweight/obesity 52

among lactating mothers in the Philippines and Iloilo City: ENNS, 2018
34 Prevalence of anemia among lactating mothers in the Philippines and 52

lactating mothers in the Philippines and Iloilo City: ENNS, 2018
36 Prevalence of chronic energy deficiency (CED), overweight, and obesity 54

among adults, 20 to 59 years old, in the Philippines and Iloilo City:
ENNS, 2018
37 Prevalence of high waist circumference and high waist-hip ratio among 56
adults, 20 to 59 years old, in the Philippines and Iloilo City: ENNS, 2018
38 Prevalence of anemia among adults, 20 to 59 years old, in the Philippines 57

and Iloilo City by sex: ENNS, 2018
39 Prevalence of elevated blood pressure and high fasting blood sugar 58

among adults, 20 to 59 years old, in the Philippines and Iloilo City:
ENNS, 2018
40 Prevalence of chronic energy deficiency (CED), overweight, and obesity 62

among elderly, 60 years old and above, in the Philippines and Iloilo City:
ENNS, 2018
elderly, 60 years old and above, in the Philippines and Iloilo City:
ENNS, 2018
42 Prevalence of anemia among elderly, 60 years old and above, in the 63
Philippines and Iloilo City by sex: ENNS, 2018
43 Prevalence of Vitamin A deficiency among elderly, 60 years old and 63

above, in the Philippines and Iloilo City: ENNS, 2018
elderly, 60 years old and above, in the Philippines and Iloilo City:
ENNS, 2018
45 Prevalence of elevated blood pressure and high fasting blood sugar 64

among elderly, 60 years old and above, in the Philippines and Iloilo City:
ENNS, 2018
vi
List of Figures
Figure No. Title Page
1 Philippine Statistics Authority (PSA) 2013 Master Sample 20
2 Methods of Data Collection 21
3 Political Map of Iloilo City 31
4 Distribution of educational attainment of household head in Iloilo City: 33

ENNS, 2018
5 Distribution of occupation of household head in Iloilo City: ENNS, 2018 34
6 Percentage of households by food insecurity items in Iloilo City: 35

ENNS, 2018
7 Percentage of food insecure households by wealth status, household 35

size, and sex of household head in Iloilo City: ENNS, 2018
8 Proportion of infants, 0-23 months old, by breastfeeding practices in the 36

Philippines and Iloilo City: ENNS, 2018
9 Proportion of infants, 6-23 months old, by complementary feeding 37

practices in the Philippines and Iloilo City: ENNS, 2018
10 Prevalence of underweight, stunting, wasting, and overweight-for-height 38

among children, under-five years (0-59 months), by sex and wealth status
in Iloilo City: ENNS, 2018
11 Prevalence of underweight, stunting, wasting, and overweight/obesity 42

among children, 5 to 10 years old, by sex and wealth status in Iloilo City:
ENNS, 2018
12 Prevalence of stunting, wasting, and overweight/obesity among 46

adolescents (> 10 to 19 years old) by sex and wealth status in Iloilo City:
ENNS, 2018
13 Proportion of current smokers among adolescents (10 to 19 years old) in 47

14 Proportion of current smokers among adolescents (10 to 19 years old) by 47

sex and wealth status in Iloilo City: ENNS, 2018
15 Proportion of current drinkers among adolescents (10 to 19 years old) in 48
16 Proportion of insufficiently physically active adolescents 48

(10 to 19 years old) in the Philippines and Iloilo City: ENNS, 2018
17 Proportion of insufficiently physically active adolescents 48

(10 to 19 years old) by sex and wealth status in Iloilo City: ENNS, 2018
18 Proportion of nutritionally-at-risk pregnant women in the Philippines and 51

vii
Figure No. Title Page
19 Prevalence of chronic energy deficiency (CED) among adults, 55

20 to 59 years old, by age group, sex, and wealth status in Iloilo City:
ENNS, 2018
20 Prevalence of overweight among adults, 20 to 59 years old, by age group, 55

sex, and wealth status in Iloilo City: ENNS, 2018
21 Prevalence of obesity among adults, 20 to 59 years old, by age group, 56

22 Prevalence of high waist circumference among adults, 20 to 59 years old, 56

by age group, sex, and wealth status in Iloilo City: ENNS, 2018
23 Prevalence of high waist-hip ratio among adults, 20 to 59 years old, 57

24 Prevalence of elevated blood pressure among adults, 20 to 59 years old, 58

25 Prevalence of high fasting blood sugar among adults, 20 to 59 years old, 58

26 Proportion of current smokers among adults, 20 to 59 years old, in the 59

27 Proportion of current smokers among adults, 20 to 59 years old, by age 59

group, sex, and wealth status in Iloilo City: ENNS, 2018
28 Proportion of binge drinkers among currently drinking adults, 59

20 to 59 years old, in the past 30 days, in the Philippines and Iloilo City:
ENNS, 2018
29 Proportion of binge drinkers among currently drinking adults, 60

20 to 59 years old, in the past 30 days, by age group, sex, and wealth
status in Iloilo City: ENNS, 2018
30 Proportion of insufficiently physically active adults, 20 to 59 years old, in 60

31 Proportion of insufficiently physically active adults, 20 to 59 years old, by 60

age group, sex and wealth status in Iloilo City: ENNS, 2018

elderly, 60 years old and above, by sex and wealth status in Iloilo City:
ENNS, 2018
33 Proportion of current smokers, current alcohol drinkers and physically 64

inactive elderly, 60 years old and above, in the Philippines and Iloilo City:
ENNS, 2018
viii
Executive Summary
The National Nutrition Survey (NNS) Malnutrition, in all its forms, includes
is the official nationwide survey conducted by undernutrition (wasting, stunting, and
the Department of Science and Technology - underweight), inadequate vitamins or minerals,
Food and Nutrition Research Institute and overweight or obesity resulting to diet-related
(DOST-FNRI) since 1978 as part of its non-communicable diseases. The aim of the
mandate to undertake research on the ENNS is to provide empirical data on the
population‟s nutritional status. A need for the nutritional and health status of Filipinos for
generation of nutrition and health data for planning and development programs, and for
local government units (LGUs) particularly in timely policy decisions at the national and
the provinces and highly urbanized cities provincial/HUCs levels. At the local level, this
(HUCs) prompted the DOST-FNRI to change report could serve as a basis for LGU to do
the design of the NNS to the Expanded problem-based nutrition programs and actions
National Nutrition Survey (ENNS). The ENNS directed on the groups with nutritional problems.
is distinct from the previous NNS as it is a This could be more cost-effective and efficient
rolling survey which extends the period of data because the data are area-based specific.
collection for three years starting from 2018 to
A total of 1,335 households and 4,417
2021 (not including 2020). The Philippines has
individuals participated in Iloilo City as part of the
81 provinces and 33 highly urbanized cities
2018 ENNS. Majority of the households had five
(HUCs). All the provinces and HUCs, and 3
or less members (73.7%). Households were
other areas or a total of 117 areas will be
comprised mostly of adults 20-59 years old
surveyed for ENNS. In order to cover all these
(49.7%) and had almost an equal proportion of
areas, the survey has covered 40 sites each
males and females. Most of the household heads
for the first 2 years (2018 to 2019) and 37
were male (70.7%), had reached at least
sites for the last year (2021). Each year, the
secondary level of education (43.1%) and
DOST-FNRI releases national estimates of
majority were involved in service works (23.6%).
the health and nutritional status of Filipinos as
well as provincial/HUCs estimates in the areas
Food insecurity was high among
covered during the survey period. The city of
households in Iloilo City (52.6%), wherein 29.2%
Iloilo was among the areas covered in 2018.
of households experienced moderate food
insecurity, 13.2% had mild food insecurity, and
For this monograph, seven survey
10.2% experienced severe food insecurity.
components are presented to summarize the
Moreover, food insecurity was higher among
assessment of the health and nutritional status
poor households, those with more than five
of Iloilo City and are reported by life stages:
members, and households that were
Anthropometric Survey, Biochemical Survey,
male-headed.
Clinical and Health Survey, Socio-economic
Survey, Food Security Survey, Infant and
Young Child Feeding (IYCF) Practices, and
Maternal Health and Nutrition.
1
The practice of exclusive Among adolescents, >10 to 19 years

breastfeeding among infants, 0-5 months, was old, prevalence of stunting was of medium
high in the city at 44.2%; however, continued severity at 24.3% and was more common
breastfeeding up to two years was not among adolescents living in poor households
common (20.8%). Complementary feeding (37.1%). Anemia was of “mild” public health
among children, 6-23 months, was markedly concern (11.3%) and was more prevalent
inadequate in energy and nutrients since only among females (13.5%). Current smoking in
6.3% of the children met the minimum this age group was more evident among males
acceptable diet (MAD) based on the quality of (8.8%) than females (1.1%). Meanwhile, the
complementary food eaten the previous day. proportion of current drinkers among
adolescents was at 20.0%. Majority of the
Among infants and preschool children, adolescents (75.9%) were insufficiently
0 to 59 months old, the prevalence of physically active.
underweight (21.6%) and stunting (30.8%)
Among women of reproductive age,
were of public health significance with “high”
15 to 49 years old, overweight and obesity
severity. Meanwhile, wasting prevalence was
were common among non-pregnant/non-
above the acceptable level of <5% based on
lactating women (35.0%) and lactating mothers
WHO cut-offs thus, also a public health
(27.2%). Anemia was of “mild” public health
concern. Anemia at 14.7% was considered a
significance both among non-pregnant/non-
“mild” public health problem while vitamin A
lactating women (12.9%) and lactating mothers
(14.5%) was a moderate public health problem
(16.0%). Vitamin A was not a public health
in the city.
concern exhibiting 1.9% prevalence. Median
Among school-age children, UIE was adequate, however, percentage of
5 to 10 years old, prevalence of underweight non-pregnant/non-lactating women and
(23.2%) and stunting (21.5%) were considered lactating mothers with urinary iodine level less
a public health problem with “high” and than 50µg/L was 12.4% and 16.8%,
“medium” severity, respectively. Wasting respectively. Among the pregnant women,
prevalence was also a public health problem 11.2% were nutritionally at- risk of delivering
since this was above the acceptable level of low birth weight babies.
<5%. Overweight and obesity for this age
Among adults, 20 to 59 years old,
group were at 19.1% and should be addressed
prevalence of chronic energy deficiency (CED)
in early stage to prevent the development of
was 7.6%, and this was notable among the
NCDs later in life. Anemia prevalence was a
younger age group, 20-29 years old (14.3%),
public health problem with “moderate” severity
and among adults from poor households
(24.6%). Iodine status was more than
(9.6%). Overweight prevalence was 29.0%
adequate based on median urinary excretion
while obesity was 11.5%. Android type of
(UIE) (218 µg/L). However, the percentage of
obesity based on high waist circumference and
children with urinary iodine level below 50µg/L
high waist-hip ratio was 16.2% and 35.8%,
in the city was 8.6%.
respectively, and this was more common
among women. Anemia among adults was of
2
“mild” public health significance (10.3%). In summary, there were marked

Prevalence of raised blood pressure level was nutritional and health problems across all age
15.2% and high fasting blood sugar was 7.0%. groups in the city: (1) high household food
Both risk factors increased with age but there insecurity; (2) low variety of foods and poor
were more males with elevated blood complementary feeding practices among
pressure. Current smokers in this age group infants and very young children; (3) high
were 21.3%, and smoking was more common percentage of stunting and underweight among
among males (39.6%) than females (6.6%). 0 to 59 month old children and school-age
The proportion of binge drinkers, among those children; (4) among adolescents, high rates of
who reported currently drinking alcoholic stunting and anemia especially among females,
beverages for the past 30 days, was 44.8% and initiation of smoking and alcohol drinking;
while the proportion of insufficiently physically (5) high overweight and obesity rates among
active adults was 33.6%. non-pregnant/non-lactating women and
lactating mothers; and high rates of anemia
Among the elderly, 60 years old and among female adults, and (6) among adults
above, the prevalence of CED was 11.0% and elderly, high rates of CED, overweight and
while overweight was 23.8%, and obesity was obesity and android type of obesity, particularly
only 8.0%. Among females, high waist females; and high rates of smoking, alcohol
circumference was 32.3% and high waist-hip drinking, and physical inactivity. Moreover, high
ratio was 77.3%. Anemia prevalence of 21.6% rate of iodine deficiency was persistent among
was of “moderate” public health significance the elderly. It is recommended that the
and affecting both sexes in the city. Vitamin A implementation of target-focused development
deficiency was low at 0.8%. Iodine intake programs and policies on health and nutrition
based on median UIE (85 µg/L) was must be accelerated, to address the different
insufficient. Likewise, the prevalence of iodine health and nutrition concerns identified in this
deficiency among elderly was 28.9%. One in survey, in order to contribute to the
three (36.4%) had elevated blood pressure achievement of the Sustainable Development
while the prevalence of high fasting blood Goals by 2030.
sugar was 11.5%. The proportion of current
smokers among the elderly was 10.9% and
current alcohol drinkers was 23.8%. Moreover,
insufficiently physically inactive elderly was
42.1%.
The results of the dietary survey

component (household and individual levels)
will be included in the Philippine Nutrition
Facts and Figures 2018: Food Consumption
Survey.
3
ENNS Results at a Glance
4
5
6
7
8
9
10
11
12
13
14
15
16
Introduction
Background and Rationale of the Expanded National Nutrition Survey
The state of the Philippines‟ health and January 1996), as these serve as vital inputs to
nutrition are important factors in securing national plans and programs.
sustained national development and economic
stability. High rates of malnutrition create a Previous NNS results were generated
cascade of developmental, social and medical at the national and regional levels. However,
problems which places a significant burden on there was a clamor from the local government
national economic growth. It is estimated that units (LGUs), the Congress of the Philippines,
undernutrition alone can reduce Gross and other stakeholders for local-level data to be
Domestic Product (GDP) by 11% (IFPRI, 2016) used for their local development plan. In 2018,
while overnutrition as a risk factor for non- the NNS was redesigned as a rolling survey for
communicable diseases also increases health three consecutive years, as the Expanded
and economic burden in the Philippines. As National Nutrition Survey (ENNS). The ENNS is
such, generation of up-to-date and critical data distinct from the previous NNS as it provides
on key health and nutrition indicators is needed national estimates of the health and nutritional
in the formulation and refinement of policies status of Filipinos as well as local-level
and programs. estimates in the areas covered during the
survey period, thereby enhancing program
The Department of Science and planning and assisting with developing timely
Technology-Food and Nutrition Research policies.
Institute (DOST-FNRI), being the research arm
of the Philippine government in food and The ENNS has eight survey
nutrition is mandated to define and update the components, namely: Anthropometric Survey,
country‟s food and nutrition situation, Biochemical Survey, Clinical and Health
particularly that of children and other Survey, Dietary Survey, Socio-economic
nutritionally vulnerable groups (E.O. 128 Survey, Food Security Survey, Infant and
Section 22, dated January 1987). Fulfilling this Young Child Feeding (IYCF) Practices and
mandate, the DOST-FNRI conducts the Maternal Health and Nutrition.
National Nutrition Surveys (NNS) every five
years and a survey known as the Updating of The anthropometric survey component
the Nutritional Status of Filipino Children and assesses the nutritional status of all population
Other Population Groups (Updating Survey) groups by determining weight-for-age, height-
was implemented starting in 1989 in between for-age, weight-for-height, BMI-for-age, waist
NNS, to provide updates on the nutritional circumference and waist-hip ratio.
status of the population. The conduct of the
NNS and Updating Survey are designated The biochemical survey component
statistical activities of DOST-FNRI that will determines the prevalence of anemia, iodine
generate critical data for decision-making of the deficiency and vitamin A deficiency (VAD).
government and private sector (E.O. 352 dated
17
The clinical and health survey household members, the household‟s housing
component assesses the prevalence of risk materials, ownership of lot, owned household
factors like overweight and obesity, elevated assets, toilet facilities and garbage disposal
blood pressure, high fasting blood glucose, and system used in the construction of wealth index
dyslipidemia. It also includes the evaluation of of households.
certain behavioral risk factors such as smoking
and exposure to second-hand smoking, alcohol The food security survey component
consumption, physical inactivity and unhealthy provides data on household food security
diet. status using the Household Food Insecurity
Access Scale (HFIAS).
The dietary survey component
provides data on the quality, quantity and The IYCF component assesses current
adequacy of diets that help track food infant and young child feeding practices of
consumption trends over time, both at the mothers for their children age 0-23 months old.
household and individual levels. The results of
the dietary survey component will be provided The maternal health and nutrition
in a separate report. survey component describes the nutritional
status of pregnant, lactating, and non-pregnant/
The socio-economic survey component non-lactating women of reproductive age.
determines the economic status of households
such as education and occupation of
Objectives of the ENNS
General Objective:
To provide empirical data on the food, health, and nutritional status in Iloilo City
Specific Objectives:
To describe the socio-demographic characteristics of the households and individuals;
To assess the physical growth and dimensions of children and other population groups
using anthropometric indicators;
To assess the nutrition biomarkers of children and other population groups (e.g.
hemoglobin, serum retinol, and urinary iodine excretion);
To determine food, energy and nutrient intakes and adequacy at the household and
individual levels; and
To determine the following:
 prevalence of NCD risk factors (e.g. physiologic and behavioral risk factors);
 magnitude of household food insecurity;
 feeding practices of infants and young children, 0-23 months; and
 maternal health and nutritional status of mothers with 0-36 month old children,
pregnant women, and lactating mothers.
18
Significance and Uses of ENNS
The outputs of the survey are Republic Act No. 11148 (Kalusugan at
anchored to the goals of the Philippine Nutrisyon ng Mag-Nanay Act), Republic Act No.
Development Plan‟s “AmBisyon Natin 2040” 8976 (Philippine Food Fortification Act),
under the strategies of accelerating human Republic Act No. 10351 (Sin Tax Law) and
capital development and the Philippine Plan Republic Act No. 11037 (Masustansiyang
of Action for Nutrition (PPAN) 2017-2022. It is Pagkain para sa Batang Pilipino Act). With the
also directed at gauging the country‟s information synthesized by the survey, policy
progress towards the achievement of the makers and administrators can be equipped
second and third Sustainable Development with the necessary data and tools needed in
Goals (SDG) and 2025 Global Nutrition initiating positive institutional change relevant to
Targets. nutrition and health. At the local level, the
results of ENNS could serve as a basis for
The NNS serves as the backbone of LGUs to address health and nutrition problems
current and future nutrition legislations and with evidence-based programs and actions
action plans. Some of the prominent directed towards specific groups.
programs that utilized the NNS data are
19
Methodology
Sampling Design
The ENNS utilized the 2013 Master cities (HUCs) and three other areas), which is
Sample (MS) of the Philippine Statistics divided into exhaustive and non-overlapping
Authority as its sampling design. The 2013 MS area segments known as PSUs with about 100
design for household-based surveys is a to 400 households (Figure 1). Sixteen
two-stage cluster sampling design with independent sample replicates are drawn from
barangays/Enumeration Areas (EAs) or group each domain to generate sufficiently precise
of adjacent small barangays/EAs as the estimates at the province or city level. On the
primary sampling units (PSUs), followed by the average, a total of 12 sample housing units/
selection of secondary sampling units households are allotted for each sample PSUs
composed of housing units/households in an HUC while 16 sample housing units/
(PSA, n.d.). The 2013 MS has 117 sampling households are allotted for every PSUs in
domains (81 provinces, 33 highly urbanized provincial domain.
Figure 1. Philippine Statistics Authority (PSA) 2013 Master Sample
20
The number of sampled households similar characteristics into “replicates” and

has increased fourfold through the expansion assigned to the years 2018, 2019 and 2021. A
in numbers of sampling domains and replicates replicate is composed of at least five provinces
in the 2013 MS and requires considerable or HUCs.
resources for the highly specialized data
collection in the ENNS. Since it is not possible An average of 1,536 households were
to complete the survey and yield reliable targeted per sampling domain except for the
national and local-level estimates within a year, biochemical, blood parameters of the clinical
data collection was spread over three years. and health, and dietary survey components.
Replicated sampling was employed in the This is due to the high cost of laboratory
selection of provinces and HUCs in order to
analyses and data collection for the dietary
gain efficiency in the generation of national
component, hence only 50% of the target
level estimates for a given year. This is done
households were covered.
by grouping the provinces and HUCs with
Data Collection, Processing and Analysis

The methods of data collection for the different survey components are presented in Figure 2.
ANTHROPOMETRY
ANTHROPOMETRY
Actual body measurements: weight, height, waist and hip circumferences
BIOCHEMICAL
BIOCHEMICAL AND
AND
CLINICAL AND
CLINICAL
HEALTH AND
HEALTH
Collection Blood pressure

Collectionof
ofblood
bloodand
ad Blood
Blood
urine samples analysis
CLINICAL AND
HEALTH,
CLINICALDIETARY,
AND
HEALTH, DIETARY,
FOOD SECURITY,
FOOD SECURITY,
IYCF, MATERNAL
IYCF, MATERNAL
HEALTH AND
NUTRITION
Food
Food weighing 24-hr
weighing 24-hrFood
FoodRecall
Recall Face-to-face
Face-to-face
interview
Figure
Figure 2. 2. Methods
Methods of of Data
Data Collection
Collection
21
Weight, height or recumbent length Weight and height measurements

(for children less than 2 years old), and waist (recumbent length for children less than two
and hip circumferences were measured by years) of children, 0-5 years old, were
trained nutritionist-dietitians (NDs), nurses and interpreted using the World Health
allied health professionals following standard Organization‟s Child Growth Standard
protocols. (WHO-CGS). The WHO Growth Reference
2007 was used to assess the nutritional status
A double digital window scale with a of children and adolescents from age 5 years
150-200 kilogram capacity was used to and 1 month to 19 years (61 to 228 months).
measure weight of subjects. Assisted weighing The cut-off points in classifying the nutritional
was done for children who were unable to stand status of children and adolescents, 0-19 years
in which the caregiver/adult companion carries old (0-228 months) are shown in Tables 1 and
the child and were subsequently weighed 2.
together. Values are then computed
accordingly by using the weighing scale 2-in-1 Underweight is based on
or tare function key to record the corresponding weight-for-age index and presents both the past
weight of the young child. Measurements were and present nutritional status of the child. While
done twice and recorded to the nearest 0.01 stunting is based on height-for-age index which
kilograms. A third reading was done if the reflects chronic undernutrition or past nutritional
difference between the two values was greater status caused by prolonged inadequate intake,
than 0.3 kilograms. recurrence of illness or improper feeding
practices. Wasting is based on
Standing height of subjects, 2 years old weight-for-height index which is also
and over, were measured using a stadiometer considered a sensitive index of current
while recumbent length of children below two nutritional status. Overweight is an indicator
years of age or those unable to stand was where the weight-for-height of the child,
measured using a medical plastic infant 0-60 months, is at >+2 SD (WHO, 2006).
measuring board (infantometer). Values were BMI-for-age for school-age children and
recorded to the nearest 0.1 cm and a third adolescents, 61-228 months, is at >+1 SD for
reading is done if the difference between the overweight and >+2 SD for obesity (WHO,
two measurements was greater than 0.5 cm. 2007).
Table 1. WHO Child Growth Standards 2006 for infants and young children (0-60 months) and WHO
Growth Reference 2007 for school-age children and adolescents (61-228 months) by
indicators and age groups
Indicators WHO Child Growth Standards 2006 WHO Growth Reference 2007
0-60 months 61-120
Weight-for-age
(0-5.0 y) (5 y & 1 mo. - 10.0 y)
Length/height-for- 0-60 months 61-228 months
age (0-5.0 y) (5 y & 1 mo. - 19.0 y)
Weight-for-length/ 0-60 months
None
height (0-5.0 y)
0-60 months 61-228 months
BMI-for-age
(0-5.0 y) (5 y & 1 mo. - 19.0 y)
22
Table 2. Cut-off points used in classifying nutritional status of children, 0-10 years
(0-120 months), based on the WHO CGS (2006) and WHO Growth Reference
(2007)
Indicator/ Nutritional Status Cut-off Points
Weight-for-Age
Underweight <-2SD
Normal -2SD to +2SD
Above Normal >+2SD
Height-for-Age*
Underheight/Stunting <-2SD
Normal -2SD to +2SD
Above Average/Tall >+2SD
Weight-for-Length/Height**
Thin/Wasting <-2SD
Normal -2SD to +2SD
Overweight >+2SD
NEC ***
* Use also for children 10 years and 1 month to 19.0 y (121-228 months)
** Use only for children 0-5 years (0-60 months)
*** NEC Not Elsewhere Classified – those whose heights are beyond the limits of the weight-for-
height tables
The cut-off points used to determine presented in Tables 3 and 4. These cut-offs are
the magnitude and severity of underweight, also used as basis to determine magnitude and
stunting, and wasting as a public health severity of undernutrition for school-age
problem among children under five years are children and adolescents.
Table 3. Cut-off points used in determining magnitude and severity of underweight

and stunting among children under-five years old (0 to <60 months) as a
Prevalence Category for Prevalence Category for
Magnitude and Severity
Underweight Stunting
Low < 10% < 20%
Medium 10-19% 20-29%
High 20-29% 30-39%
Very High ≥ 30% ≥ 40%
Table 4. Cut-off points used in determining magnitude and severity of wasting

among children under-five years old (0 to <60 months) as a public health
problem (WHO, 1995)
Magnitude and Severity Prevalence Category for Wasting
Acceptable < 5%
Poor 5-9%
Serious 10-14%
Critical ≥ 15%
23
Body Mass Index (BMI) by the WHO for adults (including lactating women) and
was used for the assessment of nutritional pregnant women, respectively.
status among adults and lactating women while The cut-off points in determining the
the Philippine reference criteria developed by magnitude and severity of underweight for
Magbitang, et al in 1988 was used for pregnant adults and lactating women are presented in
women. Tables 5 and 6 show the cut-off points Table 7.
Table 5. Cut-off points in classifying the nutritional status of adults and lactating women,
19.0 years and over (>228 months) based on Body Mass Index (WHO & NCHS, 1978)
Classification Cut-off Points
Chronic Energy Deficiency <18.5
(CED)
Normal 18.5 to 24.99
Overweight 25.0 to 29.99
Obesity ≥ 30.0
Table 6. Cut-off points in classifying the nutritional status of pregnant women based on
weight-for- height (Magbitang, et.al., 1988)

Nutritionally-at-risk < 95th percentile
Not nutritionally-at-risk > 95th percentile
Table 7. Cut-off points used in determining magnitude and severity of underweight (BMI <18.5) among
adults, 19.0 years old and over (≥228 months), as public health problem (WHO, 1995)

Low 5-9%
Medium 10-19%
High 20-39%
Very High ≥ 40%
Waist and hip circumferences of done three times and recorded to the nearest
subjects 20 years old and above 0.1 cm. Another measurement will be done if
(excluding pregnant women) were measured the difference between measurements is
using a non-stretchable tape measure. Waist greater than 0.5 cm. Pregnant women were
and hip circumferences of adults were not included because variations in the physical
measured to determine abdominal obesity. dimension might overestimate obesity and
Waist circumference is a measurement of the adiposity. Waist-hip ratio is a simple method
distance around the smallest part of the for describing the distribution of both
abdomen, located at the midway between the subcutaneous and intra-abdominal adipose
lowest rib and the tip of the hip bone or iliac tissue. It is computed using the waist and hip
crest (Averkamp, 2015). Hip circumference measurements. Cut off points of waist
refers to the distance around the largest area circumference (WC) and waist-hip ratio (WHR)
of the hips, usually the largest part of the are shown in Table 8.
buttocks (CDC, 2007). Measurements were
24
Table 8. Cut-off points for waist circumference and waist-hip ratio, by sex
(WHO, 2011b; DOST-FNRI, 2010)
Waist Circumference Waist-Hip Ratio

Males
< 90 cm Low < 0.9
90-101 cm Normal 0.9 to 0.99
≥102 cm High ≥ 1.0
Females
<80 cm Low < 0.8
80-87 cm Normal 0.8 to 0.84
≥ 88 cm High ≥ 0.85
The biochemical survey component directly pipetted into a cyanmethemoglobin

determines levels of biomarkers such as solution for determination of hemoglobin. A
hemoglobin, serum retinol and urinary iodine portable spectrophotometer was used for
excretion in blood and urine samples. Blood absorbance measurements and the results of
samples were collected by trained registered hemoglobin levels were reported to the survey
medical technologists from preschool children participants. Hemoglobin levels were
(6 months to 5 years old) via the finger prick measured to determine the prevalence and
method using sterile blood lancets. While the magnitude of anemia using the WHO
venipuncture method was used for subjects 60 Guidelines (1972, 2001) presented in Tables 9
months and over using sterile syringes and and 10.
needles. Twenty (20) microliters of blood was
Table 9. Hemoglobin concentrations below which anemia is likely to be present in

populations at sea level (WHO, 1972)
Hemoglobin Concentrations
Age/Sex/Physiological State
(g/dL)
Children 6 months - 6 years old 11.0
Children >6 - 14 years old 12.0
Adult males, ≥ 15 years old 13.0
Adult females, ≥ 15 years old (non-pregnant) 12.0
Adult females (pregnant) 11.0
Table 10. Classification of public health significance of anemia in populations on the

basis of prevalence estimated from blood levels of hemoglobin (WHO, 2001)
Category of public health significance Prevalence of anemia (%)
Low < 4.9

Mild 5.0 – 19.9
Moderate 20.0 – 39.9
Severe ≥ 40.0
25
Serum was separated from the red shipped to the DOST-FNRI. Biochemical
cells within two hours after blood collection and samples are analysed in DOST-FNRI
transferred to a trace element free blue top laboratories with ISO/IEC 17025 accreditation,
tube for the determination of vitamin A by High following international guidelines and quality
Pressure Liquid Chromatography (HPLC) assurance measures.
method (Furr, et al 1992). All blood collections
Serum retinol levels were measured to
were done inside rooms to avoid exposure of
determine the prevalence and magnitude of
the collected specimen to direct sunlight. All
vitamin A deficiency using the WHO Guidelines
biochemical samples are kept frozen in
(1976, 1982, 1996, 2011) presented in Tables
household freezers or ice chests until they are
11 and 12.
Table 11. Guidelines used for the interpretation of Vitamin A Biochemical Data
(WHO/UNICEF/HKI/VACG, 1972)
Serum Retinol
Level
µg/dL µmol/L
Deficient < 10 < 0.35
Low 10 – 19 0.35 – 0.69
Acceptable 20 – 49 0.70 – 1.74
High ≥ 50 ≥ 1.75
Table 12. Prevalence cut-offs to define vitamin A deficiency in a population and its
level of public health significance (WHO, 1996; WHO, 2011a)
Public Health Importance Serum or Plasma

Degree of Severity Retinol Prevalence (%)
Mild 2 – <10
Moderate 10 – <20
Severe ≥ 20
About 15 mL mid-stream urine sample digestion method of Dunn et al (1993) was

was collected from sample household used to determine UIE concentrations.
members: from children, 6-12 years, women of
reproductive age (15-49 years old), pregnant or Tables 13 and 14 show the severity of
lactating women, and the elderly to determine iodine deficiency based on median UIE using
urinary iodine excretion (UIE) level and the the epidemiological criteria set by the WHO/
prevalence of iodine deficiency. The acid UNICEF/ICCIDD (2001, 2007).
26
Table 13. Epidemiological criteria for assessing iodine nutrition based on median urinary
iodine concentrations in school-age children (WHO/UNICEF/ICCIDD, 2001)*
Urinary Iodine
Excretion (UIE) Iodine Intake Iodine Nutrition
(µg/L)
< 20 Insufficient Severe iodine deficiency
20-49 Insufficient Moderate iodine deficiency
50-99 Insufficient Mild iodine deficiency
100-199 Adequate Optimal
Risk of iodine-induced hyperthyroidism
200-299 More than adequate within 5-10 years following introduction of
iodized salt in susceptible groups
Risk of adverse health consequences
≥ 300 Excessive (iodine-induced hyperthyroidism,
autoimmune thyroid disease)
* Applies to adults, but not to pregnant women.
Table 14. Epidemiological criteria for assessing iodine nutrition based on urinary iodine
concentrations of pregnant women (WHO/UNICEF/ICCIDD, 2007)
Median UIE (ug/L) Iodine Intake

< 150 Insufficient
150 – 249 Adequate
250 – 499 Above requirements
≥ 500 Excessive**
** The term “excessive” means in excess of the amount required to prevent and control iodine deficiency.
Blood pressure was measured through and lifestyle advice. The prevalence of
the auscultatory method by trained NDs, elevated blood pressure is reported based on
nurses and allied health professionals among the classification and cut-off points set by the
adults 20 years old and above, using 7th Joint National Committee on detection and
non-mercurial sphygmomanometer and dual treatment of high blood pressure (JNC VII)
stethoscope following standard procedures. (NIH, 2004) presented in Table 15.
Respondents are requested to rest quietly for
five minutes in a seated position upon arrival in Moreover, blood samples were
the assembly area. They are asked about collected using vacutainer tubes with Lithium
eating, drinking any caffeine-containing Heparin for fasting blood sugar (FBS) drawn
beverage, smoking, exercising, or intake of via venipuncture method among adults 20
anti-hypertensive medications within 30 years old and above after 10-12 hour overnight
minutes before measurement. If they fasting. These were stored on ice and later
self-reported any of these activities, centrifuged to separate plasma, which was
measurement will be delayed. The maximum later packed, labeled and frozen until ready for
inflation level is recorded and then three analysis in DOST-FNRI laboratories. In the
readings of systolic and diastolic blood analysis of FBS, enzymatic colorimetric method
pressure are taken, with intervals of one to two was used using Roche COBAS Integra and
minutes. An accompanying questionnaire is Hitachi 912. Values for FBS were interpreted
used to collect information on the history of using the WHO Guidelines (1998) (Table 16).
raised blood pressure, diagnosis, medication
27
Table 15. Blood pressure classification (NIH: JNC VII, 2004)
Systolic Blood Diastolic Blood

Classification Pressure (SBP) Pressure (DBP)
(mmHg) (mmHg)
Normal <120 and <80
Pre-hypertension 120-139 or 80-89
Hypertension Stage 1 140-159 or 90-99
Hypertension Stage 2 ≥ 160 or ≥ 100
Table 16. Cut-off points for fasting blood sugar
Cut-off points (mg/dL)

Classification
WHO and IDFa Philippine CPGb
Normal <110 <100
Impaired Fasting Glucose (IFG) 110-125 100-125
Diabetes ≥126 ≥126
a
International Diabetes Federation
b
Clinical Practice Guidelines
For the dietary survey component, food For the individual food consumption,
weighing, food inventory, and food recall were two non-consecutive days 24-hour food recall
the methods employed in the collection of food was used to estimate the individual‟s food
consumption data among sample households. intake. All members of the sampled households
A digital weighing scale was used to weigh all were interviewed to collect data for the first day
food items prepared and served in the 24-hour food recall. For the second day recall,
households throughout the day, which included only 50% of the randomly selected households
food items eaten from breakfast, lunch, supper, with one day recall were interviewed to have a
and in-between snacks. Food items were two non-consecutive days food recall data. It
weighed before cooking or in their raw form. involved a face-to-face interview where food
Plate wastes, given-out food, and leftover food consumed by an individual for the past 24
were also weighed to obtain the actual weight hours were recalled and recorded starting from
of food consumed. the time the subject woke up until bedtime,
including morning, afternoon and late evening
Aside from the actual weighing of food snacks. Respondents were asked to remember
in the household, a food inventory was also and report exactly all foods and beverages they
conducted. Non-perishable food items that actually consumed during the previous 24-hour
may be used anytime of the day such as period using measuring tools (tablespoon, cup,
coffee, sugar, salt, cooking oil, and other matchbox, ruler and graduated circle sizes).
condiments were weighed at the beginning and
end of the food weighing day. If some All food items consumed, as well as
members of the household ate outside the their description, including cooking method and
home during the food weighing day, a recall of brand names, were recorded. Weights of actual
the foods eaten out was also administered. food consumed based on the two
non-consecutive 24-hour food recalls were
entered to a computer library of the Food
28
Composition Tables to estimate for energy and mildly, moderately, and severely food
nutrient intakes. These estimates are then insecure. The households increase their level
compared against the nutritional requirements of food insecurity when they experience
indicated in the Philippine Dietary Reference adverse conditions more severely or more
Intakes. The results of the food consumption frequently.
survey will be provided in another report.
The maternal health and nutrition
Health interviews regarding behavioral survey collected the nutritional status of
risk factors, such as smoking, excessive women of reproductive age, particularly the
alcohol consumption, and physical inactivity non-pregnant/non-lactating women, pregnant
were also conducted using the WHO STEPS women and lactating mothers.
instruments or the STEPwise approach to NCD
risk factor surveillance version 3.2. By In the infant and young child feeding
definition, current smokers were those who survey, the feeding practice for children aged
smoke during the time of the survey using 0–23 months is reported using 24-hour food
conventional products either on a “daily” basis recall. Breastfeeding indicators include early
(at least one tobacco or nicotine product a day) initiation of breastfeeding which is defined as
or on a regular/occasional basis. Current the proportion of children 0-23 months who
drinkers, on the other hand, are those who were put to breast within an hour after
have consumed any alcoholic beverages delivery, exclusive breastfeeding which is the
during the past 12 months at the time of the proportion of infants 0-5 months who received
survey. Binge drinking refers to excessive only breastmilk based on the 24-hour food
consumption of alcoholic beverages, recall, and continued breastfeeding at 1 year
specifically the intake of four or more or 2 years. Complementary feeding practices
(for females) or five or more (for males) among children, 6-23 months, include the
standard drinks in a row (WHO, 2008) among following indicators: minimum dietary diversity
those who reported drinking alcoholic (MDD) is the consumption of foods from at
beverages in the past 30 days. For physical least 4 food groups during the previous day,
activity among adults, a person not meeting the minimum meal frequency (MMF) reflects the
WHO recommendation of three or more days energy intake from foods other than breastmilk
of vigorous-intensity activity of at least 20 consumed the minimum number of times or
minutes per day or five or more days of more per day, and the minimum acceptable
moderate intensity activity or walking of at least diet (MAD) refers to the proportion of children
30 minutes per day, is considered insufficiently who attained both the MDD and MMF the
physically active. Among adolescents, previous day.
insufficient physical activity means doing less
than 60 minutes of moderate- to The 2018 ENNS Interview Schedules
vigorous-intensity physical activity per day. consisted of eleven booklets categorized by life
stage or by component. The list of booklets and
For the food security survey forms and the actual interview guides used are
component, the Household Food Insecurity compiled in Annex 1.
Access Scale (HFIAS) (Coates et al, 2007)
was adopted in the ENNS to determine the The summary table for the different
prevalence and magnitude of food insecurity variables collected in each specific age or
at the household level. The HFIAS is physiologic group is presented in Table 17.
categorized into four levels: food secure,
29
Table 17. Target age or physiologic groups for specific variables
Physiologic Groups
Women of Reproductive Age
Variables Infant and
Preschool
School-
Adoles- Non-
Young
Children
age
cents Pregnant Pregnant Lactating
Adults Elderly Household
Children Children
and Non- Women Mothers
Lactating
Food Security Status ✔

Food Consumption
(Food Weighing)
✔
Infant and Young Child Feeding Practices
Breastfeeding Practices ✔
Complementary Feeding Practices ✔
Anthropometric Measurements
Underweight ✔ ✔ ✔
Wasting ✔ ✔ ✔ ✔
Stunting ✔ ✔ ✔ ✔
Chronic Energy Deficiency ✔ ✔ ✔ ✔
Nutritionally at-risk ✔
Overweight and Obesity ✔ ✔ ✔ ✔ ✔ ✔ ✔
High Waist Circumference ✔ ✔
High Waist-Hip Ratio ✔ ✔
Micronutrient Status
Anemia ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔
Vitamin A 6-71mos 6-71mos ✔ ✔ ✔ ✔
Iodine Status ✔ ✔ ✔ ✔ ✔
Individual Food Consumption
✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔
(24-Hour Food Recall)
Nutrition-Related and Lifestyle Risk Factors
Elevated Blood Pressure ✔ ✔ ✔ ✔ ✔ ✔
High Fasting Blood Sugar ✔ ✔
Behavioral Risk Factors
Current Smokers ✔ ✔ ✔
Current Drinkers ✔ ✔ ✔
Binge Drinkers ✔
Physical Inactivity ✔ ✔ ✔
Ethics Review
The project proposal for “THE interview and other measurements. Signed
EXPANDED NATIONAL NUTRITION SURVEY Assent Forms were collected from respondents
(ENNS)” was submitted to the FNRI aged 7 to < 15 years old. The Informed
Institutional Ethics Review Committee (FIERC) Consent Form (ICF) contains the explanation
for clearance on July 12, 2017 which was of the background and objectives of the survey,
approved on July 31, 2017 with protocol code the data collection procedures involved, risks
FIERC-2017-017. (any undesirable effect that may result or
invasion of circumstances, e.g., blood
The signed consent forms which were collection, expected duration of the interview
translated into the different local dialects that with respondent) and benefits of participation,
are most commonly spoken in the Philippines confidentiality of information, option to withdraw
were obtained from respondents prior to without penalty or consequences.
30
Study Site
Profile of Iloilo City
Iloilo City is a highly urbanized city In terms of religion, Iloilo City is one of
located at the south-eastern tip of Panay. It the most notable centers of faith due to the
faces the Iloilo Strait and Guimaras Island. It colonization of the Spaniards. There are over
was founded in 1566 by the Spaniards. It is 95% of people in the City that are Roman
considered to be the regional capital of Catholic. Other religious minorities include
Western Visayas and the capital city of the Protestants, Iglesia ni Cristo, and Aglipayans.
province of Iloilo though it is politically
independent from the province Iloilo City is the regional hub for trade,
(City Government of Iloilo, n.d.). commerce, finance, technology, healthcare,
tourism, education, and real estate in Western
There are several rivers traversing Visayas. There are several major industries in
Iloilo City namely, Batiano, Iloilo, Dungon the City which include telecommunications
Creek, and Jaro with tributary rivers named infrastructure and utilities, real estate,
Aganan and Tigum. The total land area of the management of port facilities, banking and
city is 78.34 square kilometers while its finance, retail trading, tourism, and business
coastline area is 21.3 kilometers (Iloilo City process outsourcing.
Government, n.d.) The City is divided into
seven geographical districts. Each district has The City holds many cultural
its own town centers with plaza, Roman institutions which include national institutions,
Catholic Church, fire station, police station, and heritage houses, and mansions which gave
public market. way for the country to be called as the
“Emerging Museum City of the Philippines” and
The City‟s main language is Hiligaynon “City of Mansions.” Museums and art galleries
also referred to as “Ilonggo” which is heavily in the City showcase its rich history and
influenced by the Spanish language. It is culture. Culture of the Ilonggos can also be
spoken in Panay, Guimaras, and Negros shown through their renowned festivals which
Islands. In addition, Karay-a or Kinaray-a and celebrates their rich cultural and historical past.
English are also used in Iloilo City. Some of their festivals include the Dinagyang
festival, Jaro Fiesta (Fiesta
de Jaro), and Paraw
Figure 3. Political Map of Iloilo City1

[1] Iloilo City. n.d. Political Map of Iloilo City [Image]. Retrieved from: https://en.wikipedia.org/wiki/Iloilo_City
31
Household and Individual Response Rates
A household refers to a person living number of households and individuals covered

alone or a group of persons, who may be in the city are presented in Table 18. There
related or not, sleep in the same dwelling unit were 1,441 eligible households in Iloilo City.
and have common arrangements for the Response rate at the household level was high
preparation and consumption of food at 92.6% and at the individual level, this was
(Barcenas, 2004). 78.8% or 4,417 individuals were covered.
Household and individual eligibility

and response rates together with the total
Table 18. Household and individual eligibility and response rate in Iloilo City
Level Eligible Response Response Rate
Household 1,441 1,335 92.6%

Individual 5,602 4,417 78.8%
Socio-demographic Profile of Households and Respondents
Socio-demographic profile of than five members. Most of household heads

households and respondents were gathered were male (70.7%) and were married (60.4%).
using face-to-face interview and actual
observation. Table 19 shows the A little more than half of the household
socio-demographic profile of the households members were females (53.9%) and households
and household heads in Iloilo City. were comprised mostly of adults, 20-59 years
old (49.7%).
In Iloilo City, majority of the
households covered were comprised of five Among the women of reproductive age,
members or less (73.7%) while the remaining there were only 3.0% that were pregnant and
(26.3%) were composed of families with more 7.8% were lactating mothers in Iloilo City.
Table 19. Socio-demographic profile of households and household heads in Iloilo City: ENNS,2018
Variable n %
Household size
5 members and below 981 73.7
More than 5 members 354 26.3
Sex of household members
Male 2,012 46.1
Female 2,405 53.9
Sex of household head
Male 948 70.7
Female 387 29.3
32
Table 19. Socio-demographic profile of households and household heads in Iloilo City:
ENNS,2018
Variable n %
Civil status of household head
Separated 57 4.2
Single 126 9.7
Common Law/ Live-in 109 8.1
Widowed 236 17.6
Married 807 60.4
Respondents by age group
0 - 23 months 132 4.0
24 - 71 months 365 9.6
72 - 120 months 398 8.4
> 10 - 19 years 832 18.8
20 - 59 years 2,119 49.7
60 years and over 571 9.6
Women of reproductive age by physiological status
Pregnant 32 3.0
Lactating 79 7.8
Non-pregnant/ Non-Lactating 1,004 89.2
Most of the household heads (43.1%) based on the Philippine Standard

had at least secondary level of education while Occupational Code (PSA, n.d.). The top four
41.3% had at least college level of education. most common occupations of the household
The remaining 15.3% had at least elementary heads in Iloilo City were service, shop and
level of education and 0.2% had no grade market sales workers (23.6%). followed by
completed (Figure 4). plant and machine operators (22.1%),
laborers and unskilled workers (15.3%), and
Occupation of household heads refers craft and related trades workers (12.9%)
to the present principal employment, business, (Figure 5).
or other means of livelihood and classified
*including Post-Secondary Non-Tertiary and Short-Cycle Tertiary

**including Master and Doctoral Level Education or Equivalent Education
Figure 4. Distribution of educational attainment of household head in Iloilo City: ENNS, 2018
33
Figure 5. Distribution of occupation of household head in Iloilo City: ENNS, 2018
Food Security Status
Food security exists when all people, at insecure wherein the household sometimes or
all times, have physical and economic access often worried about food, and/or was unable
to sufficient, safe and nutritious food that meets to eat preferred foods.
their dietary needs and food preferences for an
active healthy life (FAO 1996). In Iloilo City, Meanwhile, 29.2% of households
47.4% of the households said that they were were classified as moderately food insecure
food secure. This means that majority of the wherein they had a hard time acquiring and
households in the city (52.6%) experienced accessing food, had faced uncertainties about
food insecurity wherein there was limited or their ability to obtain food, and had been
uncertain availability of nutritionally adequate forced to compromise on the quality and/or
and safe foods or limited or uncertain ability to quantity of the food they consume and obtain.
acquire acceptable foods in socially acceptable The percentage of households that
ways (Anderson 1990). experienced moderate food insecurity in Iloilo
City was similar with the national estimate
Among households who were food (28.8%).
insecure, 13.2% were classified as mildly food
Table 20. Percentage of households by food security status in the Philippines and
Philippines Iloilo City

90% CI 90% CI
Variable Percentage Percentage
(%) Lower Upper (%) Lower Upper
Limit Limit Limit Limit
Food Secure 46.1 44.1 48.0 47.4 44.2 50.6

Mildly Food Insecure 12.3 11.7 12.9 13.2 11.2 15.3
Moderately Food Insecure 28.8 27.1 30.5 29.2 26.9 31.5
Severely Food Insecure 12.8 11.2 14.4 10.2 8.4 11.9
* significant at p<0.10
34
Figure 6. Percentage of households by food insecurity items in Iloilo City: ENNS, 2018
One in every 10 households national estimate (12.8%) though not
(10.2%) in the city was classified as severely significant.
food insecure. A severely food insecure

household often cuts back the quantity of foods Furthermore, food insecurity was
and experiences the three most severe higher among poor households or those
conditions (running out of food, going to sleep households in the bottom 30% of the income
hungry and not eating for the whole day). The group (Figure 7). Food insecurity was also
percentage of households that experienced evident among households with more than
severe food insecurity was slightly less than the five members, and affected households
regardless of sex of heads.
Wealth Status Household Size Sex of Household Head

90% LL 49.4 74.6 37.7 47.3 48.4 49.3 46.7
CI UL 55.8 82.2 43.8 53.8 63.5 56.5 56.8
Figure 7. Percentage of food insecure households by wealth status, household size,
and sex of household head in Iloilo City: ENNS, 2018
35
Key Findings by Life Stage
Infants and Preschool Children (0 to 59 months old)
Childhood malnutrition encompasses Infant and Young Children 0-23 months

both undernutrition like micronutrient deficiency,
stunting, underweight and wasting; and The role of optimal infant and young
overnutrition like overweight and obesity. child feeding (IYCF) practices is crucial in
Malnutrition has important health improving child health, growth, and
consequences on growth, learning capacity, development during the first two years of life.
incidence of infectious diseases, and can even It is recommended that newborns should be
last in adult life as manifested by presence of initiated early to breastfeeding within one hour
chronic non-communicable diseases and low after birth, exclusively breastfed from birth up
individual work productivity. From a life cycle to six months, and complementary foods
perspective, the most crucial time to meet the should be introduced starting at 6 months of
nutritional needs is in the first 1,000 days age, while continue breastfeeding up to two
including the period of pregnancy until the years and beyond. The quality and quantity of
child‟s second birthday when nutritional needs complementary foods should be adequate
are high to support rapid growth and emphasizing the importance of variety or
development. diversity, frequency, and acceptability as

measured by the following indicators:
This section of the monograph reports minimum dietary diversity (MDD), minimum
the prevalence of underweight, stunting, meal frequency (MMF), and minimum
wasting, overweight/obesity, anemia and acceptable diet (MAD), which were previously
vitamin A deficiency as indicators of nutritional defined in the methodology section.
status of children under-five years of age.
90% LL 65.2 51.2 45.4 29.3 90% LL 69.8 26.2 17.0 4.1
CI UL 73.1 58.5 55.9 37.0 CI UL 85.8 62.1 64.5 37.6
*significant at p <0.10
Figure 8. Proportion of infants, 0 - 23 months old, by breastfeeding practices in the

36
Promotion of IYCF has been one of the Complementary feeding practices of

key priority programs of the Department of children, meanwhile, revealed that only 19.1%
Health (DOH) and other government agencies met the minimum dietary diversity (MDD) from
including the local government units (LGUs) to the different food groups (Figure 9). A high
address childhood undernutrition. proportion of children (95.9%) met the
minimum meal frequency (MMF) from both
Majority (77.8%) of mothers reported meals and snacks per day. However, a very
initiating breastfeeding their infants within one low proportion (6.3%) of children met the
hour after birth (Figure 9). Meanwhile, 44.2% of minimum acceptable diet (MAD) based on the
infants, 0-5.9 months, were exclusively quality of complementary food eaten the
breastfed. The proportion of children, who were previous day. This revealed that young
continued to breastfeeding at one year, was children, 6-23 months of age, in the city, fell
40.8%. Breastfeeding decreased with age short for the minimum quality and quantity of
wherein only 20.8% or one out of 5 children complementary feeding when combining both
were still being breastfed up two years of age in the diversity (MDD) and frequency (MFF)
the city (Figure 8). indicators.
90% LL 21.1 87.6 12.4 90% LL 11.6 92.7 2.9

CI UL 24.9 90.4 14.4 CI UL 26.5 99.0 9.7
Figure 9. Proportion of infants, 6 - 23 months old, by complementary feeding practices in the
Preschool Children Under-Five
In 2018, results showed that two out of Chronic malnutrition is measured by

10 children (21.6%) below five years were low height-for-age index. Stunting among
underweight or had suffered acute form of children under five years was high at 30.8%,
malnutrition in the city (Table 21). The revealing stunting as a high public health
provincial estimate in Iloilo City showed that concern in the city (Table 21). The stunting
underweight was considered high in terms of prevalence in the city was not significantly
magnitude and severity. It was also significantly different than the national prevalence (30.3%).
Four out of 10 children (41.4%) under-five
higher in poor (30.4%) than non-poor (18.5%)
years from poor households were stunted and
households. No significant difference in the
the prevalence was significantly higher in non-
prevalence was noted between boys (20.9%)
poor (26.1%) households (Figure 10). No
and girls (21.7%) (Figure 10).
37
significant difference in the prevalence was wasting by sex and household wealth status
noted between males (29.8%) and females was noted. This indicates that wasting/
(31.2%). thinness affects all children, under-five years
regardless of sex and wealth status of
Wasting or thinness is measured by households. (Figure 10).
weight-for-height index. It is a sensitive
indicator of current nutritional status as a result Overweight was observed among
of recent insufficient food intake, illness or 7.7% of children under five years of age in the
situations, like calamities. Seven out of 100 city (Table 21). The city estimate was
children (6.5%) under five years were wasted/ significantly higher than the national
thin (Table 21). The prevalence of wasting was prevalence of 4.0%. No significant difference
classified as poor based on the WHO cut-offs in the prevalence of overweight by sex and
and a public health concern (Table 4). No household wealth status was noted
significant difference in the prevalence of (Figure 10).
Table 21. Prevalence of underweight, stunting, wasting, and overweight-for-height among

children under-five years (0-59 months) in the Philippines and Iloilo City:
ENNS, 2018

Variable 90% CI 90% CI
Prevalence Prevalence
Underweight 19.1 17.7 20.5 21.6 18.9 25.1
Stunting 30.3 28.2 32.4 30.8 25.9 35.6
Wasting 5.6 5.2 6.1 6.5 3.6 9.4
Overweight-for-height 4.0 3.6 4.3 7.7* 5.3 10.1
90% LL 18.0 15.9 16.2 23.4 13.9 90% LL 25.9 22.7 24.7 35.2 20.1
CI UL 25.1 25.9 27.3 37.5 23.2 CI UL 35.6 36.9 37.6 47.6 32.1
90% LL 3.6 4.4 1.9 2.8 2.9 90% LL 5.3 4.0 4.2 0.2 6.1
CI UL 9.4 13.4 6.4 10.2 9.7 CI UL 10.1 12.3 10.6 7.8 10.8
Figure 10. Prevalence of underweight, stunting, wasting, and overweight-for-height among
children under-five years (0-59 months), by sex and wealth status in Iloilo City:
ENNS, 2018
38
Anemia is the most common indicator anemic (Table 22). This city estimate was
used to screen for iron deficiency (WHO, slightly higher than the national estimate
2001). In Iloilo City, 14.7% of preschool (14.3%), however, the difference was not
children, 6 months to 5 years of age, were statistically significant.
Table 22. Prevalence of anemia among preschool children, 6 months to 5 years old, (6-71 months) in
Prevalence 90% CI
(%) Lower Limit Upper Limit
Philippines 14.3 12.8 15.9
Iloilo City 14.7 4.1 25.3
Vitamin A deficiency (VAD) is the among preschool children in Iloilo City was
leading cause of preventable blindness in 14.5% (Table 23) and considered a
children and this also increases the risk of “moderate” public health problem based on
disease and death from severe infections. The the WHO cut-offs.
prevalence of VAD (deficient and low levels)
Table 23. Prevalence of vitamin A deficiency among preschool children, 6 months to 5 years old
(6 - 71 months), in the Philippines and Iloilo City: ENNS, 2018
Prevalence 90% CI
Iloilo City 14.5 10.2 20.2
Highlights:
 Malnutrition is pervasive with 30.8% children under-five years stunted, 21.6% underweight,
6.5% wasted, 14.7% anemic, and 14.5% vitamin A deficient in 2018;
 Stunting and underweight prevalence were significantly higher among children from poor than
non-poor households;
 Dietary diversity of children during the complementary feeding period was suboptimal,
despite high undertaking of early breastfeeding initiation (77.8%) and exclusive breastfeeding
(44.2%) during the first 6 months of life. Only 19.1% of children, 6-23 months, met the
minimum dietary diversity while a very low percentage (6.3%) met the minimum acceptable
diet, suggesting that children‟s complementary food have inadequate level of energy and
micronutrients.
39
Call to Action:
To improve the nutritional status of young children under two years of age:
 Strengthen the health and nutrition education of mothers on the following:
a. Importance of newborn screening, immunization, and deworming;
b. Timely initiation of breastfeeding within one-hour after birth;
c. Importance of exclusive breastfeeding during the first six months of life;
d. Timely introduction of age-appropriate, adequate, and safe complementary foods at
six months while breastfeeding continuously until 24-months and beyond; and
e. Feeding a wide variety of nutritious meals for young children.
 Monitor the growth and development of infants and young children paying particular attention
to low birth weight babies and sick children;
 Improve access to age-appropriate nutrient-dense complementary foods particularly among
poor and marginalized households;
 Advocate use of micronutrient powder to enrich complementary foods;
 Advocate regular check-up/visits at health facilities especially for immunization, iron and
Vitamin A supplementation, and deworming for one-year and above;
 Strengthen the establishment of IYCF support groups in the community, and hospitals and
clinics to guide mothers on appropriate infant feeding practices after birth delivery;
 Ensure adequate supply of vaccines, deworming tablets, and iron and Vitamin A supplements
at health centers; and
 Conduct continuous training on IYCF among health professionals (particularly those in the
private sector), community health workers, and mothers of child-bearing age.
To improve the nutritional status of 2-5 years of age:

 Ensure delivery of appropriate child-care and integrated health services especially for children
with moderate to severe acute malnutrition:
a. Regular assessment of nutritional status and enrollment in Community Management
of Acute Malnutrition programs for moderately and severely undernourished
preschoolers;
b. Provide sustained vitamin A and iron supplementation, and deworming;
c. Provide sustained supplementary feeding among undernourished day-care students
for at least 120 days; and
d. Provide safe drinking water, sanitation facilities, and promote good hygiene
practices;
 Improve access to food through community vegetable gardens and homestead projects;
 Promote and demonstrate utilization of diversified foods;
 Promote appropriate dietary practices during illness/sickness;
 Conduct livelihood and skills training for parents to increase their ability to access food for the
household; and
 Strengthen the capacity of local health workers in conducting nutrition education classes for
mothers and provision of health and nutrition services to pre-school children.
40
School-age Children (5 to 10 years old)

School-age children comprise the ages Stunting and underweight prevalence
of 5 to 10 years old or the middle childhood. were observed to be significantly higher
This is the period where growth is significant among children from poor than non-poor
but with a slower rate. Adequate nutrition is households (Figure 11), suggesting that
necessary to ensure growth to full potential, problems on undernutrition were more
and to sustain active physical activity in common among poor households. No
general. Undernutrition at this period have significant difference in the prevalence was
negative consequences particularly on noted between males and females.
cognition and learning capacity and ability to
prevent diseases later in life, as nutritional On the other hand, the prevalence of
problems during middle childhood may carry wasting was 9.8% (Table 24) and considered
into adulthood. This section reports the to be a public health problem. However, no
prevalence of underweight, stunting, wasting, significant difference in the prevalence was

noted by sex and household wealth status,
overweight/obesity, anemia, and iodine
indicating that all children, 5 to 10 years old,
deficiency as indicators of nutritional status of
were vulnerable to wasting (Figure 11).
children, 5 to 10 years old.
Overweight and obesity were

The picture of undernutrition among
problems among school-age children in the
school-age children in the Philippines was high
city at 19.1%, which was significantly higher
based on the global cut-off points for the
compared to the national prevalence of 11.6%
severity of nutrition situation with the
(Table 24). There were more overweight and
prevalence of underweight of 24.9% or about a
obese children among the non-poor (23.1%)
quarter of school-age children, 5 to 10 years
than the poor households (Figure 11).
old. Moreover, the prevalence of stunting was
Overweight and obesity were one of the risk
24.6%. In Iloilo City, the prevalence for both
factors in the development of NCDs later in
underweight and stunting was at 23.2% and
life thus should be addressed at an early age.
21.5%, respectively. This implies that two in
every 10 school-age children were underweight
and/or stunted (Table 24).
Table 24. Prevalence of underweight, stunting, wasting, and overweight/obesity among children,
5 to 10 years old, in the Philippines and Iloilo City: ENNS, 2018

Underweight 24.9 23.1 26.8 23.2 19.7 26.7
Stunting 24.6 22.8 26.5 21.5 17.2 25.9
Wasting 7.6 7.2 7.9 9.8 7.3 12.2
Overweight/Obesity 11.6 10.4 12.9 19.1* 15.3 22.9
41
90% LL 19.7 19.6 18.4 25.3 12.4 90% LL 17.2 16.8 16.1 23.2 11.4
CI UL 26.7 27.1 27.9 38.4 20.4 CI UL 25.9 22.9 30.8 37.7 18.7
90% LL 7.3 7.1 5.7 5.8 6.1 90% LL 15.3 14.5 12.6 8.9 18.9
CI UL 12.2 13.5 15.6 17.2 10.7 CI UL 22.9 24.9 23.3 21.1 27.2
Figure 11. Prevalence of underweight, stunting, wasting, and overweight/obesity among

children, 5 to 10 years old, by sex and wealth status in Iloilo City: ENNS, 2018
Following the age group in the The overall prevalence of anemia

Philippine Dietary Reference Intakes (PDRI), among school-age children in the Philippines
hemoglobin level of school-age children, 6 to 12 in 2018 was 13.5% and in Iloilo City, the
years old, were assessed using the global cut- prevalence was significantly higher at 24.6%
off points in determining anemia status. (Table 25). The anemia prevalence in both
Children, 6 years old whose hemoglobin level national and the city was of "mild” and
were less than 11.0 g/dL and children, 6.1 to 12 “moderate” magnitude, respectively.
years old whose hemoglobin level were less
than 12.0 g/dL were classified as anemic
(WHO, 1972).
42
Table 25. Prevalence of anemia among school-age children (6 to 12 years old) in the
90% CI
Prevalence

Iloilo City 24.6* 18.7 30.5
Determination of median urinary iodine age children in Iloilo City had “adequate”
excretion (UIE) was done to assess the iodine iodine intake based on median UIE of 150 µg/
status of school-age children, 6 to 12 years old. L. However, 8.6% of school-age children had
The iodine status of school-age children in the urinary iodine level <50 µg/L (Table 26).
Philippines in 2018 was at “optimum” iodine
nutrition or “adequate” iodine intake based on
the median UIE of 180 µg/L. Likewise, school-
Table 26. Median UIE and percent urinary iodine (UI) level of <50µg/L among school-age
children (6 to 12 years old) in the Philippines and Iloilo City by sex: ENNS, 2018
90% CI Percent UI 90% CI

Median
Lower Upper level < 50µg/L Lower Upper
(µg/L)
Limit Limit (%) Limit Limit
Philippines 180 177.6 183.2 11.5 10.3 12.7
Iloilo City 218* 199.8 236.4 8.6 5.0 12.1
Highlights:
 Stunting and underweight were a public health problem of medium to high severity;
Wasting among children was poor based on WHO cut-offs and a public health problem;
 Overweight and obesity were significantly higher compared to the national prevalence,
thus needs attention as school-age children will be at-risk to NCDs later in life if not
prevented;
 Anemia was a public health problem with “moderate” severity; and
 Iodine intake was “adequate” based on median UIE, BUT 8.6% had urinary iodine level
<50 µg/L.
43
Call to Action:
 Promote and serve nutritious and safe meals in school canteens and cafeterias;
 Intensify school feeding programs by considering the right amount and types of foods
served to school-age children complemented with micronutrient supplementation
especially for undernourished children;
 Educate school-age children on the importance of eating a wide variety of nutritious
foods and a balanced diet;
 Strengthen mass drug administration of deworming tablets in school by educating both
the parents and children on its benefits to encourage participation;
 Integrate hygiene and sanitation program activities with the administration of deworming
tablets both in schools and communities;
 Improve access to food through homestead projects;
 Encourage physical activities in schools and neighborhoods especially among wealthier
quintiles/ non-poor households; and
 Intensify monitoring of salt iodization at all channels of distribution to avoid excessive
intake and continue to promote use of iodized salt to ensure adequate.
44
Adolescents (10 to 19 years old)
At the onset of adolescence, growth susceptible to non-communicable diseases

spurt speeds up abruptly. It begins on the (NCDs) will also be reported in this section.
average at the age of 10 to 11 years for girls
In Iloilo City, two in every 10
and 12 to 13 years for boys. During the growth
adolescents (24.3%) were stunted or short for
spurt, apparent differences in the skeletal
their age. Stunting was significantly higher
system, lean body mass and fat stores can be
among male adolescents (28.6%) than among
noted. Along these changes, adolescent‟s
female adolescents (19.8%). Also, stunting
energy and nutrient needs are greater than any
was significantly higher among adolescents in
other time of life, except pregnancy and
poor households (37.1%) than non-poor
lactation. The energy needs of adolescents
households (18.7%).
vary greatly, depending on the current rate of
growth, sex, body composition, and physical
The prevalence of wasting or thinness
activity. This section reports the prevalence of
among adolescents was 14.2%. It was
stunting, wasting, overweight/obesity, and
significantly higher among males (19.8%) than
anemia as indicators of nutritional status of
females (8.8%). There was no significant
adolescents 10 to 19 years old. As it is not only
difference in the prevalence of wasting among
the amount of food intake that affects the
adolescents between poor and non-poor
nutrition and health status of a person, but
households. Table 27 presents the overall
behavior and environment also play a crucial
nutritional status of adolescents in the
role, select risk factors such as smoking,
Philippines and Iloilo City.
alcohol drinking or the harmful use of alcohol
and physical inactivity that make an individual
Table 27. Prevalence of stunting, wasting, and overweight/obesity among adolescents

(> 10 to 19 years old) in the Philippines and Iloilo City: ENNS, 2018

90% CI 90% CI
Variable Prevalence Prevalence
Lower Upper Lower Upper
(%) (%)
Stunting 26.3 24.7 28.0 24.3 21.4 27.2
Wasting 11.3 10.5 12.1 14.2 11.8 16.7
Overweight/Obesity 11.6 10.7 12.5 15.4* 13.0 17.9
Overweight and obesity among adoles- overweight and obesity between adolescent
cents is an emerging nutrition concern in the males and females. It was more observed
Philippines. It increased by 2.4 percentage among adolescents belonging to non-poor
points from the last survey conducted by DOST households (20.3%) than poor households
-FNRI in 2015. In Iloilo City, the prevalence of (6.7%). Figure 12 shows the disaggregation of
overweight and obesity was 15.4%. There was stunting, wasting, and overweight and obesity
no significant difference in the prevalence of by sex and wealth status.
45
90% LL 21.4 24.4 16.4 30.7 15.7 90% LL 11.8 15.9 5.9 12.7 9.3
CI UL 27.2 32.8 23.2 43.5 21.8 CI UL 16.7 23.6 11.7 26.1 15.8
90% LL 13.0 13.3 11.1 2.9 16.9

CI UL 17.9 19.1 18.7 10.5 23.6
Figure 12. Prevalence of stunting, wasting, and overweight/obesity among adolescents

(> 10 to 19 years old) by sex and wealth status in Iloilo City: ENNS, 2018
Anemia is also a common nutritional and considered a “mild” public health problem.
problem among adolescents. Due to abrupt It was more common among females (13.5%)
growth spurt during adolescence, both teenage than in males (8.2%), though not significant.
boys and girls need additional iron. The
prevalence of anemia in Iloilo City was 11.3%
Table 28. Prevalence of anemia among adolescents (>13 to 19 years old) in the Philippines and
Iloilo City by sex: ENNS, 2018
Variable 90% CI
Prevalence (%)
Lower Limit Upper Limit
Male 8.2 3.9 16.4
Female 13.5 8.0 21.7
46
Adolescents who smoke cigarettes, were currently smoking, similar to national

and other tobacco and nicotine products are at- prevalence of 4.0% (Figure 13).
risk for developing respiratory illnesses, cancer,
heart diseases and other diseases. Though its There were more current adolescent
effect is beyond the scope of nutrition, smoking smokers among males (8.8%) than females
eases the feeling of hunger and affects food and mostly observed among the poor
intake. Moreover, Executive Order 26 s. 2017 households (6.5%). Figure 14 shows the
prohibits minors to smoke (even lighting up), proportion of current smokers among
sell or buy cigarettes and other tobacco adolescents (10 to 19 years old) by sex and
products. In Iloilo City, 4.9% of the adolescents wealth status.
90% LL 3.7 3.6

CI UL 4.4 6.2
*proportion of current smokers aged 10 to 17.9 years old was 2.2%
Figure 13. Proportion of current smokers among adolescents (10 to 19 years old) in the
90% LL 3.6 6.4 0.3 4.1 2.1

CI UL 6.2 11.3 2.0 8.8 5.1
Figure 14. Proportion of current smokers among adolescents (10 to 19 years old) by sex and
wealth status in Iloilo City : ENNS, 2018
*proportion of current smokers aged 10 to 17.9 years old: male - 4.8%; female - 0.2%
47
Another modifiable behavioral risk years old, 14.0% were current drinkers
factor that affects the nutritional status of (Figure 15).
adolescents is alcohol consumption. Alcohol
Physical inactivity among adolescents
provides energy but no nutrients, it alters
was also determined during the survey.
nutrient absorption and metabolism. In Iloilo
Majority of adolescents or three in every four
City, 20.0% of the adolescents were current
adolescents (75.9%) in Iloilo City were
drinkers, and among younger teens, 10-17.9
insufficiently physically active (Figure 16).
90% LL 15.2 18.2 90% LL 74.8 72.4

CI UL 18.4 21.8 CI UL 77.7 79.3
Figure 15. Proportion of current drinkers among Figure 16. Proportion of insufficiently physically
adolescents (10 to 19 years old) in the active adolescents (10 to 19 years old)
Philippines and Iloilo City: ENNS, 2018 in the Philippines and Iloilo City:
ENNS, 2018
*proportion of current alcohol drinkers aged 10 to 17.9 years
old: 14.0%
Furthermore, proportion of adolescents adolescents belonging to the poor and non-

who were insufficiently physically active was poor households was also not significantly
higher among females at 78.9% than male different (Figure 17).
adolescents at 73.2% though not significant.
Likewise, proportion of physically inactive
90% LL 72.4 68.3 74.5 68.6 73.2

CI UL 79.3 78.0 83.2 81.4 80.2
Figure 17. Proportion of insufficiently physically active adolescents (10 to 19 years old) by sex
and wealth status in Iloilo City: ENNS, 2018
48
Highlights:
 Stunting and wasting among adolescents were serious problems in the city;
 Overweight and obesity was significantly higher than the national prevalence and
prevalent among non-poor households;
 Anemia was of “mild” public health concern;
 One out of five adolescents was a current alcohol drinker; and
 Three out of four adolescents were insufficiently physically active.
Call to Action:
 Provide micronutrient supplementation among females particularly iron and folic acid;
 Strengthen school nutrition programs such as gardening, supplementary feeding, and
nutrition education;
 Intensify school gardening programs that uses environmental approach to produce
various micronutrient-rich vegetables which can be used for school feeding;
 Encourage social events and skill-building activities that prepare the youth for adulthood
while minimizing exposure to risky behaviors;
 Promote healthy lifestyle habits such as smoking cessation and healthy eating through
nutrition education; and
 Revitalize and strengthen sports programs and physical fitness tests in schools and
communities to address the problem of physical inactivity among this age group.
49
Women of Reproductive Age (15 to 49 years old)
The World Health Organization defines Body Mass Index (BMI) was used to
women of reproductive age (WRA) as all determine the nutritional status of non-
women aged 15-49 years (WHO, 2006). pregnant/ non-lactating women and lactating
Optimum nutrition of a woman before, during mothers.
and after pregnancy is very important as it has
an implication on the health and nutritional Non-pregnant/non-lactating Women
status of infants and young children.
In Iloilo City, the prevalence of chronic
In the ENNS, WRA was disaggregated energy deficiency (CED) among this group
into three groups, the non-pregnant/non- was 9.1%, and it was considered as low in
terms of magnitude and severity. In contrast,
lactating women, pregnant women and lactating
the prevalence of overweight and obesity
mothers. The nutritional status, hemoglobin
(35.0%) was almost four times the prevalence
levels, vitamin A status, and urinary iodine
of CED. Therefore, overnutrition was a more
excretion levels were determined in these
common problem than undernutrition among
groups.
this group (Table 29).
Table 29. Prevalence of chronic energy deficiency (CED) and overweight/obesity among
non-pregnant/ non-lactating women of reproductive age (15 – 49 years old) in the

CED 7.8 7.3 8.3 9.1 7.8 10.5
Overweight/Obesity 35.3 33.7 36.9 35.0 32.3 37.7
One in every 10 non-pregnant/non- prevalence of 11.6%. Anemia in this group

lactating women (12.9%) in Iloilo City had was considered of “mild” public health
anemia. The prevalence of anemia was not significance (Table 30).
significantly different with the national
Table 30. Prevalence of anemia among non-pregnant/ non-lactating women of reproductive age
(15 - 49 years old) in the Philippines and Iloilo City: ENNS, 2018
90% CI
Prevalence (%)
Iloilo City 12.9 10.4 15.5
Vitamin A is also important for fetal during their reproductive years is crucial to
growth and development during pregnancy. prevent depletion of body stores and meet the
Sufficient vitamin A intake among women basic physiologic needs in preparation for
50
conception. The prevalence of VAD among was not a public health problem based on the
non-pregnant/non-lactating women in Iloilo WHO cut-offs.
City was very low at 1.9% (Table 31) and
Table 31. Prevalence of vitamin A deficiency among non-pregnant/ non-lactating women of

reproductive age (15 - 49 years old) in the Philippines and Iloilo City : ENNS, 2018
90% CI
Prevalence (%)
Based on median UIE, the iodine However, 12.4% had urinary iodine level
status among non-pregnant/non-lactating <50 µg/L (Table 32).
women in Iloilo City was adequate at 169 µg/L.
Table 32. Median UIE and percent urinary iodine (UI) level of <50µg/L among
non-pregnant/non-lactating women of reproductive age (15 - 49 years old) in the
90% CI 90% CI
Median Percent UI level
(µg/L) Lower Upper < 50µg/L (%) Lower
Upper Limit
Limit Limit Limit
Philippines 170 167.9 172.1 11.3 10.7 12.0
Iloilo City 169 156.1 182.1 12.4 9.5 15.4
Pregnant Women
The nutritional status of a pregnant was used in determining the nutritional status
woman is an important determinant of of pregnant women.
pregnancy outcomes. Those who are

nutritionally at-risk during pregnancy are at Based on Magbitang cut-off, one in
greater risk of delivering low birth weight infants ten (11.2%) of the pregnant women in Iloilo
City was nutritionally-at-risk of delivering low
and developing other pregnancy complications
birth weight babies (Figure 18).
such as pre-eclampsia and maternal mortality.
A weight-for-height table by week of pregnancy
90% LL 17.5 0.0

CI UL 22.8 22.4
Figure 18. Proportion of nutritionally-at-risk pregnant women in the Philippines and Iloilo City:
ENNS, 2018
51
Lactating Mothers
The CED prevalence among lactating almost thrice (27.2%) the rate of those with
mothers in the city was 10.7% and considered CED. Three in every 10 lactating mothers were
of “medium” public health significance in terms overweight/obese. Therefore, overnutrition
of magnitude and severity. On the other hand, among lactating mothers was more common
overweight and obesity prevalence was than undernutrition in Iloilo City (Table 33).
Table 33. Prevalence of chronic energy deficiency (CED) and overweight/obesity among lactating
mothers in the Philippines and Iloilo City: ENNS, 2018

(%) (%)
CED 11.0 9.5 12.5 10.7 4.0 17.4
Overweight/
28.5 26.1 30.9 27.2 17.9 36.4
Obesity
Anemia prevalence among lactating However, the prevalence in the city was not
mothers in Iloilo City was 16.0% and was significantly different with the national prevalence
considered of mild public health significance. of 14.4% (Table 34).
Table 34. Prevalence of anemia among lactating mothers in the Philippines and Iloilo City:
ENNS, 2018
90% CI
Prevalence (%)
Based on the median UIE, the iodine was adequate at 144µg/L, but 16.8% had urinary
status among lactating mothers in Iloilo City iodine level <50 µg/L (Table 35).
Table 35. Median UIE and percent urinary iodine (UI) level of < 50µg/L among lactating mothers in

Disaggregation/ Median level
Variable Lower Upper Lower Upper
(µg/L)
Limit Limit <50µg/L (%) Limit Limit
Philippines 103 98.5 106.5 21.2 19.7 22.8
Iloilo City 144 96.4 192.4 16.8 3.8 29.9
52
Highlights:
 Overweight and obesity were common problems among non-pregnant/ non-lactating

women and lactating mothers;
 One in every ten pregnant women was nutritionally-at-risk of delivering low birth weight
babies;
 Anemia was of “mild” public health significance among women of reproductive age; and
 Median UIE was adequate for non-pregnant/ non-lactating women and lactating moth-
ers.
Call to Action:
 Intensify nutrition education classes focusing on the first 1000 days which cover the
nutritional needs of both the pregnant mother and fetus, and those of the lactating
mother and her breastfed child;
 Conduct counseling on child spacing for pregnant and lactating mothers and their part-
ners, particularly among young couples;
 Strengthen health and nutrition services (prenatal and post natal) at health centers for
pregnant mothers to prevent pregnancy-related complications and low birth weight ba-
bies;
 Promote the use of Pinggang Pinoy as a guide for healthy eating habits;
 Promote the importance of physical activity in preventing NCDs;
 Involve community leaders and other influential people in addressing the need for in-
creased nutritional demands during pregnancy and lactation, and the need for more
rest and a decreased workload for pregnant and breastfeeding mothers; and
 Strengthen the implementation of ASIN Law from the national to the local level as well
as promotion and advocacy on the use of iodized salt to ensure adequate intake.
53
Adults (20 to 59 years old)

Chronic energy deficiency (CED) is a
Health and nutritional status of Filipino
multi-factorial nutritional problem defined as a
adults show that the triple burden of
steady-state condition in which the food intake
malnutrition – undernutrition, micronutrient
of an individual is inadequate for longer
deficiencies, and overweight and obesity – has
periods of time and may result to an increased
continuously risen and is becoming an
risk for illnesses and other health problems.
emerging threat in this age group. Moreover,
The prevalence of CED in Iloilo City was at
NCDs are the leading causes of death globally
7.6% and not significantly different with the
and in the Philippines. These NCDs pose major
national prevalence (6.9%). Moreover, the city
challenges for sustainable development
prevalence was considered of low public
causing premature deaths and an increased
health significance.
burden on low- and middle-income countries
such as the Philippines. This section reports the
Meanwhile, the prevalence of
prevalence of CED, overweight and obesity,
overweight and obesity among adults in Iloilo
and anemia as indicators of nutritional status of
City was 29.0% and 11.5%, respectively
adults (20 to 59 years old). Selected risk factors
(Table 36). This indicates that four in every 10
to NCDs such as smoking, alcohol drinking and
adults in the city had high BMI (>25 kg/m2)
binge drinking or the harmful use of alcohol,
and may have higher risk of developing
and physical inactivity are also reported in this
additional health problems (Table 36).
section to present the severity of risks that
predispose an individual to lifestyle-related
diseases.
Table 36. Prevalence of chronic energy deficiency (CED), overweight, and obesity among
adults, 20 to 59 years old, in the Philippines and Iloilo City: ENNS, 2018
(%) (%)
CED 6.9 6.6 7.1 7.6 6.4 8.7
Overweight 28.8 28.4 29.2 29.0 27.6 30.5
Obesity 9.6 9.3 9.9 11.5* 10.1 12.8
Disaggregating by age, sex and wealth Overweight increased with age. It was
status, the prevalence of CED was observed to not significantly different between female
be more prevalent among young adults, 20-29 (29.7%) and male adults (28.3%). The non-
years old, but was not significantly different poor households (30.3%) were most
among male (7.8%) and female adults (7.4%). vulnerable to overweight problem and may
However, it was more common among those increase risk of developing additional health
living in poor households (9.6%) (Figure 19). problems (Figure 20).
54
90% LL 6.4 12.1 3.6 2.1 3.2 90% LL 6.1 6.0 90% LL 7.9 5.4
CI UL 8.7 16.6 7.2 6.2 6.3 CI UL 9.5 8.8 CI UL 11.4 8.2
Figure 19. Prevalence of chronic energy deficiency among adults, 20 to 59 years old, by age
group, sex and wealth status in Iloilo City: ENNS, 2018
90% LL 27.6 18.7 26.5 28.8 31.9 90% LL 26.3 27.8 90% LL 22.4 28.4
CI UL 30.5 24.6 33.7 36.4 37.1 CI UL 30.3 31.7 CI UL 28.9 32.2
Figure 20. Prevalence of overweight among adults, 20 to 59 years old, by age group, sex, and
wealth status in Iloilo City: ENNS, 2018
On the other hand, the prevalence of excessive built up of abdominal fat around the
obesity peaked among adults, 40-49 years old. stomach and abdomen. This condition has
It was significantly higher among female been strongly linked to cardiovascular
(13.4%) than male adults, and those belonging diseases, diabetes, and some cancers.
to non-poor (12.8%) than poor households
(8.3%) (Figure 21). The prevalence of high waist
circumference (WC) and high waist-hip ratio
Another indicator to assess obesity is (WHR) among adults in Iloilo City were 16.2%
the measurement of waist and hip and 35.8%, respectively (Table 37).
circumferences. Abdominal obesity, also known
as central obesity, happens when there is
55
90% LL 10.1 6.2 9.7 11.6 8.8 90% LL 7.5 11.8 90% LL 6.0 11.4
CI UL 12.8 10.3 13.9 17.1 15.8 CI UL 11.2 15.0 CI UL 10.7 14.3
Figure 21. Prevalence of obesity among adults, 20 to 59 years old, by age group, sex and
wealth status in Iloilo City: ENNS, 2018
Table 37. Prevalence of high waist circumference and high waist-hip ratio among adults,

90% CI 90% CI
(%) (%)
High Waist Circumference 13.5 13.2 13.8 16.2* 14.5 17.8
High Waist-Hip Ratio 35.3 34.9 35.7 35.8 34.3 37.3

Looking closely by age group, the adults (6.1%). Moreover, those living in non-
prevalence of high WC increased with age. poor households (18.0%) had significantly high-
Between sexes, high WC was significantly er prevalence than poor households (11.5%)
higher among female adults (25.3%) than male (Figure 22).
90% LL 14.5 7.2 12.2 18.0 18.8 90% LL 4.7 22.9 90% LL 9.1 16.4
CI UL 17.8 10.3 17.4 23.4 26.7 CI UL 7.5 27.6 CI UL 13.8 19.6
Figure 22. Prevalence of high waist circumference among adults, 20 to 59 years old, by age
group, sex and wealth status in Iloilo City: ENNS, 2018
56
Similarly, high WHR increases with adults (7.6%), and in non-poor (37.3%) than
age. This was significantly higher among poor households (32.6%) (Figure 23).
female adults (61.2%) than among male
90% LL 34.3 16.8 29.6 40.6 50.3 90% LL 6.2 58.6 90% LL 29.7 34.9
CI UL 37.3 23.4 35.8 46.8 55.3 CI UL 9.1 63.8 CI UL 35.6 39.7
Figure 23. Prevalence of high waist-hip ratio among adults, 20 to 59 years old, by age group,
Anemia is characterized by a impaired functional status and cognitive

decreased number of red blood cells as disorders, which may affect their productivity.
measured through hemoglobin
One in every 10 adults (10.3%) had
determination. The most common
anemia in Iloilo City. The prevalence of anemia
symptoms include weakness, irritability, and
was considered as mild public health
fatigue which may result to numerous
significance (Table 38).
adverse health outcomes, including
Table 38. Prevalence of anemia among adults, 20 to 59 years old, in the Philippines and
Iloilo City by sex: ENNS, 2018
90% CI
Variable Prevalence (%)
Male 7.4 5.3 9.5
Female 12.4 10.1 14.7
Non-communicable diseases are The prevalence of elevated blood
associated with the following modifiable pressure based on a single-visit blood
behavioral risk factors namely tobacco use, pressure measurement among adults in Iloilo
harmful use of alcohol, physical inactivity and City was 15.2% (Table 39). By age group and
sex, the prevalence increased with age, and
unhealthy diet, that result to physiologic risk
was higher among males (19.6%). However,
factors like elevated blood pressure (BP), high
the prevalence was not significantly different
fasting blood sugar (FBS), dyslipidemia, and
between adults from households belonging to
obesity. non-poor (15.3%) and poor (14.6%) (Figure
24).
57
Table 39. Prevalence of elevated blood pressure and high fasting blood sugar among adults,
90% CI 90% CI
Lower Upper Lower
(%) (%) Upper Limit
Limit Limit Limit
Elevated Blood Pressure 16.0 15.6 16.4 15.2 13.5 16.9
High Fasting Blood Sugar 6.7 6.2 7.2 7.0 5.7 8.2
90% LL 13.5 3.0 8.9 18.8 26.4 90% LL 17.2 9.8 90% LL 10.7 13.6
CI UL 16.9 5.0 12.7 25.7 34.3 CI UL 22.0 13.4 CI UL 18.4 17.1
Figure 24. Prevalence of elevated blood pressure among adults, 20 to 59 years old,
by age group, sex and wealth status in Iloilo City: ENNS, 2018
The prevalence of high fasting blood Meanwhile, the prevalence of high FBS
sugar (FBS) among adults in Iloilo City (7.0%) increased with age. There was no significant
was not significantly different with the national difference in the prevalence in terms of sex and
prevalence (6.7%) (Table 39). wealth status implying that adults were at-risk
to diabetes regardless of sex and wealth status
(Figure 25).
90% LL 5.7 0.0 0.1 5.2 12.6 90% LL 5.3 4.9 90% LL 2.3 5.5
CI UL 8.2 1.8 5.4 13.4 20.5 CI UL 9.7 8.1 CI UL 12.2 8.4
Figure 25. Prevalence of high fasting blood sugar among adults, 20 to 59 years old, by age group,
sex and wealth status in Iloilo City: ENNS, 2018
About 21.3% of adults in Iloilo City (at least one tobacco product a day) or on a
were current smokers or those who smoked regular/ occasional basis (Figure 26).
during the survey either on a “daily” basis
58
LL 20.7 20.1
90% CI
UL 22.4 22.4
Figure 26. Proportion of current smokers among adults, 20 to 59 years old, in the Philippines and
The prevalence of smoking decreased mostly male adults (39.6%), and those living in
with age but mostly were young adults, 20-29 poor households (26.9%) (Figure 27).
years old (24.2%). Current smokers were
90% LL 20.1 21.2 19.3 17.9 14.9 90% LL 37.4 5.5 90% LL 23.9 16.8
CI UL 22.4 27.1 22.5 23.3 20.6 CI UL 41.8 7.8 CI UL 29.8 20.3
Figure 27. Proportion of current smokers among adults, 20 to 59 years old,

by age group, sex and wealth status in Iloilo City: ENNS, 2018
The proportion of binge drinkers, drinking in the past 30 days, in Iloilo City was
the excessive consumption of alcoholic 44.8% (Figure 28).
beverages among those who reported
90% LL 53.3 40.9

CI UL 58.1 48.7
Figure 28. Proportion of binge drinkers among currently drinking adults, 20 to 59 years old,
in the past 30 days, in the Philippines and Iloilo City: ENNS, 2018
Binge drinking was more common engaged in binge drinking. Regardless of wealth
among the age group, 30-39 years old, and status, the proportion of binge drinkers was not
was significantly higher among male adults in significantly different between poor and non-
Iloilo City. More than half of male adults were poor households (Figure 29).
59
90% LL 40.9 35.9 45.1 37.4 33.1 90% LL 48.4 2.6 90% LL 38.1 39.7
CI UL 48.7 48.5 65.0 50.2 51.8 CI UL 56.0 14.8 CI UL 58.0 48.9
Figure 29. Proportion of binge drinkers among currently drinking adults, 20 to 59 years old, in
the past 30 days, by age group, sex and wealth status in Iloilo City: ENNS, 2018
One in every three adults (33.6%) in This proportion was significantly lower than
Iloilo City was insufficiently physically active. the Philippine estimate of 40.6% (Figure 30).
90% LL 38.1 29.7

CI UL 43.1 37.5
Figure 30. Proportion of insufficiently physically active adults (20 to 59 years old) in the
The physically inactive adults were adults coming from non-poor households
among 20-49 years of age in Iloilo City. Female were significantly more physically inactive
adults (37.4%) were significantly more physically (36.5%) than poor households (27.7%)
inactive than male adults (29.0%). Furthermore, (Figure 31).
90% LL 29.7 29.8 30.3 30.3 22.4 90% LL 25.3 33.0 90% LL 24.2 32.1
CI UL 37.5 38.2 42.4 40.4 31.8 CI UL 32.8 41.8 CI UL 31.2 40.9
Figure 31. Proportion of insufficiently physically active adults, 20 to 59 years old, by age group,
60
Highlights:
 Chronic energy deficiency was of low public health significance and more prevalent
among young adults;
 Four in every 10 adults had high BMI (>25 kg/m2) and may have higher risk of
developing additional health problems;
 High WC and WHR increased with age and mostly observed among females;
 Anemia was of mild severity in terms of public health significance;
 The prevalence of raised blood pressure and high fasting blood sugar increased with
age;
 One in every five adults was a current smoker, and mostly male adults from poor
households;
 Binge drinking was more common among adults, 30-39 years old; more than half of
male adults were engaged in binge drinking; and
 One in every three adults was insufficiently physically active.
Call to Action:
 Promote Pinggang Pinoy for portion control through public and private sector initiatives;
 City government may consider interventions to improve access to healthier food
options while making poor diet choices more unattractive through disincentives such as
higher taxes and restricted access (limited hours, zoning around schools and
workplaces, etc);
 Policies such as the sin tax law may have affected smoking rates but not alcohol
intake, which needs to be addressed through adult-targeted social interventions;
 Intensify programs on smoking cessation and alcohol consumption reduction to help
adults avoid or stop smoking and binge drinking;
 Conduct and strengthen regular monitoring of weight, blood pressure, fasting blood
sugar, and lipid profile in health centers;
 Ensure adequate supply of maintenance medicines and other essential drugs at the
health centers for free distribution to at-risk adults from poor households;
 Activate health and nutrition education activities conducted by a professional
Nutritionist-Dietitians;
 Organize ehersisyo sa barangay program; and
 Environment interventions which encourage physical activity such as options for
walking, active leisure activities and the like should be given in the form of incentives
61
Elderly (60 years old and above)
Senior citizens or the elderly are The double burden of malnutrition is

characterized by significant decline in physical seen among Filipino older persons, although
activity and general metabolism (DOST-FNRI, the trend differs among cities and provinces
2017). They are vulnerable to malnutrition as a compared to the national estimates.
result of dietary factors compounded by
changes due to aging. Chronic, degenerative The prevalence of CED among
diseases such as cardiovascular diseases, elderly in Iloilo City in 2018 was 11.0% which
diabetes and osteoporosis as well as was considered a medium public health
micronutrient deficiencies are common among problem in terms of severity and magnitude.
older persons. This section reports the Similarly, the national prevalence was 13.4%
which was also considered as a medium
prevalence of CED, overweight and obesity,
public health problem.
anemia, vitamin A status and iodine status as
indicators of nutritional status of the elderly 60
On the other hand, the prevalence of
years old and above. Selected risk factors to
overweight and obesity among this group in
NCDs such as smoking, alcohol drinking and
the City were 23.8% and 8.0%, respectively
physical inactivity are also reported in this (Table 40).
section.
Table 40. Prevalence of chronic energy deficiency (CED), overweight and obesity among
elderly, 60 years old and above, in the Philippines and Iloilo City: ENNS, 2018

(%) (%)
CED 13.4 12.9 14.0 11.0 8.5 13.4
Overweight 24.7 23.9 25.5 23.8 20.2 27.3
Obesity 6.3 5.9 6.8 8.0 5.7 10.3
For android type of obesity, the and 54.8%, respectively. Both rates were
prevalence of high WC and high WHR significantly higher than national estimates
among the elderly in Iloilo City were 22.8% (Table 41).
Table 41. Prevalence of high waist circumference and high waist-hip ratio among elderly,
60 years old and above, in the Philippines and Iloilo City: ENNS, 2018
90% CI 90% CI
(%) (%)
High Waist Circumference 17.8 17.1 18.6 22.8* 19.5 26.1
High Waist-Hip Ratio 47.7 46.7 48.6 54.8* 52.7 56.8
62
Moreover, high WC and high WHR were difference was observed by wealth status
both significantly higher among elderly females (Figure 32).
than elderly males. Meanwhile, no significant
90% LL 19.5 3.9 27.7 9.2 20.8 90% LL 52.7 14.8 73.4 37.8 55.0
CI UL 26.1 10.9 36.8 21.9 28.1 CI UL 56.8 21.3 81.3 59.0 59.5
Figure 32. Prevalence of high waist circumference and high waist-hip ratio among elderly,
60 years old and above, by sex and wealth status in Iloilo City: ENNS, 2018
The prevalence of anemia among the considered a „moderate‟ public health

elderly in the City was 21.6% and was problem (Table 42).
Table 42. Prevalence of anemia among elderly, 60 years old and above, in the Philippines and
90% CI
Variable Prevalence (%)
Iloilo City 21.6 17.3 26.0
Male 23.6 15.2 24.7
Female 19.4 14.4 24.4
Sufficient vitamin A intake among the the most significant free radical scavenger
elderly helps prevent age-related muscular highly needed by the elderly. The prevalence
degeneration (AMD) or the loss of central vision of VAD among the elderly in Iloilo City was
as people age. Also, it is a potent antioxidant and very low at 0.8% (Table 43).
Table 43. Prevalence of vitamin A deficiency among elderly, 60 years old and above, in the
90% CI
Prevalence (%)
63
Iodine intake of elderly in Iloilo City was Meanwhile, three in every 10 elderly
insufficient with median UIE of 85µg/L which (36.2%) in the City had raised blood pressure.
was significantly lower than the national level. On the other hand, the prevalence of high
The iodine deficiency prevalence was 28.9% fasting blood sugar was 11.5% (Table 45).
(Table 44).
Table 44. Median UIE and percent urinary iodine (UI) level of < 50µg/L among elderly,
60 years old and above, in the Philippines and Iloilo City: ENNS, 2018

Median
Lower Upper level Lower Upper
(µg/L)
Limit Limit <50µg/L (%) Limit Limit
Philippines 108 105.2 110.3 23.3 20.4 26.3
Iloilo City 85* 76.2 93.6 28.9 23.7 34.0
Table 45. Prevalence of elevated blood pressure and high fasting blood sugar among

90% CI 90% CI
Elevated Blood Pressure 35.0 33.7 36.2 36.4 32.8 40.1
High Fasting Blood Sugar 13.8 12.2 15.5 11.5 8.6 14.5
Smoking among the elderly For physical activity among the

respondents in Iloilo City was significantly lower elderly, four in every ten (42.1%) were
at 10.9% compared to the national estimate insufficiently physically active. This proportion
(16.3%). However, the proportion of current was significantly lower compared with the
alcohol drinkers at 23.8% was not significantly national level (50.6%) (Figure 33).
different than the national estimate of 28.2%.
Smoking and harmful use of alcohol raise the
risks for NCDs.
90% LL 15.5 25.8 48.5 90% LL 8.8 21.4 37.2

CI UL 17.1 30.5 52.7 CI UL 12.9 26.3 46.9
Figure 33. Proportion of current smokers, current alcohol drinkers and physically inactive
64
Highlights:
 CED among elderly was considered a medium public health problem;

 Prevalence of high WC and high WHR were significantly higher than the national
levels;
 Anemia prevalence was considered of moderate public health significance;
 Iodine intake of elderly was insufficient with median UIE of 85µg/L, which was
significantly lower than the national level. Iodine deficiency was a persistent problem.
 Three in every 10 were at-risk to hypertension; and
 Four in every ten elderly were insufficiently physically active.
Call to Action:
 Promote programs that would increase food intake or appetite of the elderly;
 Promote physical activity such as community wellness for senior citizens;
 Conduct regular check-up in health centers or primary care units among the senior
citizens to monitor their health and nutritional status;
 Ensure continuous supply of maintenance medicines at health centers for distribution to
elderly especially among poor and marginalized households; and
 Health and nutrition education activities must be conducted by a professional
Nutritionist-Dietitians.
65
Conclusion and Recommendations
Based on the results, undernutrition and school-age children with high rates of
and micronutrient deficiencies were palpable stunting, underweight, and anemia. Among
nutrition concerns in Iloilo City. It was pervasive adolescents, stunting and anemia were still of
across all age groups and experienced more by public health concern. The initiation of
those belonging to poor households. Among 0 smoking and alcohol drinking, and high rates
to 23 month old children, despite high of insufficient physical activity increase the
undertaking of early breastfeeding initiation risk for NCDs. Overnutrition and anemia were
(77.8%) and exclusive breastfeeding (44.2%) concerns among non-pregnant/non-lactating
during the first six months of life, continued women and lactating mothers. Among adults
breastfeeding at one year and two years of age and elderly, high rates of overnutrition, high
was only 40.8% and 20.8%, respectively. Also, rates of smoking, alcohol drinking and
dietary diversity of children during the physical inactivity were observed. Moreover,
complementary feeding period was suboptimal, iodine deficiency was persistent among the
with only 19.1% of children, 6-23 months, elderly. At the household level, food insecurity
meeting the minimum dietary diversity and a was experienced by more than half of the
very low percentage (6.3%) meeting the households with one in every 10 experienced
minimum acceptable diet, suggesting that the severe food insecurity (10.2%), which may
children‟s complementary food have have contributed to the nutrition and health
inadequate level of energy and nutrients. problems in the city.
Undernutrition and micronutrient deficiency
were evident among 0 to 59 month old children
Health Policy Recommendations
It is recommended that the Development programs, identified in this

implementation of target-focused development survey, should prioritize maternal and child
programs and policies on health and nutrition health and nutrition in order to contribute to
must be accelerated to address the different the achievement of the Sustainable
health and nutrition concerns in the city. Development Goals by 2030.
66
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68
Annex 1. List of ENNS Booklets and Forms

BOOKLET/ RESPONSIBLE
FORM TITLE RESPONDENT COMPONENT
FORM NO. RESEARCHER
BOOKLET 1 HOUSEHOLD MEMBERSHIP, ANTHROPOMETRIC AND BLOOD PRESSURE MEASUREMENTS
ENNS Form 1.1 Household Membership and Demographic Information HH Head Socio-economic AR
ENNS Form 1.2 Household and Other Demographic Information HH Head Socio-economic AR
ENNS Form 2.1 Measurements, All Household Members All Members Anthropometry AR
Members, Clinical and
ENNS Form 5.1 Blood Pressure Measurement of 10 Years Old and Above AR/CHR
10y above Health
BOOKLET 2 HOUSEHOLD FORMS
Household Food Security (Household Food Insecurity Ac- Mother/
ENNS Form 1.3 Food Security AR
cess Scale) Meal Planner
ENNS Form 1.4 Household Food Frequency HH Head Food Security AR
Government
ENNS Form 1.6 Household Government Program Participation HH Head/ Mother AR
Program
HH Head/ Mother/ Government
ENNS Form 1.7 Household Awareness and Usage of Iodized Salt AR
Meal Planner Program
BOOKLET 3 MATERNAL HEALTH AND NUTRITION
Mother‟s Knowledge, Health-seeking Behaviors and Prac-
ENNS Form 3.1 Mother Maternal AR
tices (For currently pregnant women)
Mother‟s Knowledge, Health-seeking Behaviors and Prac-
ENNS Form 3.2 Mother Maternal AR
tices (For all mothers with child ≤ 36 months)
BOOKLET 4 CHILDREN, 0 to 23 MONTHS OLD
Birthweight and Related Information of Children, 0-71
ENNS Form 4.1 Mother Anthropometry AR
Months
Mother/
ENNS Form 4.2 Infant and Young Child Feeding Practices, 0-23 Months IYCF AR
Caregiver
Government Program Participation of Children, 0-71 Government
ENNS Form 4.3 Mother AR
Months Program
Mother/
Biochemical Information on Infections, Supplements and Caregiver/ Mem- Biochemical/
ENNS Form 8.3 ber, AR
Medications for Household Members 6 Months and Above Clinical
15y and above
BOOKLET 5 CHILDREN, 24-71 MONTHS OLD
Birthweight and Related Information of Children, 0-71
ENNS Form 4.1 Mother Anthropometry AR
Months
Government Program Participation of Children, 0-71 Government
Months Program
Mother/
Biochemical Information on Infections, Supplements and Caregiver/ Biochemical/
ENNS Form 8.3 Member, AR
15y and above
BOOKLET 6 CHILDREN, 6-12 YEARS OLD
Government Program Participation of Children, Government
6-12 Years Old – with additional questions Program
Smoking and Alcohol Consumption of 10 Years Old and Members, Clinical and
ENNS Form 5.3 AR/CHR
Above 10y and above Health
Physical Activity of Adolescents 10-17 Years Old Member, Clinical and
and Adults 18 Years Old and Above 10y and above Health
Mother/
15y and above
BOOKLET 7 ADOLESCENT, 13-17.99 YEARS OLD
Government
ENNS Form 4.5 Youth Development Session (YDS), 13-18 Years Old Member, 13-18y AR
Program
Knowledge and Practice of Reading Product Labels of Pack- Member, Government
ENNS Form 4.7 AR
aged Foods and Beverages (15 Years Old and Above) 15y and above Program
69
BOOKLET/ FORM RESPONSIBLE

FORM TITLE RESPONDENT COMPONENT
NO. RESEARCHER
Reproductive History Questionnaire for All Women of Member, Government
ENNS Form 4.10 AR
Reproductive Age, 15-49 Years Old 15-49y Program
Smoking and Alcohol Consumption of 10 Years Old and Members, Clinical and
Physical Activity of Adolescents 10.0 to 17.9 Years Old Member, Clinical and
and Adults 18 Years Old and Above 10y and above Health
Mother/
15y and above
BOOKLET 8 ADULT, 18 YEARS OLD AND ABOVE
Member, Government
ENNS Form 4.5 Youth Development Session (YDS), 13-18 Years Old 13-18y AR
Program
Government Program Participation of Senior Citizens, 60 Member, Government
ENNS Form 4.6 AR
Years Old and Above 60y and above Program
Knowledge and Practice of Reading Product Labels of
Member, Government
ENNS Form 4.7 Packaged Foods and Beverages, AR
15y and above Program
(15 Years Old and Above)
Member, Government
ENNS Form 4.8 PhilHealth Membership, 21 Years Old and Above AR
21y and above Program
Female Mem-
Reproductive History Questionnaire for All Women of ber, Government
ENNS Form 4.10 AR
Reproductive Age, 15-49 Years Old Program
15-49y
History of Raised Blood Pressure and Diabetes Member, Clinical &
Questionnaire of 18 Years Old and Above 18y and above Health
Smoking and Alcohol Consumption of 10 Years Old and Members, Clinical &
Physical Activity of Adolescents, 10.0-17.9 Years Old and Member, Clinical &
Adults, 18 Years Old and Above 10y and above Health
Mother/
15y and above
BOOKLET 9 HOUSEHOLD FOOD CONSUMPTION
ENNS Form 6.1 Household Membership (for Dietary) Household Dietary DR
ENNS Form 6.2 Household Food Inventory Household Dietary DR
ENNS Form 6.3 Household Food Record Household Dietary DR
BOOKLET 10A INDIVIDUAL FOOD CONSUMPTION, ALL CHILDREN, 0-36 MONTHS
24-Hour Food Recall, All Children, 0-36 Months (≤ 3.0 Mother/
ENNS Form 7.1 Dietary DR
Years Old) Caregiver
Checklist of Food and Liquid Intake of Children 0-36 Mother/
ENNS Form 7.3 Dietary DR
Months Caregiver
BOOKLET 10B INDIVIDUAL FOOD CONSUMPTION, > 3.0 (37 MONTHS) TO 14.99 YEARS OLD
Member, > 3.0
24-Hour Food Recall, All Children, > 3.0 (37 Months) –
ENNS Form 7.2 (37 months) – Dietary DR
14.99 Years Old
14.9 years old
BOOKLET 10C INDIVIDUAL FOOD CONSUMPTION, 15 YEARS OLD AND OVER
Member,
ENNS Form 7.2 24-Hour Food Recall, 15 Years and Over Dietary DR
15y and above
Member,
ENNS Form 7.4 Consumption Practices, 15 Years Old and Above Dietary DR
15y and above
BOOKLET 11 BIOCHEMICAL INFORMATION AND INDICES
Biochemical/
ENNS Form 8.1 Household Membership and Biochemical Information HH Head BR
Clinical
Biochemical/
ENNS Form 8.2 Biochemical Indices All Members BR
Clinical
AR – Anthropometric Researcher; CHR – Clinical and Health Researcher; DR – Dietary Researcher; BR – Biochemical Researcher
70
Annex 2. ENNS Survey Team

TEAM I
Team Coordinator Ma. Lilibeth P. Dasco

Alternate Team Coordinator Maylene P. Cajucom
Assistant Coordinator Taharudin B. Rachman
Field Monitoring Supervisor Fritz Jerald C. Pinlac
(Biochemical)
Statistician Cheder B. Sumangue
Information Technologist/ John Carlo Velasquez / Archie C. Umlas
Programmer
Special Disbursing Officers Sheryl C. Velasco
Ma. Lilibeth P. Dasco
Team Leader (Technical) Kathrina N. Almenie May Jane D. Patnaan

Marites E. Ambayec Lorelane C. Ramirez
Jannet O. Gutierrez Ma. Cristina Velez
Team Leader (Operations) Mary Grace E. Adolfo Melody O. Lamangen

Chriseldy S. America Dianne Leticia A. Lambito
Janine Ruth S. Barrozo Diana C. Lodriguito
Anthropometric Researchers Marnellie S. Abanilla Aiza S. Getalla

Adrian Jay A. Almario Ben-Nasir J. Jala
Richzanne Grace S. Arrojado Joshua Elijah L. Lira
Charlene G. Batusin-in Victor Emman D. Monzon
Trisha Kaye D. Butlay Matthew Raul C. Quidato Jr.
Ma. Leica Grace V. Cabinbin Ginivie Y. Rendon
Jasmin S. Dinopol Erwin Y. Salen
Kathleen Ruth Terese P. Dolores Janet D. Salomes
Bernie Jhon G. Gentoba Christine E. Su
Dietary Researchers Medarcha S. Adjajul Noime M. Loable

Cristy T. Agpalo Erwin Ray E. Octavio
Stephanie C. Barrio Charlene B. Onas
Kimberly M. Basiya Maria Cassandra B. Ortaliz
Nylisa Joie D. Bron Jonah Mae J. Padernal
Kayla Anne D. Calumpong Eloisa Luz C. Prado
Rachelle G. Dela Cruz Danisse Nicole G. Quindo
Lailanie M. Entol Carol Fe C. Repil
Cassandra A. Eparwa Dianne B. Delos Reyes
Jane M. Fernandez Jan Abigail C. Sablon
Kathleen Jane K. Gabuya Noeme N. Taglinao
Raiza B. Jama Dovie Dawn A. Vergara
Biochemical Researchers John Vincent B. Canlas John Gideon A. Narvaez

Coreen Maurice I. Gianan Cristine Joy F. Sedano
Kurt Ivan M. Hernandez Mica Gelline T. Villalon
Clinical and Health Researchers Krizzle Love J. Bulaga Van Jay B. Degala
Happie C. Capapas Jeanifer G. Quistadio
Hardy John F. Daria Roarke Luigi C. Virtudazo
Science Aides Dustin A. Amigo Harold E. Dorado

Alvin N. Angeles Dennis F. San Gabriel
Joseph R. Bustos Elmer J. Ramat
71
Annex 3. Data Management Team

Statisticians Marvin C. Delos Santos Sarah Jane S. Gohilde
Jonel G. Patricio Maverick Aaron C. Lising
John Michael E. Borigas Rovie Jane B. Caliguiran
Clark D. Baylon Leah Mae C. Bonita
Claudine G. Gilban
Andre King S. Santos
IT Support Staff / Programmers Edward Regis D. Valdez Archie C. Umlas

John Carlo Velasquez J. Aaron Paul S. De Leon
Yonard A. Abucay Aaron Gregor Lim
Content Validators Ahmed Jaber T. Asadil Rasell R. Manalo

Allan R. Colibao Jeeberly U. De Ade
Cecil S. Salen Shirlyn Gil S. Tangec
Shania Lyn M. Siadto Sheila Mae C. Montaño
Milky Jan G. Ortiz Tiffany Bianca B. Abellera
Bianca Joy B. Ubac Jenny Rose A. Malaque
Kristine Nicole R. Dasco Ann Francis R. Genove
Katty T. Parreño Kimberly O. Ybañez
Assistants to the Coordinators / Remedios S. America

Support Staff Nelisa P. Cortez
Ma. Sheryl C. Velasco
72
Annex 4. Biochemical Survey Team

Biochemical Coordinators Rosemarie J. Dumag Michael E. Serafico
Marites V. Alibayan Joselito Rosario C. Ulanday
Ma. Karyn B. Vallejo Maribeth S. Castillo
Herbert P. Patalen Soleded G. Pepito
Supervising Validators Dave P. Briones Joan M. Castro

Carl Vincent D. Cabanilla
Chemists Rujyla Claire P. Cariño Jim Pauline C. Guiyab

Faith Chalice M. Isla Mikka Aira R. Ocampo
Marynol Grace M. Ursabia Maria Josephine A. Lumabas
Richard Ron A. Rodriguez Jerina Marjorie A. Ramos
Zeny G. Grama Riatries Y. Saavedra
Junnlit Loraine B. Rivera Ruvy Ann O. Rosales
Arianne Gayle P. Vianzon Ivy E. Refugio
Lian C. Cantal Eunice Anne K. Dulatre
Medical Technologists Neah Fe G. Cañada Paul Stephen B. Ortia

(Clinical Analysts) Rendal Sarah Grace P. Garingo Matthew Brando C. Pecadizo
Patricia Gilyn V. Sanchez
Science Aides Monina J. Latigar Lucilo B. Lilis, Jr.

Lemuel A. Visto Reith Harry D. Nebrida
Disa S. Simon
Ramon L. Ignacio
Christy C. Muros
Marjon S. Sison
Suzette H. Malinao
73
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ii

2018 Expanded National Nutrition Survey

The Food, Health and Nutrition

MARIO V. CAPANZANA, Ph.D.

The Project Team

THE EXPANDED NATIONAL NUTRITION SURVEY 2018 MANAGEMENT TEAM

Mario V. Capanzana, Ph.D.

Imelda Angeles-Agdeppa, Ph.D.

SURVEY OPERATIONS DATA MANAGEMENT

Marina B. Vargas, Ph.D. † Charmaine A. Duante, MSc Epid (PH)

Ma. Lilibeth P. Dasco, MSAN, MDM Glen Melvin P. Gironella

Josie P. Desnacido, MSAN

Charina A. Javier, MDE

FINAL REPORT WRITERS

Grateful acknowledgment and appreciation are due to the following:

Table No. Title Page

2 Cut-off points used in classifying nutritional status of children, 23

3 Cut-off points used in determining magnitude and severity of underweight 23

4 Cut-off points used in determining magnitude and severity of wasting 23

5 Cut-off points in classifying the nutritional status of adults and lactating 24

6 Cut-off points in classifying the nutritional status of pregnant women 24

7 Cut-off points used in determining magnitude and severity of underweight 24

8 Cut-off points for waist circumference and waist-hip ratio, by sex 25

9 Hemoglobin concentrations below which anemia is likely to be present in 25

10 Classification of public health significance of anemia in populations on the 25

12 Prevalence cut-offs to define vitamin A deficiency in a population and its 26

13 Epidemiological criteria for assessing iodine nutrition based on median 27

14 Epidemiological criteria for assessing iodine nutrition based on urinary 27

Table No. Title Page

15 Blood pressure classification (NIH: JNC VII, 2004) 28

16 Cut-off points for fasting blood sugar 28

17 Target age or physiologic groups for specific variables 30

18 Household and individual eligibility and response rate in Iloilo City 32

19 Socio-demographic profile of households and household heads in 32

20 Percentage of households by food security status in Iloilo City: 34

21 Prevalence of underweight, stunting, wasting, and overweight-for-height 38

22 Prevalence of anemia among preschool children, 6 months to 5 years old 39

23 Prevalence of vitamin A deficiency among preschool children, 39

24 Prevalence of underweight, stunting, wasting, and overweight/obesity 41

25 Prevalence of anemia among school-age children (6 to 12 years old) in 43

27 Prevalence of stunting, wasting, and overweight/obesity among 45

28 Prevalence of anemia among adolescents (13 to 19 years old) in the 46

29 Prevalence of chronic energy deficiency (CED) and overweight/obesity 50

30 Prevalence of anemia among non-pregnant/non-lactating women of 50

Table No. Title Page

31 Prevalence of vitamin A deficiency among non-pregnant/non-lactating 51

33 Prevalence of chronic energy deficiency (CED) and overweight/obesity 52

34 Prevalence of anemia among lactating mothers in the Philippines and 52

36 Prevalence of chronic energy deficiency (CED), overweight, and obesity 54

38 Prevalence of anemia among adults, 20 to 59 years old, in the Philippines 57

39 Prevalence of elevated blood pressure and high fasting blood sugar 58

40 Prevalence of chronic energy deficiency (CED), overweight, and obesity 62

43 Prevalence of Vitamin A deficiency among elderly, 60 years old and 63

45 Prevalence of elevated blood pressure and high fasting blood sugar 64

Figure No. Title Page

1 Philippine Statistics Authority (PSA) 2013 Master Sample 20

2 Methods of Data Collection 21

3 Political Map of Iloilo City 31

4 Distribution of educational attainment of household head in Iloilo City: 33

5 Distribution of occupation of household head in Iloilo City: ENNS, 2018 34

6 Percentage of households by food insecurity items in Iloilo City: 35

7 Percentage of food insecure households by wealth status, household 35

8 Proportion of infants, 0-23 months old, by breastfeeding practices in the 36