Perceived Nutritional Status, Body Satisfaction and

Fad Dieting among Middle-Adolescent Students of the

University of the Philippines Rural High School
Sarah Marie A. Don a, Marjorie Anne A. Layosa a, Gemaima C. Evangelista a, and Liezl M. Atienza a *
a
Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines, Los Baños, Laguna

* Corresponding author: lmatienza@up.edu.ph

ABSTRACT
Adolescents are at the stage when they are most influenced, and body image and satisfaction with
one’s appearance are formed. At the same time, exposure to health risks of under and overnutrition,
and unrealistic body image portrayed in the media and peers put adolescents into a vulnerable po-
sition to try popular quick strategies such as fad dieting to achieve their body goal. The objectives of
this study are to investigate prevalence of fad dieting among middle-adolescent students in Universi-
ty of the Philippine Rural High School (UP RHS) and determine the factors that influence its practice.
The practice of fad dieting, actual and perceived nutritional status (NS) among UP RHS students
were obtained through survey questionnaire and anthropometric measurements.

Results showed that there is a discrepancy between the actual and perceived NS of middle-adoles-
cent students. Despite having normal NS, some students perceive being underweight or overweight.
Body dissatisfaction was also observed despite students having normal NS, and dissatisfaction rates
increase among overweight students. Only 17% of the study population have tried fad dieting to lose
weight and an association was observed such that those who are fad dieters have normal and over-
weight perceived NS, and low body satisfaction.

This study has presented evidence that middle-adolescents students have engaged with fad diets
and other unhealthy dietary practices influenced by their perceived NS and body satisfaction. Nutri-
tional policies, assessment and interventions should be given importance to promote healthy lifestyle
and to prevent negative health effects among this age group in the long run.

Keywords: adolescence; body image; body satisfaction; fad diet

INTRODUCTION velopment in early adolescence from 11 to 14

Adolescence is the period between childhood
and adulthood where physical, psychologi-
cal, and social growth and development takes
place. Although these occur simultaneously all
throughout adolescence, they can be further
categorized according to when specific growth
and development happens most – pubertal de-
years old, brain development in middle adoles-
cence from 14 to 17 years old, and emotional
stability in late adolescence from 17 to 19 years
old (Salmela-Aro, 2011). Middle adolescence
therefore is the stage where brain development
is prominent, the functional and the emotional
center develops which govern self-control, judg-
ment, emotions, and organization. The develop-

Issue No. 9 1
ment of body image is of particular concern be-
cause of these physical and cognitive changes
in this period of growth (Voelker et al., 2015).
Adolescents often derive self-esteem from their
physical appearance resulting in body satisfac-
tion. Body satisfaction is a separate construct
from body image that denotes an investment in
and concern with appearance (Grogan, 2006).
The scrutiny in body shape often lead to feelings
of body dissatisfaction (Benowitz-Frederick et
al., 2012). Body dissatisfaction is often the rea-
son of weight management, and not as a result
of health concern (Lowry et al., 2000). Hence,
the importance of a healthy diet that supports
healthy body image should be emphasized in
this age group.
Having a healthy diet is important during the ad-
olescent stage due to rapid growth. The 2016
National Nutrition Survey (NNS) (DOST-FNRI,
2016) in the Philippines reported that only 31%
of the households were able to meet the 100%
recommended energy intake. Although there
are still no available data on the intake of ad-
olescents per se, anthropometric data showed
that the mean weight and height of adolescents
aged 10-19 had increased from 2013 to 2015.
However, stunting remains a public health prob-
lem, wasting and thinness remain as serious
public health concerns, while overweight and
obesity were increasing in prevalence in this
age group.
Factors that affect adolescent eating patterns
and behaviors, either positively or negatively,
are mass media, body image, peer influences,
parental modeling and others due to psychoso-
cial and cognitive development (Brown & With-
erspoon, 2002). Some examples of poor eating
practices and behaviors are unhealthy weight
control and binge eating behaviors such as
meal skipping (WHO, 2016), using food substi-
tutes, self-induced vomiting and taking dietary
pills (Neumark-Sztainer, 2009), and clinical eat-
ing disorders such as Anorexia Nervosa and
Bulimia Nervosa (Rosen, 2010).
2 January - December 2020
One of the unhealthy eating behaviors is the
practice of fad diets. Despite its increasing
popularity, a review study on four weight loss
techniques show that there are limited studies
that prove the benefits and long-term effects of
such diets (Obert, Pearlman, Obert, & Chapin,
2017). For instance, the increasing popularity
and practice of fad diets such as the Atkin’s diet
(AD) which is a low-carbohydrate fad diet, Inter-
mittent Fasting (IF) which is a cycle between pe-
riods of fasting and eating, and Ketogenic diet
(KD) which is a high-fat, adequate-protein, and
low-carbohydrate diet, in the Philippines has
alarmed the National Nutrition Council (NNC)
Governing Board resulting into releasing a poli-
cy statement (Resolution No. 4, Series of 2018)
(NNC, 2018) of not recommending fad diets for
weight loss as it may pose potential health risk
and dangers.
Having said that eating behaviors and practices
in the adolescent period are easily influenced
by many factors, attempt of fad dieting has a
great possibility. Thus, having concrete knowl-
edge on the prevalence and influences of those
practicing such diets is of great importance to
properly assess, address, and prevent the risk
for negative health effects in the long run. This is
particularly important as there is knowledge gap
on the prevalence of fad dieting among adoles-
cents in the Philippines.
The objectives of this study are to investigate
prevalence of fad dieting among middle-ado-
lescent students in University of the Philippines
Rural High School (UP RHS) and determine the
different factors influencing the practice of such.
METHODOLOGY
Data Collection
This cross-sectional study was conducted in UP
RHS located in Los Baños, Laguna. The respon-
dents were middle-adolescent students with
age ranging from 14 to 17 years old (Grades
8 to 10). The sampling size (n) of 156 students
were calculated using the formula:
where z is the z-score (1.96); p is the standard
deviation (0.50); e is the margin of error (0.06);
and N is the population size (372). However,
only 93.6% response rate was recorded, and
due to limited time, the study carried on with 147
students as the sampling size.
Informed consent was signed by each random-
ly selected respondents prior to data collection.
Two types of data were gathered for the pur-
pose of this study – actual and perceived nu-
tritional status (NS), and the practice and influ-
ence of fad diets. For the NS, anthropometric
measurements such as weight and height were
measured during morning school hours using
bathroom scale and microtoise, respectively.
Actual nutritional status was determined by 1)
measuring weight and height using bathroom
scale and microtoise, respectively; 2) calculat-
ing body mass index (BMI) using the formula
BMI=weight (kg)/height (m2); and 3) interpreting
BMI using the Centers for Disease Control and
Prevention (CDC) BMI-for-age charts (Centers
for Disease Control and Prevention, 2001).
Whereas, a devised survey questionnaire was
used to obtain eating behavior of students while
the practice and influence of fad diet was ob-
tained using adapted and modified fad diet
questionnaire (Pedtke, 2001) with “pinggang
pinoy” for teens 13-18 years old as visual ref-
erence of a balanced meal. It was pre-tested to
ensure the validity and reliability of the question-
naire in terms of the participants’ interpretation
of the questions and respondent burden. The
Issue No. 9
said questionnaire was self-administered and
distributed during school hours.
Data Analysis
Descriptive and inferential statistics were per-
formed using Microsoft Excel while visual pre-
sentations of data were generated using Sig-
maPlot 13.0 (Systat Software, Inc. San Diego
CA, USA). Survey and anthropometric data
were separately analyzed due to confidentiali-
ty agreement with the respondents, as the an-
thropometrics were done separately from the
survey. Lastly, Pearson Chi-square statistic was
used to analyze the association between the
practice of fad diets and the factors that may
influence its practice.
RESULTS AND DISCUSSION
Actual and perceived nutritional status
The anthropometric measurements showed that
most (74%) of students had normal NS, howev-
er there was a high prevalence of overnutrition
in the study population where 16% were over-
weight while 8% were obese (Table 1). Essen-
tially, the 2016 NNS (FNRI, 2016) reported that
overnutrition among adolescents aged 10 – 19
years have increased significantly throughout
the years, from 8.3% in 2013 to 9.2% in 2015.
The interplay of overnutrition and exposures to
media and influence of peers put adolescents
into a vulnerable situation to attempt different di-
etary habits which sometimes are poor and dan-
gerous to achieve body goals (Gungor, 2014). It
has been noted that the risk of dieting increases
with increasing degree of overnutrition (Whyte
et al., 2004). Interestingly, studies have shown
that adolescents who try fad diets are more
likely caused by their body image and fatness
perception rather than their NS alone (Banjari,
Čačić Kenjerić, Mandić, & Nedeljko, 2011).
3
Table 1. Nutritional status of middle-adolescent Current Eating Behavior
students in UP RHS.
With regards to the current eating behavior, re-
Nutritional Status Number (n=147,%) sults showed that majority (42.2%) of the stu-
Underweight 3 (2%) dents still consume three, full balanced meals
Normal 109 (74%)
(Fig. 2). However, skipping of meals was highly
prevalent in the study population group, partic-
Overweight 23 (16%)
ularly the breakfast meal (32.0%). Some also
Obese 12 (8%)
restrict food items like the staple rice (12.9%) or
abstain from certain foods (2.0%), and replace
Our results showed the existing difference of
meals with shakes known as meal replace-
actual NS and perceived NS among middle-ad-
ment (MR) (2.7%). Only few reported to only
olescent students. As seen in Figure 1, the
drink water (1.4%). Further, it was observed
students’ perception of having normal NS was
that some students may skip meals and restrict
less than the actual proportion of having nor-
food items at the same time. The current eat-
mal NS (64 % vs 72%, respectively) (Fig. 1).
ing behavior of middle-adolescent students are
While there was a higher percentage of those
alarming because at such age, nutrient and en-
who perceived themselves as overweight (19%
ergy inadequacy are already foreseeable, and
perceived NS vs. 16% actual NS) and under-
studies have shown that unhealthy eating be-
weight (13% perceived NS vs. 2% actual NS),
haviors early in life is associated with adverse
than their actual NS. These results are similar
health consequences later in life (Borraccino et
with previous studies that showed the tendency
al., 2016).
of normal weight individuals to perceive them-
selves as heavier or lighter than their actual
status (Banjari et al., 2011; Neumark-Sztainer,
Wall et al., 2011; Scaglioni et al., 2011). Given
that perception of NS can greatly impact weight
management and dieting behaviours, the high
number of students that perceived their NS in-
correctly/inaccurately is quite alarming.

Figure 2. Current eating behavior of middle-ad-

olescent UP RHS students (n = 147).

In addition, our results showed that meal skip-

Figure 1. The actual and perceived nutritional
status of middle-adolescent students of UP
RHS (n = 147).
ping was the most common strategy to lose
weight (55.1%) (Fig. 3). Other activities to to
lose weight include low calorie diets (21.0%),
chewing gum (14.3%), drinking water (4.8%),
and vomiting (2.7%). Some distracts them-
selves through physical activity (2.7%), using
phone (0.7%) or sleeping (0.7%). Likewise,
combinations of different activities to hold back
hunger or lose weight were noted. Generally, it
can be observed that middle-adolescents were

4 January - December 2020

already engaged with weight control behaviors
and practices which are considered unhealthy
and dangerous such as meal skipping, and
vomiting, among others.
Figure 3. Activities done by middle-adolescent
students of UP RHS to lose weight (n = 147).
Satisfaction with Perceived Nutritional
Status
Body image is one of the main factors affecting
the eating behaviors and practices of adoles-
cents. Similarly, body satisfaction is reported to
have inverse significant relationship with dieting
behavior (Mostafavi-Darani et al.,2013). In this
study, perceived nutritional status was used as
a proxy of body image. Hence, we evaluated
the satisfaction of middle-adolescent students
towards their perceived NS (Fig. 4).
Among students who perceived their NS as
normal, results showed that majority (77.%)
were at least satisfied with it (19.5% complete-
ly satisfied, 57.6% satisfied), however, 22.8%
were dissatisfied despite the perception of hav-
ing normal NS (18.5% dissatisfied, 4.3% very
dissatisfied). While for students with perceived
underweight NS, majority (73.7%) were still
satisfied with it, while higher proportion of 21%
dissatisfied and 5.3% very dissatisfied were
observed. On the other hand, for students with
perceived overweight NS, majority were not sat-
isfied (52% dissatisfied, 20% very dissatisfied)
while the remaining (28%) were satisfied of be-
Issue No. 9
ing overweight. Interestingly, among students
with perceived obese NS, majority (66.7%) were
satisfied while 33.4% were dissatisfied (16.7%)
and very dissatisfied (16.7%). These are consis-
tent with findings of studies which showed that
underweight adolescents have higher body sat-
isfaction than those who were normal and over-
weight (Kantanista et al., 2017) and that higher
BMI or obesity is associated with body size dis-
satisfaction, lower peer esteem and depression
(Mirza et al.,2005; Weinberger et al., 2016). For
the observed body satisfaction among obese
students, similar results were also observed in
the study of Benkeser, Biritwum and Hill (2012)
where majority of the subjects reporting satisfac-
tion with their body were overweight or obese.
Figure 4. Satisfaction and dissatisfaction of
middle-adolescent UP RHS students on their
perceived nutritional status (n = 147).
Generally, results showed that body dissatisfac-
tion was experienced by adolescents despite
having normal NS and such dissatisfaction
was higher among those with perceived over-
weight NS. This is relevant because studies
have shown that as the body dissatisfaction
increases, so is the desire to lose weight and
try out weight loss and fad diets (Kim & Yeon,
2017; Mirza et al., 2005). Furthermore, dieting is
prevalent even among adolescents with under-
weight and normal NS which strongly suggests
that body image is the motivating factor in this
population (Whyte et al., 2004).
5
Results showed that 17% of the students have
tried fad diets to lose weight (Fig. 5). It was
expected that there would be more students
to try fad diets as this age group is most eas-
ily influenced in terms of eating behaviors and
practices (Salmela-Aro, 2011). Nonetheless, it
was found that the practice of fad dieting was
significantly associated with their perceived NS
(Table 2). Results further showed that most of
those who have practiced fad diets have normal
and overweight perceived NS.
Figure 5. Proportion of middle-adolescent UP
RHS students who have and have not tried fad
diets (n = 147).

Table 2. The relationship of perceived nutritional status and fad dieting.

PERCEIVED NUTRITIONAL STATUS

CATEGORY TOTAL
Obese OW Normal UW SUW
Fad Dieter 0 9 15 1 0 25
Non-Fad Dieter 6 16 78 19 1 120
TOTAL 6 25 93 20 1 145

* Pearson Chi-Square: 9.8047; P-value: 0.044; α = 5%

An association was also observed in terms
of the satisfaction towards perceived NS and
fad dieting (Table 3). Supporting studies have
shown that body dissatisfaction is associated
with dieting and disordered eating behaviors
(Mirza et al., 2005; Rodgers & Chabrol, 2009;
Banjari et al., 2011; Bucchianeri et al., 2016).
Similarly, our study showed that those who
have practiced fad diets have low body satis-
faction while those who have not practiced fad
diets have higher satisfaction rate with their per-
ceived NS (Table 3, Fig. 6).

Table 3. The relationship of body satisfaction and fad dieting.

BODY SATISFACTION
CATEGORY Completely TOTAL
Satisfied Dissatisfied Very dissatisfied
satisfied
Fad Dieter 3 8 9 5 25
Non-Fad Dieter 16 71 27 8 122
TOTAL 19 79 36 13 147

* Pearson Chi-Square: 9.8047; P-value: 0.044; α = 5%

6 January - December 2020

 Figure 6. Satisfaction and dissatisfaction of Figure 7. Fad diets tried by middle-adolescent
fad and non-fad dieters middle-adolescent UP UP RHS students (n = 147).
RHS students to their perceived nutritional (IF – intermittent fasting; KD – ketogenic diet;
status (n = 147). MR – meal replacement; AD – Atkin’s Diet)

Fad diets

Among the fad diets, majority of the middle-ad-

olescent students (69%) have tried intermittent
fasting (IF), 23% and 26% have tried the keto-
genic diet (KD) and meal replacement (MR), re-
spectively, while 12% have tried the Atkin’s diet
(AD) (Fig. 7). As observed, students have tried
more than one and/or combination of fad diets.
Skipping of meals was very prevalent among
the study group which may partly explain the
high prevalence of practicing IF which is a
Figure 8. Duration of adherence to fad diets by
characteristic of this fad diet. Meanwhile, only
middle-adolescent UP RHS students (n = 147).
few reported to practice AD although greater (IF – intermittent fasting; KD – ketogenic diet;
proportion was observed to have a no-rice and MR – meal replacement; AD – Atkin’s Diet)
meat-only diet (Fig. 2) which is a characteristic
of AD. Thus, it may be inferred that the students
may not be fully aware of their actual practice Our results show that very few students ad-
of fad diets. hered to fad diets for >3 months (IF- 2 out of 17;
KD- 1 out of 6; MR- 1 out of 7; AD- 0 out of 3)
The appeal of fad diets as quick-fix solution to (Fig. 8). Generally, it was observed that majority
weight management, as oppose to a perma- of the students adhered to fad diets for not more
nent plan of eating and exercising right, results than a month. Also, only in the IF group that ad-
to its popularity among the general population herence for more than 6 months was observed
(Pedtke, 2001). Hence, the duration of students’ while majority of the KD and AD groups only
adherence to each fad diets was investigated adhered for less than 3 months and less than
(Fig. 8). a week, respectively. This can be explained by

Issue No. 9 7
the fact that “dieting” to most suggests an in-
tentional, often temporary, change in eating to
achieve weight loss (Whyte et al., 2004). Fad
diets are also extremely restricting resulting to
poor dietary adherence in addition to adoles-
cents desiring fast results in short time. More-
over, adherence is improved with supervision
and social support (Lemstra et al., 2016) which
are not emphasized with fad dieting. Despite the
observed poor adherence of students to fad di-
eting, such dietary habit remains to be alarming
given that adolescent period is characterized
by dramatic physical growth and development
which consequently result to increased needs
for energy, protein, vitamins, and minerals
(Brown, 2011). Thus, their dietary habits should
allow them to constantly keep up with their in-
creased nutritional needs. To further understand
the adherence behavior of the fad dieters, the
duration of weight loss and their satisfaction to
each fad diets were investigated (Fig. 9 and 10).
Figure 9. Duration of weight loss from fad
dieting of middle-adolescent UP RHS students
(n = 147).
The duration of weight loss during their fad di-
eting is shown on Figure 9. Results showed
that 26.9% of fad dieters did not experience
any weight loss, while 15.4% of fad dieters ex-
perienced temporary weight loss (less than a
8 January - December 2020
month). This may partly explain the poor adher-
ence of most fad dieters as students may tend
to instantly give up on the fad diet as they deem
it ineffective based on their weight status. On
the other hand, 38.4% were reported to have
a sustained weight loss for more than a month.
This may reflect those who adhered to the fad
diet for longer periods of time and/or practiced
other weight loss strategies not covered by the
study.
Nonetheless, it was noted that students, in gen-
eral, reported high degree of satisfaction with
fad diets (Fig. 10). Specifically, all who tried KD
were satisfied followed by AD, IF and MR. This
is despite the fact of their poor adherence and
weight loss results when going through fad di-
eting. Therefore, their satisfaction or desirability
could be related to the extreme popularity of fad
diets regardless of the results.
Figure 10. Satisfaction of middle-adolescent
UP RHS students to fad diets (n = 147). (IF –
intermittent fasting; KD – ketogenic diet; MR –
meal replacement; AD – Atkin’s Diet)
CONCLUSION AND
RECOMMENDATIONS
Overall, this study has presented evidence that
fad dieting among middle-adolescents students
exists. There is a difference on the actual and
perceived NS among middle-adolescent stu-
dents wherein students tend to perceive their
NS as overweight or underweight despite hav-
ing normal NS. Unhealthy eating behavior of
skipping meals especially breakfast, vomiting,
abstinence of certain food such as rice were ob-
served among the study population. Also, body
dissatisfaction was observed even with the per-
ception of having normal NS, and dissatisfaction
increase with perceived overweight NS. Intermit-
tent fasting, ketogenic diet, meal replacement
and Atkin’s diet were among the fad diets tried
by some students to lose weight. An association
was observed such that those who are fad diet-
ers have normal and overweight perceived NS
and low body satisfaction. Despite poor weight
loss and dietary adherence, majority of the stu-
dents reported their satisfaction with fad diets.
Adolescents with inaccurate NS perception and
engaging in unhealthy dietary practices such
as fad dieting to lose weight were observed
in this study. Hence, it is recommended to in-
tensify nutrition education that would create
behavioral change toward good perception of
their nutritional status and desirable dietary
habits among this age group as they are seen
to be vulnerable to such fad diets and increased
risk to negative health effects later in life. Pro-
motion of sustainable healthy diet and lifestyle
habits including physical activity can be in-
cluded in the school curriculum, media adver-
tisements and other policy regulating actions
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er, S. G., and Luck-Sikorski, C. 2016.
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Individuals: A Systematic Review and
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424-441.

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Society and Adolescent Health Commit-
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www.euro.who.int/__data/assets/
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sheet_Diet.pdf%3Fua%3D1.

Issue No. 9 11
Knowledge, Attitude, and Practices on Protected Mealtimes
among Registered Nutritionist- Dietitians in Private
Tertiary Care Hospitals in Laguna
Tomee Vikki Lei R. Chua a *, Marie Faye R. Nguyen-Orca a, Irma U. Danao a
a
Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines, Los Baños, Laguna

* Corresponding author: tomeevikkileichua@gmail.com

ABSTRACT
Hospital meal environment is often overlooked in terms of patient nutrition care management.
Protect­ed Mealtime (PM) is an initiative done by some countries to promote proper meal practices
in the hospital, in turn curtail hospital malnutrition. The study aimed to determine the knowledge,
attitude, and practices (KAP) of registered nutritionist-dietitians (RNDs) on PM in the province of
Laguna. There were nine (9) identified tertiary care hospitals in the province and out of the 24 RNDs
employed, 19 agreed to be part of the study. A pretested questionnaire was then used to determine
the KAP on PM of the respondents. The RNDs in the study were mostly aged 20-35 years old.
Around half of the respondents (58%) knew about the concept of PM and that PM-like practices are
employed as measures to improve the nutritional status of admitted patients. Most (84.21%) of the
respondents believed that PM is an effective way to alleviate hospital malnutrition. However, 58%
thought that it is not an efficient program. Several barriers and challenges were also identified by the
respondents. PM is indeed perceived as a valuable practice to curb malnutrition in the hospital, but
some hurdles should still be addressed. Whatever the practice or initiative, it is vital to acknowledge
the existence of hospital malnutrition and to realize ways to diminish it.

Keywords: hospital meal environment, nutrition care, protected mealtime

INTRODUCTION Admitted patients often miss multiple meals due

Hospital malnutrition still remains and contin-
ues to exist as an unrecognized and underrated
problem. Because it is frequently ignored, there
is inadequate intervention, which later on lead to
the worsening of the patients’ nutritional status
during hospitalization. Malnutrition in patients is
primarily because of poor dietary intake due to
disease-related metabolic changes and patient
dissatisfaction with the food served (Domin-
guez, 2013). Most of the time, this mal­nutrition
problem is attributed to the hospital food while
the meal environment is often overlooked
(Hope, Ferguson, Reidlinger & Agarwal, 2016).
to feeling unwell or owing to the instructions of
medical procedures. This, fused with lack of
physical activity can lead to substantial mus-
cle loss during periods of immobility (Holmes,
2019), which make the patients more vulnerable
to malnutrition. Porter & Mitchell (2015) even
observed energy deficits in the intake of patients
in sub-acute care leading to nutritional decline
and longer lengths of stay. Several factors con-
tribute to hospital malnutrition that can either be
personal or organizational (Cheung, Pizzola &
Keller, 2013). In the study conducted by Domin-
guez (2013) in the Philippines, it was noted that
nutrition did not seem to be included as part of
the patients’ routine care as evidenced by the

12 January - December 2020

lack of improvement of the nutritional status of
those with malnutrition during the course of their
confinement.
Given that the present atmosphere at the wards
during mealtimes is distracting, with interrup-
tions such as taking blood samples that result
to poor food intake, Protected Mealtime (PM)
was initiated (Laur, McCullough, Davidson &
Keller, 2015). PM aims to address the prob-
lem of malnutrition in the hospital by increasing
positive interruptions (feeding assistance) and
minimizing unnecessary interruptions (rounds
and diagnostic procedures) during mealtimes
(Porter, Haines & Truby, 2017). This interven-
tion encourages hospitals to stop all non-urgent
clinical activity during mealtimes so that the pa-
tients could eat their meals without interruptions
(Cross & MacDonald, 2009). With PM, the im-
portance of mealtimes is emphasized with ded-
icated time for the service of food supporting
ward-based staff to concentrate on the nutrition-
al needs of patients at mealtimes (NHS, 2019).
Hospital staff, visitors, and volunteers can also
assist patients with their meals, if needed. Pos-
itive outcomes are documented. For instance, it
was noted that there was improved food intake
with additional staff, as well as just reorganizing
mealtime tasks to promote food intake (Young,
Mudge, Banks, Ross, & Daniels, 2013). Chang-
ing both the mealtime practice and dining envi-
ronment in hospitals can redefine mealtime as
an important nutritional activity (Edwards, Car-
rier& Hopkinson, 2017). PM changes the orga-
nizational structures of traditional mealtimes, to
establish positive mealtime experience and give
a better focus on the meal itself. PM is current-
ly implemented in the United Kingdom, Cana-
da, and Australia (Porter et al, 2017). In these
countries, nurses have been at the forefront of
this intervention. On the other hand, dietitians
who underwent specialized training in nutrition
are able to focus on assessment and identifica-
tion of patients at risk of malnutrition, resulting
in prevention of malnutrition, and improvement
Issue No. 9
of nutritional status (Holmes, 2019). Thus, it is
safe to say that dietitians are at the driving seat
in curbing hospital malnutrition. Given its execu-
tion and proven effectiveness in foreign coun-
tries, studying and researching about the pos-
sibility of its implementation in the Philippines,
based on the perspective of the professionals
mainly involved in this intervention, can open
this initiative to the Filipino public as a promising
approach to improve food intake.
The study aims to evaluate the knowledge, at-
titude, and practices (KAP) on PM of registered
nutritionist-dietitians (RNDs). This research can
then prove its effectiveness and efficiency as a
nutrition intervention in the Philippines, which
can later be applied to the hospital setting to
help improve the nutrition, health and well-be-
ing of the Filipino patient. The study is limited
to RNDs in private tertiary care hospitals in the
province of Laguna. The hospitals under study
were limited to that of members of the Private
Hospitals Association of the Philippines, Inc.
(PHAP, Inc.) to ensure that these are tertia-
ry-level hospitals.
METHODOLOGY
The study employed a descriptive cross-sec-
tional design. Data gathering was done using a
survey questionnaire containing both structured
and unstructured questions. The population of
the study are RNDs employed in private tertia-
ry-level hospitals in Laguna that are members
of the PHAP, Inc. There were nine (9) hospitals
that satisfied the criteria with a total of 24 RNDs
employed. Complete enumeration of the target
population was performed.
The survey questionnaire contained items to as-
sess the KAP of nutrition interventions in hospi-
tal settings. There were twelve (12) knowledge
questions aimed to assess the awareness on
the existence of malnutrition in hospitals, con-
13
tribution of hospitalization to malnutrition of pa-
tients, nutrition interventions in hospitals, caus-
es of poor food intake of patients, the concept
of PM and its implications. Whereas, twelve
(12) questions were included to determine the
attitudes of RNDs on the importance of uninter-
rupted mealtimes, the efficiency and effectivity
of PM if implemented, and lastly, PM imple-
mentation tailored to the Filipino culture. PM or
PM-like practices of RNDs were also evaluated
(12 questions). Aside from KAP questions, par-
ticipants were also asked about their perceived
advantages, disadvantages, barriers, and rec-
ommendations on the implementation of PM in
the Philippines. Pre-testing of the questionnaire
was done among RNDs of other tertiary care
hospitals to ensure the survey instrument’s va-
lidity, comprehensibility, and language appropri-
ateness.
The survey conducted followed the standards
set by the Declaration of Helsinki where the re-
spondents were asked for their informed con-
sent by explaining to them the scope of their in-
volvement, the risks and benefits, confidentiality
and most importantly that their participation is
voluntary and they can withdraw any time they
please.
RESULTS AND DISCUSSION
Participants
The KAP survey focused on the following issues
targeted by the PM initiative: hospital malnutri-
tion, nutrition interventions, mealtime practices,
mealtime interruptions, and food intake. The
questionnaire administered also aimed to gain
the opinion of the RNDs on PM. In the nine (9)
private tertiary-level hospitals in the province,
there was a total of 24 RNDs employed. Among
those, two (8.33%) were absent for the entire
duration of the study and three (12.5%) did not
give their consent to participate, making a total
of 19 respondents where there was only one
male respondent. Majority of the respondents
are comprised of young adults aged 20-35 years
old (84%) but there are some middle-aged re-
spondents as well (16%) as seen in Figure 1.

Data were encoded and statistically analyzed

using Microsoft Excel. Descriptive statistics
such as mean, standard deviation, minimum
and maximum values were used to describe de-
mographic characteristics and to determine the
KAP of the participants on PM. For knowledge,
each correct response to one of the 12 items
was valued as one, while incorrect responses
Figure 1. Age distribution of the RNDs employ­
were scored as zero. For attitudes, a score of 1
ed in the tertiary-level hospitals in Laguna
was given for strongly disagree, 2 for disagree,
3 for neutral, 4 for agree, and 5 for strongly
agree to items 1, 2, 4, 6, 9, and 10, while vice Knowledge, Attitude, and Practices on
versa of the score was given to items 3, 5, 7, 8, Protected Mealtimes
11, and 12. For practices (12 items), affirmative
responses were scored as one; otherwise they Twelve knowledge questions consisted of
were scored as zero. The frequencies of these items on hospital malnutrition, nutrition inter-
scores were then converted to percentages. ventions, mealtime practices and PM. Figure

14 January - December 2020

2 summarizes the results of the scores of the
respondents corresponding to PM knowledge.
Notably, 57.89% of the respondents knew
about PM. Moreover, 89.47% of the respon-
dents were implement­ing PM as an initiative
to improve the nutritional status of the patient.
Effective manage­ment of hospital malnutrition
entails an interdisciplinary team approach and
leadership that promote open communication
among disci­plines (Tappenden et al, 2013). As
follows, RNDs, as the nutrition experts, ought to
convey their knowledge about proper diet and
eating practices and suggest interventions such
Figure 2. Knowledge of RNDs on PM and its implications
Twelve PM-related attitude items among RNDs
were assessed in the study questionnaire. A
good number of respondents (83.89%) believed
that nutrition and mealtimes are important in
comparison to other demands and activities
such as taking medical drugs and diagnos-
tic tests (Table 1). In the same way, they be-
lieved that all non-urgent procedures should
be ceased while the patient is eating (84.22%).
Also, positive attitude was noted when asked
whether PM improves outcomes for hospital
Issue No. 9
as PM to reduce hospital malnutrition. They
have to edu­cate other staff, visitors, and peo-
ple that might be passing through the ward that
the patients’ mealtime is an important time. For
instance, in the study conducted by Huxtable &
Palmer (2013), foodservice staff was educated
on the significance of proper placing of meal
trays in patient’s side tables and delivering and
collecting trays in a way that maximized the time
provided to patients to eat. Knowledge transla-
tion is vital to foster cultural change in a way
nutrition is prioritized in the hospital (Cheung et
al, 2013).
patients (83.33%) and that PM is an effective
nutrition intervention (84.21%). However, only
57.90% believed that PM is an efficient nutri-
tion intervention. Interestingly, only 31.58% be-
lieved that patients eat more if uninterrupted. A
fair number of respondents perceived that PM
should be implemented in a manner tailored
to the Filipino culture (52.63%). The collective
attitude of RNDs towards the PM initiative may
have stemmed from the prioritization of nutrition
in the healthcare system. Xia & McCutcheon
15
(2006) ascertained that nutrition issues ap-
peared to receive less priority in the ward than
other nursing care activities. As described by
Ottrey et al, 2017, PM is an example of an inter-
vention that is not as straightforward as it may
seem. Due to the factors such as attitudes and
awareness, the environment, leadership and
time pressures, tensions may rise between the
delivery of patient centered care and the system
in which this care is being delivered (Ottrey et
al, 2017; Ottery et al, 2020). Having a positive
attitude towards PM is essential for it to work,
as this initiative focuses on what is in the best
interest of the patients.

Table 1. Attitude of respondents on PM

Percent (%)

Strongly Strongly
Disagree Neutral Agree
disagree agree

Comparable importance of nutrition and mealtimes to 0.00 0.00 11.11 38.89 50.00
diagnostic procedures
Cessation of non-urgent procedures during mealtime 0.00 0.00 15.79 42.11 42.11
Patients eat more food if uninterrupted 31.58 21.05 15.79 15.79 15.79
Patients should be allowed to eat their meals without 0.00 0.00 5.26 26.32 68.42
unnecessary interruption
Mealtimes should be protected in all hospitals 16.67 16.67 27.78 22.22 16.67
PM should be made available for patients and nursing 5.26 0.00 10.53 57.89 26.32
assistant
PM can be used to reduce food wastage 5.26 21.05 26.32 36.84 10.53
PM can be used to reduce patient complaints on 5.26 21.05 47.37 15.79 10.53
hospital food
PM improves outcomes for hospital patients 0.00 0.00 16.67 50.00 33.33
PM is an effective nutrition intervention 0.00 0.00 15.79 52.63 31.58
PM is an efficient nutrition intervention 5.26 10.53 26.32 47.37 10.53
PM should be implemented in a manner tailored to the 5.26 10.53 31.58 36.84 15.79
Filipino culture.

Twelve practice items in the questionnaire in-
cluded the usual procedures done by RNDs in
hospitals with PM. When assessed for PM or
PM-like practices, it was found that on the ave­
rage only 48.17% had ongoing practices (Fi­
gure 3). In relation to practices, 88.89% stated
that they protect all patient meal service. The
hospitals’ dietary departments being in charge
of patient food delivery, play an immense role
in protecting the patients’ mealtimes. The NHS
Foundation Trust (2019) stated that the timing
and content of meals are important elements
in supporting patients to eat well. In terms of
informing staff on protecting mealtimes, only
16.67% claim to be doing such a task. Under-
standably, most of the respondents do not per-
form tasks similar to those with PM or PM-like in
place in their hospitals. For instance, in the Mid
Essex Hospital, there is a mealtime preparation
bell which is rung at least 15 minutes before the
meal service that signals the nursing team to
prepare and inform the patients on the mealtime
and also alerts the other members of the team
that non-urgent activities should be stopped
and recommence only after the mealtime period
(Mid Essex Hospital Trust-NHS, 2018). In the
Philippines, the current practice is that the hos-
pital dietitian runs the dietary department of the
hospital where closest interface of this depart-
ment to an admitted patient is when the dietary

16 January - December 2020

staff delivers meal to patients which rarely en-
gage in any interaction. In most occasions, the
staff places the meal in front of the patient and
Figure 2. Practices of respondents that may enable PM
Insights on Protected Mealtimes
The participants were asked for their insights
and perceptions on the advantages, disad-
vantages, and barriers of PM as well as their
recommendations for implementation (Table
2). The respondents were well-aware of the
benefits of PM particularly that it improves the
eating patterns of patients that consequent-
ly may reduce the rate of hospital malnutrition
cases and also the duration of hospital stay of
the patients. On the other hand, the RNDs in
the study mentioned that PM may delay medi-
cal services (those that are deemed unneces-
sary by the initiative, such as diagnostic tests)
and may cause inconvenience to some hospital
staff. The perceived barriers were chiefly about
the reception and interests of those involved
in the practice including the patients and their
relatives, and the whole hospital staff. After all,
one of the main reasons why patients do not eat
Issue No. 9
leaves it there without doing anything else (Xia
& McCutcheon, 2006).
properly is because of the constant presence
of people at the bedside (relatives and friends,
maintenance and cleaners, phlebotomists and
physiotherapists, and doctors). The participants
recommended that PM must undergo meticu-
lous planning and methodical implementation. It
should be noted that, the practice of PM is not
only about informing through a display of sig-
nage outside the wards or about saying “we are
going to start protected mealtime.” More so, the
respondents mentioned that a proper informa-
tion dissemination mechanism must be in place
for extensive recognition of the initiative.
Clearly, implementation of PM initiatives needs
a thorough understanding of both the complex
healthcare and food service systems. Efforts tar-
geted to address inadequate food intake in the
hospital should depart from strategies that man-
age foodservice processes and nutritional care
as linear, instead, consider the complex interac-
17
tions that occur at mealtimes for patients’ nutri-
tional intake to improve (Ottrey, Porter, Huggins,
& Palermo, 2017). Mealtimes can be made en-
joyable and pleasant by allowing patients to eat
in a peaceful and undisturbed surrounding and
with the quiet environment, the staff can totally
focus on their patients’ eating needs. Economic
consideration is another constraint that should
be taken into account of. Managing hospital
malnutrition demands cost-effective planning
and administration in addition to robust evidence
of physical outcomes (Mitchell & Porter, 2015).
Ottrey and her associates (2018a) explored
the perspectives and experience of volunteers
and visitors on the hospital wards at mealtime
where they found that the hospital staff viewed
the volunteers and visitors as both assets, as
they contribute to patient care at mealtimes, and
liabilities because they inhibit patient progress
and staff work practices. For the hospital staff,
hospitals should have effect­ive inter-profession­
al collaboration. Healthcare organizations
should attempt to build a culture that supports
staff from different professions to work togeth-
er and prioritize mealtimes to improve nutrition
care (Ottrey et al, 2018b) because, PM can only
be successful with the combined efforts of the
healthcare team. Circumstances within the do-
mains of environmental context and resources,
social influences, social or professional role and
identity and behavioral regulation played a part
to the implementation process at the individual,
team and organization­al levels (Porter & Ottrey,
2018). Hospitals that had most success in exe-
cuting PM supplied comprehensive staff educa-
tion about the initiative and gained cooperation
and support from all levels of staff, from ward
to management, entailing reworking their priori-
ties around the mealtime periods (Cheung et al,
2013). In the review conducted by the National
Patient Safety Agency (NPSA) in 2007, it was
pointed out that the critical success factors of
the PM were the trust (hospital) policy, promo-
tion, communication and leadership (Pennine
Acute Hospitals HNS Trust, 2020). Moreover, a
multi-faceted system-level approach to nutrition
care, including changes to dietary and meal-
time practices was found to be associated with
measurable and sustained improvements in
nutrition­al intake (Young, Banks & Mudge,2018).

Table 2. Insights of the RNDs on the advantages, disadvantages, and barriers of PM and their
recommendations

Category Response
Advantages • can somewhat improve nutritional status of patients
• reduce the rate of hospital malnutrition cases
• give patients time to focus on eating without unnecessary interruptions
• develop healthy eating patterns
• eating behavior may be taken even after confinement
Disadvantages • tends to delay other medical services and procedures such as taking medicines and laboratory
tests
• maybe troublesome for most of the hospital staff
Barriers • Conflicting interests of patients, visitors (relatives), healthcare professionals and practitioners,
and the hospital staff
Recommendations • implementation must be planned thoroughly prior to widespread implementation
• there should be a team of healthcare professionals for this planning phase and it requires the
approval of the hospital administration
• if already in implementation phase, information dissemination must take place
• all hospital personnel must be aware of this initiative

18 January - December 2020

CONCLUSION AND
RECOMMENDATIONS
Nutrition is an important part of patient care.
PM is a hospital nutrition intervention initiative
in England, Australia, and Canada, that has yet
to be implemented in the Philippines. PM is a
patient-centered approach believed to be an ef-
fective measure against poor food intake, can
contribute to shorter hospital stay, and reduction
in patient malnutrition as it improves both meal-
time experiences and patient care. This study
aimed to evaluate the KAP on PM of RNDs in
private tertiary care hospitals. These param-
eters are believed to be essential to assess
the possible implementation of PM in the local
setting. This is the first study to be conducted
in hospitals in Laguna, Philippines for this aim.
The simplest form of nutritional support is just
to get patients to increase oral food intake.
Thus, it is the responsibility of RNDs, together
with other healthcare professionals and hospital
staff, to promote proper nutrition and to protect
mealtimes. The PM is a well-established initia-
tive from the UK where there is a different cul-
tural, social and economic condition compared
with the Philippines. Therefore, adaption of the
PM should also consider those differences pri-
or to implementation. Top management should
also be involved in this nutrition intervention to
improve overall hospital practices through the
creation of a policy and working environment
supportive of PM. For such, a total change man-
agement approach should be considered. The
study highlights that it is important not only to be
knowledgeable about hospital malnutrition and
mealtime practices, but also to have a positive
and agreeable attitude towards protecting meal-
times in order for it to be evident in the hospital
practices. Nutrition information dissemination
may need to be conducted more frequently
for an increase in awareness. Consequently,
healthcare professionals must be aware that
protecting mealtimes is done to plan adequate
nutrition interventions that enable an under-
standing of hospital malnutrition. In this way, all
possible nutrition interventions are exhausted to
Issue No. 9
achieve quality healthcare and to improve the
nutrition situation in the hospitals. Further study
can also be done on the relation of improved
nutrition situation, length of hospital stay, read-
mission and hospital cost. RNDs should incor-
porate the practices similar to PM in their daily
routines to better assist their patients. Although
RNDs play a valuable role in the development
and documentation of PM, they are only one
facet to consider when it comes to the imple-
mentation of PM in hospitals. The study was not
able to evaluate the ward team who has more
direct contact to the patients during the confine-
ment specifically during meal times. Further,
the Department of Health (DOH), as the over-
all steward and technical authority on health,
and being the national health policy-maker and
regulatory institution, should be tapped as it can
mandate the development of national plans,
technical standards, and guidelines on health.
In addition, further research must be done in
order to gain better understanding and a more
promising outcome to this nutrition intervention.
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and time to EAT: Improved nutritional
intake for older medical patients receiv-
ing protected mealtimes and/or addi-
tional nursing feeding assistance. Clin.
Nutr. 2013, 32, 543–549.

Weekes, C. E. (2008). The effect of protect-

ed mealtimes on meal interruptions,
feeding assistance, energy and pro-
tein intake and plate waste. Proceed-
ings of the Nutrition Society 67(OCE).
doi:10.1017/s0029665108007519

Xia, C., & McCutcheon, H. (2006). Mealtimes

in hospital ? who does what? Journal
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Young, A. M., Banks, M. D., & Mudge, A. M.

(2018). Improving nutrition care and in-
take for older hospital patients through
system-level dietary and mealtime

Issue No. 9 21
Assessment of Lactation Stations in the
University of the Philippines Los Baños
Jaidee P. Agne a *, Divine Grace C. Domingo b, Joan I. Delomen b, Leila S. Africa, PhD b
a
Science Education Institute, Department of Socience and Technology, Los Baños, Laguna
b
Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines, Los Baños, Laguna

* Corresponding author: jnpuertoagne@alum.up.edu.ph

ABSTRACT
The University of the Philippines Los Baños (UPLB) has expressed its support for breastfeeding
promotion and setting up of lactation stations through the issuance of Memorandum No. 017, Series
of 2017. Despite the administration’s unwavering support, many units in UPLB still face challenges
in establishing lactation stations. This study generally aimed to provide a basis for recommendation
in establishing lactation stations in UPLB. Specifically, it aimed to identify units in UPLB with lactation
stations, assess the provisions supplied by units, and identify potential barriers to the establishment
of lactation stations. The assessment, which involved 78 out of 119 UPLB units from different col-
leges and offices, found that awareness on breastfeeding promotion did not necessarily translate to
the presence of lactation stations. Only eight (8) units had established lactation stations and offered
provisions. Despite the interest of various units in setting up lactation stations, disinterest observed
in some units were due to the lack of space, absence of plan or proposal, individual offices already
serving as lactation space, limited facilities, and few possible end-users. Overall, units with lactation
stations were able to offer provisions and amenities that made them operational, although these still
need further improvement. Hence, funding priorities must focus on units with existing lactation sta-
tions to improve provisions and amenities.

Keywords: breastfeeding, lactation station, readiness

INTRODUCTION administration of Chancellor Fernando C. San-

The establishment of lactation stations, along
with the proper dispensation of lactation station
provisions, is an integral component of breast-
feeding promotion in the workplace. The work-
place plays an important role in the successful
transition of lactating mothers from postpartum
to work resumption. In the Philippines, private
and public establishments are mandated to pro-
vide breastfeeding support to lactating women
through the implementation of Republic Act
(RA) No. 10028, also known as the “Breast-
feeding Promotion Act of 2009.” The University
of the Philippines Los Baños (UPLB), under the
chez, Jr., has also conveyed its support through
the issuance of Memorandum No. 017 in Feb-
ruary 2017. The memorandum encouraged all
UPLB units to establish lactation stations and
enhance the information dissemination cam-
paign on the benefits of breastfeeding, in sup-
port of the Magna Carta of Women (RA 9710)
and RA 10028 (Arana, 2017).
According to the World Health Organization, ex-
clusive breastfeeding for the first six months of
a child’s life is fundamental to achieve optimal
growth, development, and health (National In-
stitute of Child Health and Development, 2018).

22 January - December 2020

Breastfeeding offers various benefits to the
mother as well, such as reduced risk of ovarian
and breast cancer, postpartum weight loss, and
delayed onset of post-partum period. Hence,
positive workplace support is likely beneficial
to both mother and child. Local research has
shown that workplace support through lactation
stations influences breastfeeding duration of
mothers with young children (Ocampo-Guirin-
dola and Valdeabella-Maniego, 2018). Through
designated lactation areas, mothers are able to
express milk to provide for their child at home,
sustain milk supply, and relieve the discomfort
of a full breast (International Labor Organiza-
tion, 2015). Meanwhile, employers who support
breastfeeding also benefit from the presence of
a lactation station in terms of improved female
employee retention after maternity leave, earlier
and easier transition from postpartum to work
resumption, lower employee absenteeism and
health costs due to better child health, improved
management-employee relationship, increased
job productivity, and better employee satisfac-
tion (International Labor Organization, 2012).
Despite the growing evidence supporting the
positive implications of workplace support on
continued breastfeeding of lactating female em-
ployees, the establishment of lactation stations
and dispensation of provisions face serious
challenges in the university setting. Across the
United States, not all colleges and universities
have designated spaces for breastfeeding and
most do not even have lactation policies (Bos-
tick et al., 2016).
Seemingly, legislation and policies are not
enough to effect change in the workplace. Fac-
tors that affect workplace capacity to set up
lactation stations must also be identified to find
an appropriate solution in terms of support and
implementation.
In this context, the purpose of this assessment
was to provide a basis for recommendation in
establishing lactation stations in UPLB. Essen-
tially, assessment results will assist the UPLB
Issue No. 9
administration in identifying the needs and re-
quirements of each unit to set up a lactation sta-
tion for possible future funding. More specifical-
ly, the study aimed to determine the UPLB units
with lactation stations, identify lactation station
provisions offered by UPLB units, and identify
potential barriers to the establishment of lac-
tation stations and dispensation of provisions
across UPLB units.
METHODOLOGY
Study population and sampling method
The target population consisted of UPLB units
that have childbearing female employees while
unit per office/college served as the unit of
analysis. The sampling frame used involved a
list of UPLB units with childbearing female em-
ployees aged 15-45 years old provided by the
Human Resource and Development Office.
Furthermore, to facilitate the conduct of the
assessment, the Office of the Chancellor (OC)
released Memorandum No. 051, Series of 2019
calling for the participation of all units. Respon-
dents were selected using purposive sampling,
which involved the enumeration of UPLB units
having female employees aged 15-45 years old.
The number of female employees and location
of UPLB units were taken into consideration in
selecting the sampling frame. The exclusion cri-
teria for this study were as follows: units with
few female employees and units located outside
the campus. Out of 119 UPLB units, 78 (65.5%)
participated in the assessment (Table 1).
Data Collection
The study administered a descriptive cross-sec-
tional survey to the sampling population to as-
sess existing lactation stations in their respective
areas. Data collection was conducted from May
to July 2019 using the paper-and-pen survey
method. Each unit was represented by a unit
head or representative. A two-page question-
23
naire was used to obtain the unit’s information,
composition, awareness on RA 10028, presence
of lactation stations, lactation station provisions
offered, and barriers to the installation of lacta-
tion station. The questionnaire was pretested
prior to the conduct of research. The question-
naire was divided into four parts, as follows: A)
Personal Information, B) Composition of Unit, C)
Establishment of Baby-Friendly Workplace, and
D) Comments and Recommendation. Questions
developed were adopted from the Department of
Health’s (DOH) lactation station accreditation list
form. A combination of open-ended, closed-end-
ed, and multiple-choice questions were used to
assess UPLB units with and without lactation
stations.

Table 1. Percentage of UPLB units that participated in the assessment

No. of Units No. of Units

College/ Office per college/ who %
office participated
1. College of Agriculture and Food Science (CAFS) 14 9 64.3%
2. College of Arts and Sciences (CAS) 12 7 58.3%
3. College of Development Communication (CDC) 7 3 42.9%
4. College of Engineering and Agro-Industrial Technology (CEAT) 11 8 72.7%
5. College of Economics and Management (CEM) 7 4 57.1%
6. College of Forestry and Natural Resources (CFNR) 13 7 53.8%
7. College of Human Ecology (CHE) 6 4 66.7%
8. College of Public Affairs and Development (CPAF) 5 5 100.0%
9. College of Veterinary Medicine (CVM) 8 3 37.5%
10. Graduate School (GS) 1 0 0.0%
11. Office of the Chancellor (OC) 6 3 42.9%
12. Office of the Vice Chancellor for Administration (OVCA) 6 4 66.7%
13. Office of the Vice Chancellor for Academic Affairs (OVCAA) 7 6 85.7%
14. Office of the Vice Chancellor for Community Affairs (OVCCA) 5 5 100.0%
15. Office of the Vice Chancellor for Planning and Development (OVCPD) 5 5 100.0%
16. Office of the Vice Chancellor for Research and Extension (OVCRE) 5 4 80.0%
17. School of Environmental Science and Management (SESAM) 1 1 100%
TOTAL 119 78 65.5%

Data Analysis establishing lactation stations. Hence, the total

Data were analyzed using WPS Office Spread-
sheet. Frequency and percentage counts were
used to analyze the results of close-ended
questions. For open-ended questions, a mul-
tiple response format was employed to deter-
mine the lactation station provisions offered by
UPLB units and identify potential barriers to
number of responses is more than the number
of respondents. Responses to the open-ended
questions were summarized and coded based
on similarities. All responses with the same
meaning were grouped into a single category.
Data were then processed and proportions an-
alyzed.

24 January - December 2020

RESULTS AND DISCUSSION
Profile of UPLB Units
In terms of employee size, majority (75.6%) of
UPLB units were classified as medium-sized,
with 10 to 100 employees (Table 2). In terms of
the number of childbearing female employees
within reproductive age, almost three-fourths
(74.4%) of UPLB units surveyed only have 1 to
9 regular female employees fitting the criteria,
16.7% have 10 to 19 female employees, and
only 9% have 20 to 29 female employees.
Table 2. Percentage distribution of UPLB units
disaggregated by unit characteristics (i.e., clas-
sification by employee size and number of fe-
male employees), 2019
n (%)
Characteristics of UPLB Units (n=78)
A. Employee Size
Small (less than 10 16 (20.5%)
employees)
Medium (10 to 100 employees) 59 (75.6%)
Large (200 and more employees) 2 (2.6%)
No response 1 (1.3%)
B. Number of childbearing age female employees
1 to 9 58 (74.4%)
10 to 19 13 (16.7%)
20 to 29 7 (9.0%)
Awareness on the Enhanced Breastfeeding
Promotion Act and Presence of Lactation
Station in UPLB Units
The findings of this study showed that the uni-
versity’s deliberate efforts in breastfeeding
promotion seemed to have paid off in terms of
awareness. Regarding awareness on RA 10028
or the Expanded Breastfeeding Promotion Act,
which provides for the establishment of lactation
stations, almost half (47.9%) of UPLB units were
informed of the said law (Figure 1). In a study
conducted by Ramirez et al. (2017), awareness
Issue No. 9
is identified as one of the facilitating factors in
the implementation of the said law.
In a previous assessment conducted among fe-
male employees and students in the university,
female respondents recognized the importance
of breastfeeding and setting up of lactation sta-
tions. Only a few functional lactation stations,
however, are available in the university. Similar
findings were observed among colleges and
universities across the United States. Aside
from the lack of designated space for lactation
stations in US colleges and universities, majori-
ty do not have lactation policies as well (Bostick
et al., 2016).
Figure 1. UPLB units’ awareness on RA 10028
and presence of lactation station (N = 119)
According to RA 10028, lactation stations are pri-
vate, clean, sanitary, and well-ventilated rooms
or areas in the workplace or public places where
nursing mothers can wash up, breastfeed, or
express milk. This study revealed that only eight
(8) out of 78 UPLB unit-respondents have ex-
isting lactation stations (Table 3). UPLB units
with lactation stations were the following: (1)
College of Arts and Science – Institute of Com-
puter Science; (2-3) College of Human Ecology
– Department of Social Development Services
and Institute of Human Nutrition and Food; (4)
25
Office of the Vice Chancellor for Administration
– Supply and Property Management Office; (5)
Office of the Vice Chancellor for Academic Af-
fairs – Learning Resource Center; (6-7) Office
of the Vice Chancellor for Community Affairs –
University Health Service and Business Affairs
Office; (8) and Office of the Vice Chancellor for
Planning and Development – Land Grant Man-
agement Office.
Table 3. Number and percentage of UPLB
units with lactation station per college or office
for lactation stations, the management still sup-
ports breastfeeding promotion initiatives in the
workplace. Lactating mothers were allowed to
express their milk and have lactation breaks.
Similar findings were also observed among
non-hospital employers and companies in New
Jersey and Michigan (Bai et al., 2015; Hojnacki
et al., 2012). While this may be the case, set-
ting up lactation stations is not as complicated
as it seems. Offices can adopt different lacta-
tion station prototypes despite the absence of
a designated room while still meeting the basic
requirements.

No. of Total Num-

College/ Units with ber of Unit Percent- Lactation Station Provisions Offered
Office Lactation Respon- age
Station dents
1. CAFS 0 9 0%
Figure 2 illustrates the lactation station ameni-
ties provided by UPLB units. Although only eight
2. CAS 1 7 14%
(8) UPLB units had lactation stations, 11 units
3. CDC 0 3 0%
(including those without a designated lactation
4. CEAT 0 8 0%
station) stated that they offer provisions. Major-
5. CEM 0 4 0% ity of these units have corner areas with pro-
6. CFNR 0 7 0% vision for privacy (90.9%); are well-ventilated,
7. CHE 2 4 50% well-lighted, and free from harmful substances
8. CPAF 0 5 0% (60.0%); and have handwashing facilities and
9. CVM 0 3 0% electrical outlets (60.0%). Further, only half of
10. GS 0 0 0% UPLB units (50.0%) with facilities for lactation
11. OC 0 3 0% stations have a breastfeeding policy posted in-
side the room, while only a few (30.0%) have
12. OVCA 1 4 25%
cooling units exclusively for pumped breast
13. OVCAA 1 6 17%
milk. Some respondents also mentioned that
14. OVCCA 2 5 40%
they were not aware (10%) of the basic provi-
15. OVCPD 1 5 20%
sions.
16. OVCRE 0 4 0%
17. SESAM 0 1 0% Among the basic lactation station provisions,
breastfeeding policy is one of the contributing
factors to the successful implementation of
Despite the low number of lactation stations in
lactation stations. It is also essential to guide
the university, some UPLB units were found to
end-users on the provisions and usage of lac-
offer lactation station provisions in the absence
tation stations. Findings revealed, however,
of a dedicated private room for breastfeeding
that only few UPLB units have breastfeeding
employees. In relation to this, some units have
policy posted. Posting of breastfeeding policy
a private corner area for milk expression. Appar-
is particularly important since it constitutes a
ently, this setup is not uncommon at all. This im-
form of communication between employers and
plies that despite the lack of a dedicated space
employees on breastfeeding initiatives. It also

26 January - December 2020

validates support from the management, secure
the rights of lactating employees, and influence
initiation rates of breastfeeding among work-
ing mothers (Dodgson et al., 2004; Chen et al.,
2006). Hence, to have an effective breastfeed-
ing policy, it is essential to develop a detailed
policy incorporating schedule, frequency of us-
age, and responsibilities of stakeholders in the
maintenance of the said facility (Payton et al.,
2019). In terms of location, results of the as-
sessment showed that some lactation stations
were located near toilet facilities. In the past,
the inappropriate practice of arranging toilet fa-
cilities as lactation stations sparked indignation
among lactating mothers due to the exposure
of mother and child to unsanitary feeding envi-
ronment. Hence, the relocation of lactation sta-
tions should be considered if it is near or inside
a toilet facility. Other provisions identified in this
study include provisions for electrical outlets,
handwashing facilities, and cooling units, which
are also essential amenities to ensure clean and
hygienic pumping and storage of breast milk.
Figure 2. Basic lactation station provisions of-
fered by UPLB units with and without lactation
station.
Results revealed that other provisions were
also supplied, including the conduct of seminars
encouraging mothers to breastfeed (30.0%),
implementation of lactation breaks (20.0%),
breastfeeding orientation (10.0%), and pres-
ence of breastfeeding support group (10.0%).
Overall, UPLB units with lactation stations were
able to offer provisions and amenities that made
Issue No. 9
the stations operational, although these still
need further improvement.
Despite the absence of lactation stations in
most UPLB units, more than half of respondents
(52.5%) expressed their interest in setting up
lactation stations. Some even indicated possi-
ble lactation station provisions that they hoped
to offer. Likewise, majority of respondents indi-
cated their desire to provide a designated area
with handwashing facilities, cooling units, and
furniture. Other interested units, however, in-
dicated that they still need the management’s
approval.
Potential Barriers of Establishing Lactation
Stations
Some UPLB units (22.7%) indicated that they
were not keen on setting up lactation stations
because of inadequate room and spaces
(37.0%), no plan or proposal on installation
of lactation stations (25.9%), limited facilities
(3.7%), individual offices already serving as lac-
tation stations (3.7%), and low number of pos-
sible end-users due to employees having older
children or no children at all (3.7%). In the as-
sessment, reasons for disinterest revealed the
units’ priorities in terms of structural capacity.
On the positive side, more than half of UPLB
units wanted to have their lactation stations ac-
credited.
The limited structural capacity of units was one
of the major factors that hinder the establish-
ment of lactation stations. This was also ob-
served in similar studies by Brown et al. (2001),
Libbus and Bullock (2002), Writters-Green
(2003), and Dunn et al. (2004) (as cited in Bai
et al., 2012). Hence, to promote breastfeeding
practices in the workplace, it is essential to re-
organize physical facilities and workplace set-
ting. Physical facilities are not only limited to the
provision of a private designated area, but also
include amenities discussed earlier. Lack of fa-
cilities is also considered a barrier to creating a
27
mother-baby friendly environment, as observed
in multiple studies by Brown et al. (2001), Lib-
bus and Bullock (2002), Writters-Green (2003),
and Dunn et al. (2004) (as cited in Bai et al.,
2012). It is also important to consider, however,
that the capacity of the unit to set up a lactation
station and provide amenities is also affected by
financial constraints (Siregar et al., 2019).
Furthermore, the absence of plans or proposals
to set up lactation stations supports the previ-
ously discussed notion that the awareness of
university management and stakeholders on
breastfeeding legislation did not necessarily
translate to compliance. In an integrative re-
view, organizational factor is one of the barriers
to successful implementation of baby-friendly
initiative in the hospital, community, and neona-
tal intensive care unit settings (Semenic et al.,
2012). Similarly, in units with no plans of estab-
lishing lactation stations, lack of administrative
support in terms of organizational priority at the
unit level may have been a contributing factor
(Semenic et al., 2012). It should also be noted
that establishments can avail of a two-year ex-
emption from establishing lactation stations if
there are no lactating or pregnant employees
and no female clients visit or transact with the
establishment (Department of Labor and Em-
ployment, 2015). Indeed, the exemption from
establishing lactation stations due to low or
no end-users justified the lack of plan of some
UPLB units. Interestingly, a similar study con-
ducted among managers of private and public
companies in Brazil also indicated that lack of
demand in terms of end-users influences the
need for setting up lactation stations (Fernandes
et al., 2016). Hence, if there is no demand, there
is no need to set up one. Considering the to-
pography of the university, setting up of lactation
stations in all units may not be feasible due to
inaccessibility. Meanwhile, some units seemed
indifferent to the idea of a designated lactation
room since they already have been practicing
shared breastfeeding spaces, wherein lactating
mothers can express milk in offices shared with
28
colleagues. Apparently, this is a common setup
in units with limited space. In a study conducted
by Fernandes (2016), employers stressed that
the solution for limited space is the adoption of a
multipurpose space; hence, a room that is not in
use can also serve as a lactation station.
Overcoming potential barriers paves the way to
the installation of lactation stations with ameni-
ties that can be utilized by stakeholders. In a
study conducted by Ocampo-Guirindola and
Valdeabella-Maniego (2018), workplace support
through the utilization of lactation stations had
significant positive influence on breastfeeding
duration of mothers with young children. Having
a designated lactation station also allows work-
ing mothers to express milk to provide for her
child at home, sustain milk supply, and relieve
the discomfort of a full breast (International La-
bor Organization, 2015).
The study also found that UPLB units had di-
vided thoughts on accrediting lactation stations.
Results revealed that 45 (37.8%) UPLB units
were interested in applying for a mother-baby
friendly workplace certification granted by the
DOH, in partnership with World Vision. The said
certification aims to promote and encourage
breastfeeding in both private and public sec-
tors. Under the certification, a lactation station
should meet certification criteria and standards
defined by the DOH (Official Gazette, 2012).
The remaining 16 (13.4%) UPLB units that were
not interested in accreditation stated that it was
not among their priorities due to limited and
temporary space, management directive (i.e.,
should be at the college-level implementation),
absence of facility, no current set-up, inessen-
tiality, and limited awareness on accreditation.
Overall, while the assessment extracted es-
sential data to establish an initial understand-
ing of the needs and perceptions of UPLB units
on the installation of lactation stations, the lack
of local studies related to lactation stations in
the university setting is considered a limitation.
January - December 2020
This could have been helpful in enriching the
discussion in this paper. In general, the study
identified eight (8) UPLB units with lactation sta-
tions and three (3) additional units that offered
provisions despite the absence of a designated
lactation station. The basic lactation station pro-
visions supplied by these units included corner
areas with provision for privacy; well-ventilated,
well-lighted rooms that are free from harmful
substances; handwashing facilities and elec-
trical outlets; posted breastfeeding policy; and
cooling units. For some units with no lactation
stations, the potential barriers to dispensing
lactation station provisions included inadequate
space, absence of plans or proposals, limited
facility, presence of a makeshift lactation area,
and low number of possible end-users.
CONCLUSION AND
RECOMMENDATIONS
Despite the high level of awareness on lacta-
tion stations in UPLB, only a few units of the
university have established such private spaces
for nursing mothers. The absence of a designat-
ed lactation station notwithstanding, some units
managed to supply lactation station provisions
(e.g., designating private corner areas that
are well-ventilated, well-lighted, and free from
harmful substances; availability of handwashing
facilities, cooling units, and electrical outlets;
and posting breastfeeding policy). Various fac-
tors, however, influenced the units’ capacity to
set up lactation stations. Inadequate space, lack
of plan, shared lactation area, limited facilities,
and few possible end-users were identified as
constraints in this study. Given these findings, it
can be concluded that several UPLB units have
installed a sustainable lactation station setup.
Despite this, stakeholders cannot not fully utilize
the station due to limited facilities. It is apparent
that the limitations faced by lactation stations
in the university also reflect the potential bar-
riers identified by units without lactation sta-
tions. Hence, study results suggest that funding
Issue No. 9
priorities should be geared towards providing
assistance to existing lactation stations for the
enhancement of amenities, accreditation, and
installation of basic lactation station prototypes
in accessible areas with the largest number of
stakeholders.
In terms of lactation station installation in the
university, UPLB units with limited space can
adopt DOH lactation station prototypes based
on their structure and capacity. However, it is
still advised that large universities install sev-
eral lactation stations to minimize walking dis-
tance (International Labor Organization, 2015).
Hence, establishing common lactation stations
in areas with the largest number of stakehold-
ers is preferred. Furthermore, it is also ideal
that lactation stations should not be more than
five minutes of walking distance (Basu, 2012).
Finally, lactation stations must satisfy DOH re-
quirements, and the accreditation of existing
lactation stations in the university as part of the
Mother-Baby Friendly Workplace Initiative is an
important step towards this direction.
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nal of Human Lactation, 28(3), 317-334.

Issue No. 9 31
Relationship of Personal Hygiene Score with Sex,
Nutritional Status, Morbidity, and Academic Grades
Among Primary Grade School Children in a
Public Elementary School in Pila, Laguna
Paul Alteo A. Bagabaldo a *, Marie Rose A. Bonifacio b, Marjorie Anne A. Layosa a, Ann C. Cayetano a,
Leila S. Africa, PhD a
a
Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines, Los Baños, Laguna
b
School of Engineering and Technology, Northwestern Mindanao State, College of Science and Technology

* Corresponding author: pabagabaldo@up.edu.ph

ABSTRACT
Poor hygiene is one of the indirect causes of undernutrition especially in low-resource settings.
Undernutrition has been linked with low academic performance among schoolchildren; however,
limited evidence exists on the relationship between personal hygiene and children’s academic
grades, particularly in local settings. Thus, the present study aimed to determine the association
among personal hygiene score (PHS), sex, nutritional status (NS), morbidity profile, and academic
grades of schoolchildren. The study randomly selected 85 primary grade school children attending a
government elementary school in Pila, Laguna. The PHS of students was assessed using a pre-tested
questionnaire; data on socio-demographics, water source, and toilet facilities were obtained from the
parents; and anthropometric measurements and academic grades were obtained through secondary
sources. Appropriate tools and statistical analyses were applied using 90% level of confidence.
Results showed that PHS was significantly associated with sex, with very good PHS observed more
frequently among females than males (42.9% vs. 29.6%). Conversely, no significant association was
seen between PHS and academic grades, and between academic grades and all three indices of NS.
Notably, PHS was significantly associated with some hygiene-related morbidities, particularly cough
and cold, head lice, headache, and dental carries. PHS also had a moderate strength of relationship
with BMI-for-age index (rs value of 0.510), wherein significantly associated hygiene practices include
use of soap in handwashing, use of toothbrush with toothpaste, and handwashing after eating.
Despite the lack of strong association between PHS and academic grades, personal hygiene should
still be given importance in designing school-based interventions aimed towards improving overall
health and learning capabilities of primary grade school children.

Keywords: academic grade, hygiene-related morbidity, nutritional status, personal hygiene, school
children

INTRODUCTION four sub-forms of undernutrition: wasting (low

Undernutrition is a type of malnutrition that is
directly related to inadequate dietary intake and
infectious diseases. It is influenced by three
broad factors: food, health, and care. There are
weight-for-height), stunting (low height-for-age),
underweight (low weight-for-age), and deficien-
cies in vitamins and minerals, all of which make
children more vulnerable to disease and death
(World Health Organization [WHO], 2020). All

32 January - December 2020

forms of undernutrition are estimated to contrib-
ute to 3.1 million child deaths each year, equiv-
alent to 45% of deaths among children less
than 5 years of age (WHO, 2015). Undernutri-
tion prevalence, particularly for underweight,
wasting, and stunting, is increasing alarmingly
both in local and global settings. Global data
show 6.9% prevalence for wasting and 21.3%
prevalence for stunting among children under
five years old (United Nations Children’s Fund
[UNICEF], 2020). In the Philippines, the prev-
alence of underweight, stunting, and wasting
among schoolchildren in 2018 were reported
at 25.0%, 24.5%, and 7.6%, respectively (Food
and Nutrition Research Institute, 2018).
Undernutrition is indirectly caused by low ma-
ternal education and improper child care, lack
of access to healthcare services, and poor envi-
ronmental conditions, such as poor cleanliness,
water, sanitation, and hygiene (WASH) prac-
tices (UNICEF, WHO, and World Bank, 2013).
Disease spreads quickly, especially when no
safe and sufficient water is available for use,
handwashing facilities are not available, and
toilets are in poor condition (WHO, 2015). This
could cause diseases, such as cholera, intesti-
nal worms, and diarrhea, which tend to inhibit
the absorption of nutrients by the body, leading
to undernutrition and compromised immunity
(Mshida, et al., 2018).
The association between diarrhea and other en-
teric infections and child nutritional outcomes is
complex, but a recent analysis of cohort data
suggested that repeated diarrhea incidence in
the first two years of life significantly increases
the risks of being stunted (Dangour et al., 2013).
Several studies also suggested that proper
hygiene and sanitation practices and sustain-
able access to WASH facilities could promote
improved nutritional status and reduced sus-
ceptibility to infections and morbidities among
schoolchildren (Haque et al., 2014; He et al.,
2018; Manzoni et al., 2019; Rah et al., 2015).
Moreover, a large-scale study with 1.1 million
children under five years of age from 70 low-
and middle-income countries showed that ac-
Issue No. 9
cess to improved water and sanitation was as-
sociated with lower mortality and reduced risk of
child diarrhea and mild or severe stunting (Fink
et al., 2011).
With all ages susceptible to disease, undernutri-
tion and compromised immunity are particularly
detrimental to the health of school-age children,
who spend long hours in schools and in play-
grounds. Thus, access to WASH services is an
essential element of a healthy community, which
has a positive impact on nutrition and therefore
on the learning performance of children. The
positive impact of WASH practices and/or inter-
ventions on health and nutritional outcomes lies
in the interruption of transmission of fecal patho-
gens from the environment to humans, water
sources, agricultural fields, and contaminating
fly populations (WHO, 2015).
In the Philippines, notable progress has been
made to improve access to WASH services, in-
cluding the issuance of Department of Educa-
tion Order (DO) No. 56, s. 2009, titled “Imme-
diate Construction of Water and Hand Washing
Facilities in All Schools for the Prevention of
Influenza A (H1N1),” and DO No. 65, s. 2009,
titled “Implementation of the Essential Health
Care Program (EHCP) for the School Children.”
These were issued to institutionalize good
health and hygiene practices among students,
especially since WASH interventions in school
intervention programs are among the promising
strategies in combating undernutrition and mor-
bidity among children (Darvesh et al., 2017).
However, significant steps are still needed to be
taken to address the needs of very poor and vul-
nerable populations in far-flung areas.
Achieving optimal nutritional status entails pro-
vision of not only adequate food and care, but
also of a healthy environment, which includes
interventions involving proper WASH practic-
es and services that promote a clean and safe
environment, leading to an increased access
to better quality of life and education (WHO,
2009). Several studies have shown the nega-
tive effects of undernutrition on academic per-
33
formance among schoolchildren (Acham et al.,
2008; Ghosh et al., 2013; Haile et al., 2016; Iz-
idoro et al., 2014; Shaw et al., 2015; Naelga and
Doncillo, 2016; Abebe et al., 2017). However,
limited evidence exists on the relationship be-
tween personal hygiene and children’s nutrition-
al status and academic grade, particularly in the
local setting. Thus, the present study aimed to
assess the socio-demographic profile, personal
hygiene score (PHS), nutritional status, morbidi-
ty profile, and academic grade of schoolchildren
attending a government elementary school in
Pila, Laguna and to determine the association of
these factors with the academic grades of chil-
dren. Study results could contribute to filling this
knowledge gap in the local setting and serve as
baseline data in designing school-based inter-
ventions to augment understanding of the po-
tential effects of WASH-related interventions in
improving schoolchildren’s health and learning
capabilities in resource-constrained settings.
METHODOLOGY
Study Design and Sampling Procedure
The study is a cross sectional survey conducted
among primary grade school children aged six
to nine years old in a government elementary
school in Pila, Laguna. At the time of data collec-
tion, the school has a total of 229 primary grade
school students between six to nine years old
(grade levels I to III). Simple random sampling
was used in selecting study respondents. The
computed sample size was 85 students, derived
using the formula n = [Npq / (N/D2) + pq], where
p is 0.5, margin of error is 7%, and level of con-
fidence is 90%. Exclusion criteria were adopted
to rule out the participation of children not within
six to nine years of age and those who have
communicable and other genetic diseases.
Ethical Considerations
Since the study involved obtaining data from hu-
man participants, several considerations were
34
applied to protect and ensure their dignity and
welfare. These include asking permission from
the elementary school to conduct the study and
obtaining informed consent from the parents
of the respondents. The children and/or their
guardians were given the choice to decline par-
ticipation at any time. Since the subjects were
six to nine years old, only verbal assent from the
children were secured by the researchers.
Data Collection Procedures
A pre-tested questionnaire modified based on a
related study by Deb et al. (2010) was used to
evaluate the PHS of the primary grade school
children. Data on hygiene practices, state of
personal cleanliness, and presence of some
morbidity among the children were obtained by
basic examination of children’s overall health
and physical appearance and interviews with
the children and their parents and/or guard-
ians. These data were collected first thing in the
morning before the start of their classes to avoid
confounders. The state of personal hygiene of a
respondent was scored either 0 (unfavourable)
or 1 (favourable), while practices related to per-
sonal hygiene were scored 0 (never practiced),
1 (practicing 1-3 times per week), or 2 (practic-
ing 4-7 times per week). PHS was then com-
puted by getting the sum of all scores obtained
by the respondent and interpreted using the
following scale: 0-5 points (poor), 6-10 points
(fair), 11-15 points (good), and 16-20 points
(very good).
Other information such as birth dates and ac-
ademic grades were obtained from school re-
cords, while anthropometric measurements
were provided by another researcher who had
measured these following standard protocols.
Moreover, data on household socio-demo-
graphics, water source, and toilet facilities were
obtained using a separate pre-tested question-
naire directed towards the parents or guardian
of the children. To avoid respondent bias, data
collection was administered through personal
interviews with the children and/or their parents
January - December 2020
and probing was done whenever necessary.
Data collection was done from November to De-
cember 2016. Data obtained were processed
and encoded using MS Excel with PH Stat and
MegaStat add-ins. WHO AnthroPlus software
was used to calculate the z-scores and to deter-
mine the nutritional status of students.
using deep well as source of water for bath-
ing and washing dishes and clothes (55.3%).
For toilet facility, more than half of households
(52.7%) used the pour-flush type while more
than a quarter (26.3%) practiced open-pit toilet
system.

Statistical Analysis Table 1. Socio-demographics, water source,

and toilet facilities of primary grade school chil-
The characteristics of the primary grade school dren and their households.
children were summarized using descriptive
statistics. Data obtained were analyzed using Distribution of the respondents by age

Chi-square test to determine the association 6 years old 27.1%

between sex and nutritional status; sex and 7 years old 28.2%
personal hygiene score; nutritional status and 8 years old 35.3%
state of personal hygiene/hygiene practices; 9 years old 9.4%
and PHS and presence of hygiene-related mor- Distribution of the respondents by grade level
bidities. Cramer’s V coefficient was used to de- Grade I 27.0%
termine the strength of association. Moreover,
Grade II 31.8%
Spearman’s rank order correlation coefficient
Grade III 41.2%
was calculated to determine the degree of re-
Distribution of the respondents by sex
lationship between PHS and nutritional status;
Male 50.6%
nutritional status and academic grade; and PHS
and academic grade Female 49.4%
Educational attainment of household breadwinner
College graduate 7.9%
RESULTS AND DISCUSSION Vocational course 5.3%
Highschool graduate 68.4%
Characteristics of Primary Grade School Highschool undergraduate 7.9%
Children and their Households Elementary graduate 2.6%
Elementary undergraduate 5.3%
The elementary school comprised two sections
Monthly household income
for grade levels I and II and three sections for
10,000 pesos and below 65.8%
grade level III. A total of 229 students were
10,001 – 30,000 pesos 34.2%
between 6-9 years old, from which 85 stu-
dents were randomly selected. Table 1 shows Water source for drinking

the information on socio-demographics, water Tap water 15.8%

source, and toilet facilities of respondents and Purified water 84.2%
their respective households. Respondents were Water source for washing
composed of a fairly equal number of male and Tap water 44.7%
female children at 50.6% and 49.4%, respec- Deep well 55.3%
tively. Majority of household breadwinners were Toilet facility
high school graduates (68.4%) and earning PhP
Water-flush 18.4%
10,000 and below monthly (65.8%). Most were
Pour-flush 52.7%
drinking water from purified sources (84.2%);
Open-pit 26.3%
however, more than half of households were
Others 2.6%

Issue No. 9 35
Nutritional Status of Primary Grade School
Children
Figure 1 shows the nutritional status of prima-
ry grade school children according to BMI-for-
age, weight-for-age, and height-for-age indi-
ces. Among respondents, majority had normal
BMI-for-age (88.2%), weight-for-age (68.2%),
and height-for-age (71.8%). However, wasting
(7.1%), severe wasting (1.2%), and overweight
(3.5%) were still present among the children.
Based on weight-for-age, 21.2% of children
were classified as underweight, 9.4% as se-
verely underweight, and 1.2% as overweight.
Stunting and severe stunting were also present
at 21.2% and 7.0%, respectively.

Figure 1. Nutritional status according to BMI-for-age, Weight-for-age, and Height-for-age of

Primary Grade School Children

Cleanliness and Personal Hygiene Practices use and before eating for at least 4-7 times a
of Primary Grade School Children week was also noted among 65.7% and 60.0%
of respondents, respectively. Handwashing af-
Personal hygiene practices of primary grade ter eating and after playing or doing any activity,
school children were also assessed using the however, were only done 1-3 times a week by
pre-tested questionnaire attached as Annex 1. more than half of the children.
Figure 2 shows the state of personal hygiene
of primary grade school children, wherein ma-
jority had clean and combed hair (77.1%),
trimmed and clean nails (55.3%), clean uniform
(74.3%), and clean hands and skin (82.4%). It
was alarming to observe, however, that almost
half of respondents (44.7%) had dirty and un-
trimmed nails, and more than a quarter had dirty
and messy hair (29.9%) and unclean uniforms
(25.7%), which might suggest the lack of child
care at home and school.

In terms of personal hygiene practices (Figure

3), most respondents use soap for handwashing
(58.8%) and taking a bath (94.1%) for at least
Figure 2. Status of personal hygiene of
4-7 times a week. Washing of hands after toilet
primargy grade school children

36 January - December 2020

 Figure 3. Personal hygiene practices of primary grade school children
Personal Hygiene Scores (PHS) and
Academic Grades of Primary Grade School
Children
After the assessment of cleanliness and per-
sonal hygiene practices of primary grade school
children, PHS was then computed (Figure 4).
More than half (62.3%) of the children had good
PHS while 31.8% had very good PHS. The re-
maining respondents (5.9%) had fair PHS, while
none exhibited poor PHS. In terms of academic
grades, most schoolchildren had B (34.2%) and
B- grades (31.5%). Further, analysis showed
that none of the students had a grade of A.
Figure 4. Personal hygiene scores and aca-
demic grades of primary grade school children
Hygiene-related Morbidities among Primary
Grade School Children
Presence of hygiene-related morbidities was
also assessed among the schoolchildren. Re-
Issue No. 9
sults showed that 16.5% had diarrhea and
15.3% had head lice, while 3.5% and 17.6%
had experienced headache and fever, respec-
tively (Figure 5). Alarmingly, it was noted that
the two most prevalent hygiene-related morbid-
ities among primary school children were cough
and cold (58.8%) and dental caries (22.4%).
Figure 5. Hygiene related morbidities among
primary grade school children
Sex and Nutritional Status
The association between sex and nutritional
status (BMI-for-age, weight-for-age, height-for-
age) were investigated. As shown in Table 2, the
prevalence of normal BMI-for-age among boys
(90.7%) and girls (85.7%) were comparable.
Meanwhile, more boys were classified as over-
weight (4.7%) than girls (2.4%), while more girls
were classified as wasted (11.9%) compared to
boys (4.6%). This finding is similar to the results
of Wang et al. (2018) and Zhang et al. (2018),
37
wherein adolescent boys were found to be more Table 4 shows that more boys were chronically
prone to obesity than girls due to the former’s malnourished or stunted than girls (25.6% vs.
excessive energy intake and underestimation 16.7%). This result agrees with the study of
of body weight. Analysis showed, however, that Wamani et al. (2007), which found that the prev-
sex has no significant association with BMI-for- alence of stunting was higher among boys than
age (p-value = 0.25, α = 0.10, Cramer’s V = girls in households with the same socioeconom-
0.22). ic status. In the same manner, more girls were
classified as normal compared to boys (76.2%
vs. 67.4%). Both sexes had around 7% preva-
Table 2. Distribution by sex of grade school chil- lence of severe stunting and no occurrence of
dren according to BMI-for-age classification tallness was documented in the studied popula-
tion. However, no association was reported be-
Nutritional Status Males Females tween sex and height-for-age (p-value = 0.5991,
(BMI-for-age) No. (%) No. (%)
α = 0.10, Cramer’s V = 0.11).
Severely wasted (<-3SD) 1 (2.3) 0
Wasted (-3SD to <-2SD) 1 (2.3) 5 (11.9)
Normal (-2SD to +2SD) 39 (90.7) 36 (85.7) Table 4. Distribution by sex of grade school chil-
Overweight (>+2SD) 2 (4.7) 1 (2.4) dren according to height-for-age classification
Total 43 (100) 42 (100)
χ2= 4.11, p-value = 0.25 , df = 3 Nutritional Status Males Females
(height-for-age) No. (%) No. (%)
Severely Stunted (<-3SD) 3 (7.0) 3 (7.1)

Similar findings were observed using the weight- Stunted (-3SD to <-2SD) 11 (25.6) 7 (16.7)
for-age index (Table 3), wherein boys (67.4%) Normal (-2SD to +2SD) 29 (67.4) 32 (76.2)
and girls (69.0%) had comparable prevalence Tall (>+2SD) 0 0
for normal nutritional status. Prevalence of Total 43 (100) 42 (100)
severely underweight (9.3% vs. 9.5%), under- χ2= 1.02, p-value = 0.5991, df = 2
weight (20.9% vs. 21.4%) and overweight (2.3%
vs. 0%) between males and females were also
comparable. Similarly, no association was re- The population under study revealed that more
ported between sex and weight-for-age (p-value girls generally had normal nutritional status
= 0.8041, α = 0.10, Cramer’s V = 0.108). compared to boys. Moreover, more boys were
stunted than girls while more girls were wasted.
The absence of statistical association between
Table 3. Distribution by sex of grade school sex and the three nutritional status indices could
children according to weight-for-age be attributed to the fact that weight and height
classification are more affected by other direct factors, such
as dietary consumption and presence of dis-
Nutritional Status Males Females ease or illness (Hruby and Hu, 2015).
(weight-for-age) No. (%) No. (%)
Severely Underweight (<-3SD) 4 (9.3) 4 (9.5)
Sex and Personal Hygiene Score
Underweight (-3SD to <-2SD) 9 (20.9) 9 (21.4)
Normal (-2SD to +2SD) 29 (67.4) 29 (69.0) Aside from nutritional status, the association of
Overweight (>+2SD) 1 (2.3) 0 sex with PHS was also investigated. As shown
Total 43 (100) 42 (100) in Table 5, more boys obtained good PHS com-
χ2= 0.99, p-value = 0.8041 , df = 3 pared to girls (77.4% vs. 50.0%), while more
girls had very good PHS compared to boys
(42.3% vs. 20.9%). The latter finding could be

38 January - December 2020

attributed to the innate characteristics of girls to ticularly having clean hands and skin (85.7%)
groom more and make themselves appealing and clean and well-trimmed nails (91.5%). How-
and presentable to others (Duckett et al., 1989). ever, these values were not significantly asso-
Using Cramer’s V test, sex showed a moder- ciated (p-value = 0.1690, p-value = 0.4418, re-
ate association with PHS (p-value = 0.0648, α = spectively).
0.10, Cramer’s V = 0.25).
Table 6. Strength of relationship between PHS
Table 5. Distribution of male and female prima- and Nutritional Status
ry grade school children according to PHS
Spearman’s Strength of
Variables Coefficient Relationship
Personal Male No. Female No.
Hygiene Score (PHS) (%) (%) PHS and BMI-for-age 0.510 Moderate
Poor (0-5 points) 0 0 PHS and weight-for-age 0.322 Weak
Fair (6-10 points) 2 (4.7) 3 (7.1) PHS and height-for-age 0.263 Weak
Good (11-15 points) 32 (77.4) 21 (50.0)
Very good (16-20 points) 9 (20.9) 18 (42.3)
Table 7. Correlation of BMI-for-age and state of
Total 43 (100) 42 (100)
personal hygiene
χ2= 5.47, p-value = 0.0648 , df = 2

Trimmed and Clean Clean Hands and

Nails Skin
Personal Hygiene Score and Nutritional BMI-for- No. (%) No. (%)
age
Status Unfavor- Favor- Unfavor- Favor-
able able able able

The analyzed association between PHS and Severely 1 (2.6) 0 0 1 (1.4)

wasted
nutritional status showed weak relationship for
Wasted 4 (10.5) 2 (4.3) 0 6 (8.6)
both PHS and height-for-age and weight-for-
Normal 32 (84.2) 43 (91.5) 15 (100) 60 (85.7)
age, with rs value of 0.263 and 0.322, respec-
Over-
tively (Table 6). Interestingly, PHS and BMI- weight 1 (2.6) 2 (4.3) 0 3 (4.3)
for-age exhibited a moderate relationship, with χ2= 2.69, χ2= 2.43,
rs value of 0.510, suggesting that BMI-for-age p-value = 0.4418, p-value = 0.1690,
df = 3 df = 3
among 6-9-year-old primary grade school chil-
dren might improve as PHS increases. Based
on this, it can be suggested to intensify proper On the other hand, in terms of practices relat-
hygiene practices, especially among girls most ed to personal hygiene (Table 8), BMI-for-age
affected by wasting. It should be noted, how- had significant association with the use of
ever, that PHS was not the sole reason for the soap for handwashing, use of toothbrush with
observed wasting prevalence among primary toothpaste, and handwashing after eating. This
grade school children. means that BMI-for-age are dependent on these
hygiene-related practices, which can be the fo-
Since there was a moderate relationship be- cus of interventions for wasting problem among
tween PHS and BMI-for-age, it was also import- primary grade school children. Meanwhile, ma-
ant to look into the state of personal hygiene jority of the children (87.5%) who took a bath at
and hygiene practices that contributed to the least 4-7 times a week had normal nutritional
said association. As seen in Table 7, most of status, although the association was not signifi-
the children’s nutritional statuses were normal if cant (p-value = 0.8712).
they have good state of personal hygiene, par-

Issue No. 9 39
Table 8. Correlation of BMI-for-age and practices related to personal hygiene

Use of soap for hand Use of toothbrush with Hand washing after eating
Taking a bath
washing toothpaste No.
BMI-for- No. (%)
No. (%) No. (%) (%)
age
1-3x/ 4-7x/ 1-3x/ 4-7x/ 1-3x/ 4-7x/ 1-3x/
Never Never Never 4-7x/ wk
wk wk wk wk wk wk wk
Severely 1 1 1 1
0 0 0 0 0 0 0
wasted (20) (50) (50) (1.2)
2 4 1 5 2 4 6
Wasted 0 0 0 0
(6.7) (8) (5.6) (7.7) (4.4) (10.5) (7.5)
4 28 43 1 16 58 1 42 32 5 70
Normal (80) (93.3) (86) (50) (88.9) (89.2) (50) (93.3) (84.2) (100) (87.5)
3 1 2 1 2 3
Overweight 0 0 0 0 0
(6) (5.6) (3.1) (2.2) (5.3) (3.8)
χ2= 0.71,
χ2= 18.68, χ2= 42.39, χ2= 43.87, p-value =0.8712,
p-value =0.0047, df = 6 p-value =1.54e-07, df =6 p-value =7.84e-08, df = 6 df = 3

Personal Hygiene Score and Presence of
Hygiene-related Morbidities
PHS and different types of reported morbidi-
ties experienced by the subjects suggest the
association of personal hygiene practices with
the acquisition of morbidities (Table 9). How-
ever, some children still experienced diarrhea
despite having good or excellent PHS (66.2%
and 29.6% prevalence, respectively), although
no significant association was found between
these two variables. The result was the same for
PHS and fever, with 73% of schoolchildren hav-
ing experienced fever despite obtaining good
PHS, which suggests that fever is multi-causal,
i.e., it could have been caused by other factors.
In addition, 51.4% of schoolchildren who had
not experienced cough and cold were found
to have good PHS and 37.1% have very good
PHS. However, 70% of those who had experi-
enced coughs and colds obtained good PHS
and 28% had very good PHS. The calculated
significant association between PHS and pres-
ence of cough and cold (p-value = 0.09, α =
0.10, Cramer’s V = 0.237) was in line with the
study of Sarkar (2013), which found that stu-
dents with poor hygienic practices mostly suffer
from fever with or without cough/cold, diarrhea,
head lice, and dental caries. Despite the associ-
ation identified, the statistical analysis does not
necessarily mean a cause-effect relationship
between the studied variable; thus, it can be in-
ferred that cough and cold is affected by various
factors, such as immediate environment, dietary
intake, and immune system (Chang and Wid-
dicombe, 2007). Meanwhile, 68.1% of students
without head lice had good PHS and 25% had
very good PHS. Results also showed a strong
association between good PHS and absence
of head lice (p-value = 0.006, α = 0.10; Cram-
er’s V = 0.345). Other factors associated with
presence of head lice include belonging to big
households with low socioeconomic status, re-
siding in densely populated areas, and presence
of longer hair (Meister and Ochsendorf, 2016),
although it was not related to frequent brushing
or shampooing (Frankowski and Weiner, 2002).
Moreover, 62.2% and 32.9% of those who
have not experienced headache had good and
very good PHS, respectively. Results showed
moderate association between the two vari-
ables (p-value = 0.0829, α = 0.10; Cramer’s V
= 0.242). This means that headache, which is
a symptom of various diseases, occurs less to
a child with good to very good PHS. With this,
good PHS could have reduced occurrence of
headache among primary grade school chil-
dren. On the other hand, a moderately strong

40 January - December 2020

association was observed between higher PHS
and absence of dental caries and/or toothache
(p-value = 0.0586, α = 0.10; Cramer’s V =
0.258).
Meanwhile, 66.7% and 25.8% of children who
did not experience dental caries or toothache
have good and very good PHS, respectively,
which might be due to the prevalent practice
of using toothpaste during brushing of teeth as
toothpaste prevents formation of cavities (Cury
and Tenuta, 2014). Lastly, no significant rela-
tionship was seen between PHS and presence
of fever (p-value = 0.5585, α = 0.10; Cramer’s V
= 0.117) and between PHS and presence of di-
arrhea (p-value = 0.1586, α = 0.10; Cramer’s V
= 0.208). These results were in contrast with the
results of Mansour et al. (2013) wherein poor
hygiene practices (lack of soap and sharing a
toilet, and absence of towels in bathrooms) were
more frequently observed among children with
diarrhea and with He et al. (2018) wherein chil-
dren belonging to households with lacking hy-
giene facilities had higher odds of suffering from
diarrhea, cough and fever. The results could
imply that the presence of fever and diarrhea
could have been caused by other factors other
than personal hygiene practices of the children
including breastfeeding practices (Lamberti et
al., 2011), malnutrition (Brown, 2003), and par-
ents’ knowledge and practices against diarrhea
(Mumtaz et al., 2014).

Table 9. Personal hygiene score and presence of hygiene-related morbidities among the primary
grade school children.

Personal Hygiene Score (PHS)

Hygiene-related Morbidities Chi-square
Fair Good Very Good Total
Absent No. (%) 3 (4.2) 47 (66.2) 21 (29.6) 71 (100) χ2= 3.68,
Diarrhea p-value =
Present No. (%) 2 (14.3) 6 (42.9) 6 (42.9) 14 (100) 0.1586
Absent No. (%) 4 (11.4) 18 (51.4) 13 (37.1) 35 (100) χ2= 4.79,
Cough and Cold p-value =
Present No. (%) 1 (2) 35 (70.0) 14(28.0) 50 (100) 0.0911
Absent No. (%) 5 (6.9) 49 (68.1) 18 (25.0) 72 (100) χ2= 10.14,
Head lice p-value =
Present No. (%) 0 4 (30.8) 9 (69.2) 13 (100) 0.0063
Absent No. (%) 4 (4.9) 51 (62.2) 27 (32.9) 82 (100) χ2= 4.98,
Head ache p-value =
Present No. (%) 1(33.3) 2 (66.7) 0 3 (100) 0.0829
Absent No. (%) 4 (5.7) 42 (60.0) 24 (34.3) 70 (100) χ2= 1.16,
Fever p-value =
Present No. (%) 1(6.7) 11 (73.3) 3 (20.0) 15 (100) 0.5585
Absent No. (%) 5 (7.6) 44 (66.7) 17 (25.8) 66 (100) χ2= 5.67,
Dental carries p-value =
Present No. (%) 0 9 (47.4) 10 (52.6) 19 (100) 0.0586

Nutritional Status and Academic Grade
Based on the obtained data, majority of stu-
dents had a grade of B (83-86) and B- (80-82). A
significant number of students, however, had a
grade equivalent to C (77-79). Though these are
still considered passing scores, it is better if the
children can have higher grades. To identify the
determinants of a student’s grade, several vari-
ables were observed. First, the association be-
tween nutritional status and academic grades of
the student was explored, and a very weak rela-
tionship was observed between these variables.
The obtained Spearman’s coefficient values
were -0.153, -0.155, and -0.149 for BMI-for-age,
weight-for-age, and height-for-age, respective-

Issue No. 9 41
ly (Table 10). These indicate that the academ-
ic grades of children were not associated with
their nutritional status, implying that other fac-
tors may have affected the students’ academic
grades. This result coincides with the findings
of Naelga and Doncillo (2016), which found no
relation between academic performance and
BMI among grade 2 students in Cagayan de
Oro City. Alcuizar (2016) observed the opposite,
however, and reported that nutrition and living
condition had significant effects on academic
performance among students in Iligan City.
Table 10. Spearman’s Coefficient of Nutritional
Status and Academic Grade
Spearman’s Strength of
Variables Coefficient Relationship
BMI-for-age and
-0.153 Very weak
Academic Grade
Weight-for-age and -0.155 Very weak
Academic Grade
height-for-age and
Academic Grade -0.149 Very weak
Personal Hygiene Score and Academic
Grade
The association between personal hygiene
score and academic grades of the children
yielded a value of 0.002, which indicates a very
weak relationship between the two variables. As
mentioned earlier, the academic grades of the
primary grade school children might be mainly
affected by more direct factors, including learn-
ing facilities (Figueroa et al., 2016), communica-
tion, proper guidance and child care (Panopio,
2017), presence of family stress (Mushtaq and
Khan, 2012), economic status, and parent’s
education (Farooq et al., 2011). These factors
were also observed among the study group,
most of them belonging to households with less
than PhP 10,000 monthly income and whose
parents had high school level of education. This
does not imply, however, that personal hygiene
of students should be taken for granted, as Vally
et al. (2019) showed that a school-based WASH
42
intervention reduces school absences due to
diarrhea, which can consequently lead to im-
proved academic performance.
CONCLUSION
This study found that PHS was significantly
associated with sex and some hygiene-related
morbidities, particularly cough and cold, head
lice, headache, and dental carries. Among the
three nutritional status indices, only BMI-for-age
had a significant and moderate relationship with
PHS. Meanwhile, BMI-for-age was significantly
associated with the use of soap in handwash-
ing, use of toothbrush with toothpaste, and
handwashing after eating among schoolchil-
dren. Conversely, no significant association was
observed between nutritional status (in all three
indices) and academic grades and between
PHS and academic grades. Despite the lack of
strong association between PHS and academic
grades, PHS was still observed to have signif-
icant association with different hygiene-related
morbidities, which could affect the overall nu-
tritional status and well-being of the children.
Thus, personal hygiene should still be given im-
portance in planning and implementation of nu-
trition-related interventions in the primary school
setting, wherein both parents and teachers can
play a positive and significant role.
RECOMMENDATIONS
The reported significant association of PHS
with BMI-for-age and different hygiene-related
morbidities revealed the importance of personal
hygiene practices in improving the former and
preventing the latter. Personal hygiene should
be taught to and given emphasis among school-
children through awareness and proper health
education. This also implies the need for improv-
ing school handwashing and toilet facilities to
encourage schoolchildren to utilize these ame-
nities more frequently. A more detailed survey
is also recommended for the school to design
January - December 2020
more appropriate school-based interventions in-
volving the students, parents, teachers, and the
school. Other factors worthy to investigate in-
clude intake of breakfast before going to school,
diet quality and eating habits, quantity and qual-
ity of sleep, parental support, school learning
facilities, quantity and quality of teachers, and
other information on socio-economic profile.
Improvement on parent-teacher-student rela-
tionships to make them more effective and sus-
tainable is also encouraged to provide learning
continuity from school to home and vice versa,
particularly on knowledge and practices related
to personal hygiene. Proper planning, imple-
mentation, monitoring, and evaluation should
also be applied to these potential interventions.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
ACKNOWLEDGEMENTS
The authors thank the school and all the stu-
dents, parents, and teachers for participating in
this study. The authors also acknowledge Dr.
Maria Theresa M. Talavera and Dr. Nancy A.
Tandang for sharing their knowledge and exper-
tise towards improving the study.
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46 January - December 2020

Development of a Valid and Reliable Questionnaire to
Evaluate an Adult’s Knowledge, Attitude and Practices
on Cholesterol Management
Diorella Marie M. Tria, MSc a *, Leila S. Africa, PhD a, Aimee Sheree A. Barrion, PhD a
b
Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines, Los Baños, Laguna

* Corresponding author: dmtria@up.edu.ph

ABSTRACT
High levels of total cholesterol (TC) are among the top significant contributing factor for cardiovascu-
lar diseases. With only less than half of the global population with good cholesterol awareness in both
genders, the public’s knowledge of cholesterol is critical in potential prevention and preparedness
according to World Health Organization. The aim of this paper was to develop a reliable and valid
instrument to measure the knowledge, attitude and practices (KAP) of adults on cholesterol manage-
ment. The questionnaire was designed to develop an evaluation tool that can assess the risk of Filipi-
no adults to hypercholesterolemia. Content validity was facilitated by eight experts in health, nutrition
and medicine fields. Revisions were made based on their validation. The resulting questionnaire with
satisfactory content validity index of ≥0.80 was pilot-tested on 50 random subjects. The Cronbach’s
alpha was used to further determine the questionnaire’s internal consistency. The % mean score ±
SD of the knowledge (58.90%±1.77), attitude (72.70%±1.95) and practices (58.20%±1.58) of this
study revealed that the test subjects exhibited average awareness on cholesterol management. All
key areas resulted to have a Cronbach alpha statistic of ≥0.70. The developed questionnaire with the
desirable validity and reliability may be used as a reference tool to measure KAP levels on choles-
terol management of adults.

Keywords: attitude; cholesterol management; hypercholesterolemia; knowledge; practice; question-

naire development; reliability; validity

INTRODUCTION annual mortality rate of CVD has an average

High total cholesterol (TC) or also known as
hypercholesterolemia, is among the top sig-
nificant contributing factor for Cardiovascular
Disease (CVD) among adults that cause death
rates to increase around the world. According
to World Health Organization (2018), about 17
million people died from CVDs incurring a toll
rate of 30% of the global burden. In the Philip-
pines, CVD is still the leading cause of death ac-
counting for 170,000 incidents every year. The
increase of 2.3%, and since 1990, cases across
the country has increased by 52.2% (DOST-FN-
RI, 2016). Results from various cohort studies
in other countries have proven that high total
cholesterol is an independent and inverse pre-
dictor of CVD which has a great impact in in-
creasing its prevalence rate (Briel et al., 2009;
Brown et al., 2013; Pajak et al., 2016). About
61.9% of adults (50 to 59 years) have been
suffering from borderline cholesterol, followed
by 58.9% adults (60 to 69 years), then 57.5%
adults in their 70s and 51.5% adults aging 40

Issue No. 9 47
to 49 years (DOST-FNRI, 2016). However, most
adult population with high TC are undertreat-
ed and underdiagnosed. Evidence had shown
that for every percentage of those who are at
risk to hypercholesterolemia, almost half of the
population is unaware of their condition (Lee et
al., 2014) and that only 36% in both genders
has adept knowledge about cholesterol and its
management (WHO, 2018). Wrong dissemina-
tion of information about cholesterol lowering
treatments was driven by the population’s poor
knowledge about cholesterol (Catapano et al.,
2015). Reported data on whether the Philippine
population has an adequate knowledge, good
attitude and practices regarding CVD and its
risk factors are very limited that local govern-
ment today prioritize the assessment of aware-
ness to address the alarming public burden of
its mortality rate (DOST-FNRI, 2016). It is not
known whether the relation of cholesterol level
to risk of CVD has reached the knowledge of the
public within the nation. Thus, this study aims to
develop a valid and reliable evaluation tool to
effectively assess an adult’s level of knowledge,
attitude and practices on cholesterol manage-
ment. Gathered information is expected to keep
every target individual engaged to adopt healthy
attitudes as their routine to gradually reduce
their own lifetime risk. The awareness of the
general public will be a precondition for success
in the control of hypercholesterolemia and fur-
ther risk to other CVDs (Aminde et al., 2017).
METHODOLOGY
Phase 1: Content Validity
Literature Review
The development of questionnaire was carried
out by a related review. Previous studies con-
taining information on levels of cholesterols and
its risk factors published since 2010 were con-
sidered. Modifiable risks and health threats led
by cholesterols and its relation to an individual’s
48
vascular health were identified. A questionnaire
with five sections that consist of true or false,
multiple choices, frequency and Likert scales
was structured. Items were categorized under
5 Sections: (A) Basic Profile; (B) Cholester-
ol Knowledge; (C) Foods and Cholesterol; (D)
Cholesterol Risk Factors and Practices; and (E)
Attitude for a Healthy Lifestyle.
Expert Panel Review
Several studies suggested that an expert panel
tasked to review an instrument should have at
least five members considering a practical value
of chance agreement (Zamanzadeh et al., 2015;
Rodrigues et al., 2017). Thus, the questionnaire
validation was conducted by an eight-member
expert panel who were selected based on the
following conditions: 1- had been employed in
the field of health, nutrition, or medicine with
work experience for more than 3 years; 2- had
knowledge and interest on cholesterol, its risk
factors and cardiovascular diseases. The pan-
el consisted of two medical doctors, three nu-
tritionist-dietitians, and three food-nutrition re-
searchers. Items were initially adjusted based
on necessary revisions suggested by the panel.
Questionnaire validity was measured by Con-
tent Validity Index (CVI) to determine the rele-
vancy and clarity of each item. Content validity
was determined through the mean CVI (2a) of
the experts (where N= number of experts and
A= number of agreeing experts). With a CVI of
<0.80, item was either revised or deleted. The
4-point Likert scale that was used to measure
the mean CVI were as follows: 1=irrelevant;
2=somewhat relevant; 3=quite relevant; and
4=highly relevant. Ratings of 3 and 4 were ac-
cepted thus, a CVI of ≥0.80 is recommended
since it denotes a good evidence of relevant
content validity (Haynes et al., 1995). Probabili-
ty of chance occurrence (Pc) and modified Kap-
pa value (k*) were then calculated based form
the study of Larsson et al. Pc (2b), was comput-
ed to represent the estimate of the relative av-
January - December 2020
erage frequency with which the experts agreed
upon on an item. The computed Kappa value
(2c) was used to determine the interrater reli-
ability among the experts. The Kappa statistics
varies from 0 to 1 (Larsson et al., 2015). How-
ever, a higher level for acceptable relevance
was more efficient to assess a health-related
questionnaire. Thus, the guidelines described
by Cicchetti and Sparrow (1981) for evaluat-
ing computed Kappa value was used: Fair = K
(0.40-0.59); Good = K (0.60-0.74); and Excel-
lent = K (0.75-1.0). Results from the panel were
quantified. The questionnaire was subjected for
pilot testing to determine its reliability for data
collection.
(2a)
(2b)
(2c)
Phase 2: Content Reliability
Pilot Testing
Selected subjects were asked in a specific area
in Laguna, Philippines to take part of the aware-
ness assessment as part of the inter-rater reli-
ability investigation. The aim was to determine
the efficiency of the resulting questionnaire.
50 random subjects were selected based on
the following criteria: (1) within the age range
set for the study (Adults ≥20); (2) no commu-
nicable disease; (3) not currently diagnosed of
hypercholesterolemia; and (4) had satisfied the
requirements set on the general consent form.
Sample size was based on the general flat
rule that ≥30 subjects are feasible to estimate
a parameter in a pilot study research (Browne,
1995). Summary statistics for the profiling of the
participants was used for descriptive analysis.
Issue No. 9
Item Analysis
Items were evaluated quantitatively through the
analysis of reliability, consistency, difficulty and
discrimination. The reliability and consistency
of the items were assessed using Cronbach’s
alpha to determine how closely related was the
set of items to each category. The Cronbach’s
coefficient with α ≥0.70 was considered reli-
able (Taber, 2017). Cronbach’s alpha, following
the principle of Kuder-Richardson Formula 20
(KR-20), was computed for all sections of the
questionnaire (excluding Section A). This way
of determining the Cronbach’s α is applicable in
determining internal consistency with questions
of dichotomous choices (correct/incorrect or
category A/category B) (Kuder and Richardson,
1937). The said principle was directly applied to
sections B and C to determine the Cronbach’s
alpha, since both sections have designated cor-
rect answers in every item. In the case of sec-
tions D and E, choices were divided into two,
representing the category in which the items be-
long. Choices from section D were subcatego-
rized into low risk and high risk while in section
E, choices were subcategorized into healthier
and unhealthier lifestyle. Difficulty (3a) and dis-
crimination (3b) indices were also analyzed to
determine the quality and differentiation of the
items (Friatma and Anhar, 2019).
(3a)
(3b)
Where:
Hc = high-scoring subjects with correct answers
Lc = low-scoring subjects with correct answers
From the data gathered, KAP of the participants
was also assessed as part of the pilot study
results. T-test was performed for independent
variables to determine the correlation of KAP
scores. Scoring system for knowledge, attitude
and practice assessment was based from the
49
same method (KR-20) used in determining item
reliability and consistency. KAP level of >50%
was labelled as “passing scores”. Scores were
further divided into quartiles categorized as fol-
lows: excellent (91-100%); good (71-90%); av-
erage (51-70%); and poor (≤50%).
RESULTS AND DISCUSSION
Questionnaire Development
A 70-item questionnaire was initially construct-
ed to determine the KAP level of a population
about cholesterol and their views of their risk
to hypercholesterolemia. The first phase of the
development was guided by several reviews of
related literatures. Existing questionnaires and
instruments that measure adults’ awareness
to cholesterol, hypercholesterolemia and CVD
were considered in this study. The question-
naire used Section A to assess the competency
of every participant to answer the items. The
second section was summarized by overview
information about cholesterol in order to assess
the facts which were well known by the subjects.
The third section was intended to measure the
subjects’ awareness to the type of food that
causes cholesterol levels in the body to change.
Section D included items that determine the
subjects’ current health condition, which were
mostly self-reported data based on their own
records and estimation. The last section sole-
ly focused on the subjects’ behaviour-specific
routines. This section also aimed to determine
the proportion of population who were willing to
practice a healthier lifestyle for a change. Below
is the list of sample question categories for each
KAP component of the questionnaire:
Section A: Basic Profile
• (name, sex, age, educational attain-
ment, household income, civil status)
50
Section B: Cholesterol Knowledge
• (high cholesterol definition, types of
cholesterol, cholesterol levels in adults,
facts about high and low cholesterols)
Section C: Foods and Cholesterol
• (Foods high or low in cholesterol, foods
associated with dairy products, animal
and plant sources)
Section D: Cholesterol Risk Factors and
Practices
• (cholesterol and family history, cho-
lesterol level self-awareness, blood
pressure self-awareness, body weight
self-awareness, exercise, smoking &
drinking alcoholic beverages frequency)
Section E: Attitude for a Healthy Lifestyle
• (attitude towards starting or maintaining
a healthier lifestyle)
Questionnaire Validity
The questionnaire was validated to assess its
efficiency and appropriateness to the target
age group, and to determine the relevance of
items for every category. This phase revealed
that 69% (48 out of 70) of the total items had
met the criterion with promising scores for its
validity and relevancy. Items with CVI scores
of ≥0.80 had the Pc value of <0.0313 that in-
dicates excellent degree of expert agreement.
Results were summarized as shown in Table 1.
A CVI of 1.0 means that all experts had agreed
to an item’s inclusion to the questionnaire while
a Kappa value (k*) of 1.0000 shows a high
agreement on the relevancy of the items for
each section. Items with the lowest CVI score
(0.63) were automatically deleted and were not
furtherly evaluated.
January - December 2020
Table 1. Results of the validity and relevancy of the questionnaire items (Qn).

CVI1 k*2
Section A: Q8, Q9
Section B: Q12, Q15, Q18, Q19, Q21, Q24, Q25
0.50-0.79 Section C: Q27, Q30, Q31, Q32, Q34, Q37, Q40 Excellent
Section D: Q42, Q47, Q50
Section E: Q58, Q66, Q69
Section A: Q1, Q2, Q3, Q4, Q5, Q6, Q7, Q10
Section B: Q11, Q13, Q14, Q16, Q17, Q20, Q22, Q23
Section C: Q26, Q28, Q29, Q33, Q35, Q36, Q38, Q39 Fair: Q8, Q9, Q27, Q31, Q32,
0.80 – 1.0
Section D: Q41, Q43, Q44, Q45, Q46, Q48, Q49, Q51, Q37, Q40, Q47, Q66, Q69
Q52, Q53, Q54, Q55
Section E: Q56, Q57, Q59, Q60, Q61, Q62, Q63, Q64,
Q65, Q67, Q68, Q70
1
Content Validity Index accepted value: ≥0.80
2
Modified Kappa accepted value: Fair=0.40-0.59; Good=0.60-0.74; Excellent=≥0.75

Questionnaire Reliability
Pilot testing of the resulting 48 items for in-
ter-rater reliability analysis was done to deter-
mine the degree of agreement among actual
raters and to determine the effectiveness of the
structure and content of the questionnaire. Ta-
ble 2 shows the profile characteristics of the re-
spondents (Section A) and their corresponding
KAP scores.
Results showed that more than half of the total
respondents passed the KAP scores (K=66%;
A=74%; P=56%) however, only the attitude as-
sessment (Amean±SD=72.7%±1.95) showed a good
score rating. Knowledge (Kmean±SD=58.9%±1.77)
and practice level (Pmean±SD=58.2%±1.58) of the
participants were found to be on the average
rating scale. Statistical analysis showed that
knowledge scores were both significant to at-
titude (p-value: 0.008) and practice (p-value:
<0.001) scores. Results implied that with at
least average knowledge level on cholester-
ol management can result to good attitude but
average lifestyle practice scores. Higher rates
of KAP scores were observed from participants
who are female, with age range of 31-40, with
at least college degree, with monthly household
income of >Php20,000 and married with at least
one child. Several studies showed similar trend
stating that the population in the highest quartile
of awareness are of the same characteristics
as in this study (Bonaccio et al., 2013; Liang et
al., 2019). Comparing the data from the latest
report of Food and Nutrition Research Institute
(2016), findings showed that higher cases of
CVD risk factors in the country are found in fe-
male and adults with age ranging from 40.0 to
49.9. However, the same report showed a sig-
nificantly positive correlation between CVD risk
and higher socioeconomic status in contrast to
this study (Duante et al., 2019; DOST-FNRI,
2016). In addition, providing the information for
current medications and working mobility were
included to let researchers link and confirm
the risk of every respondent to the result of the
KAP assessment. The classification followed
the guidelines of American College of Sports
Medicine (ACSM) wherein “active” are those
with moderate to intense activities for at least
30 minutes for ≥5 days/week while “sedentary”
are those with the same intensity of work but for
only <5 days/week (Bennett et al., 2006).

Issue No. 9 51
Table 2. Profile characteristic and KAP scores of the respondents.

n1 (%) with PASSING SCORES2

Characteristics N (%)
Knowledge Attitude Practice
Sex
Male 25 (50%) 14 (56%) 17 (68%) 11 (44%)
Female 25 (50%) 19 (76%) 20 (80%) 17 (68%)
Age Group3
20-30 0% - - -
31-40 27 (54%) 19 (70%) 22 (81%) 17 (63%)
41-50 23 (46%) 14 (61%) 15 (65%) 11 (48%)
Educattional Attainment
Highschool graduate 1 (2%) 0% 1 (100%) 0%
College level 11 (22%) 4 (36%) 6 (55%) 5 (45%)
College graduate 35 (70%) 26 (74%) 27 (77%) 26 (74%)
Post graduate 3 (6%) 3 (100%) 3 (100%) 3 (100%)
Current Employment
Employed 32 (64%) 24 (75%) 21 (66%) 21 (66%)
Self-employed 8 (16%) 5 (63%) 8 (100%) 4 (50%)
Out of work > 1 year 3 (6%) 1 (33%) 2 (67%) 0%
Out of work < 1 year 2 (4%) 1 (50%) 2 (100%) 1 (50%)
Homemaker 5 (10%) 2 (40%) 4 (80%) 2 (40%)
Monthly Household Income (Php)
< 10,000 1 (2%) 0% 1 (100%) 0%
10,000-20,000 19 (38%) 9 (47%) 9 (47%) 5 (26%)
20,001-40,000 19 (38%) 15 (79%) 16 (84%) 14 (74%)
> 40,000 11 (22%) 9 (82%) 11 (100%) 9 (82%)
Civil Status
Single (without child) 18 (36%) 14 (78%) 13 (72%) 8 (44%)
Married (with child) 27 (54%) 17 (63%) 21 (78%) 18 (67%)
Widowed (with child) 5 (10%) 2 (40%) 3 (60%) 2 (40%)
Current maintenance in medication/s
Yes 5 (10%) 2 (40%) 4 (80%) 4 (80%)
No 45 (90%) 31 (78%) 33 (73%) 24 (53%)
Working Mobility
Active 30 (60%) 21 (70%) 23 (77%) 15 (50%)
Sedentary 20 (40%) 12 (60%) 14 (70%) 13 (65%)
TOTAL 50 (100%) 33 (66%) 37 (74%) 28 (56%)
1
n% is based from total N%
2
KAP passing score: >50%
3
For Age characteristic: µ/Mean=39; ∂/Variance=33.1; SD/Standard Deviation=5.8; MIN/Minimum value=31; MAX/Maximum
value=49

52 January - December 2020

Cronbach’s alpha provides a useful mode in Table 4. Difficulty and Discrimination indices of
analysis to determine the reliability of a certain the validated questionnaire.
item in its set. As the over-all observation for
previous analyses, the use of Cronbach’s alpha Items
Parameter Criteria Action
generally states that it increases as the correla- (N=40)a

tion between the items also increase (Friatma Difficulty Index

and Anhar, 2019). The accepted alpha value 0.90-1.00 Very easy 0 (0%) Reject
which indicates a good reliability is ≥0.70. The 0.71-0.89 Easy 7 (17.5%) Revise
alpha range of 0.70 to 0.90 is the desirable reli- 0.31-0.70 Moderate 30 (75%) Accepted
ability value and that ≥0.95 is not recommended 0.21-0.30 Difficult 3 (7.5%) Revise
as it may indicate item redundancy (Bonett and 0.20-0.00 Very difficult 0 (0%) Reject
Wright, 2014; Taber, 2017). Table 3 shows the Discrimination Index
result of determining the Cronbach’s alpha of
(-) negated Very poor 0 (0%) Reject
the KAP questionnaire (excluding Section A) as value
a test to its internal reliability among the respon- <0.20 Poor 0 (0%) Reject
dents. Results revealed that the effectivity of the 0.20-0.40 Moderate 13 (32.5%) Revise/
resulting items after the content validation were Reject

found to be reliable in KAP assessment on the 0.40-0.70 Good 24 (60%) Accepted

cholesterol management of the respondents. 0.70-1.00 Very good 3 (7.5%) Accepted
N represents the number of combined items where
a

Section A was excluded

Table 3. Cronbach’s alpha of KAP sections.

Section ∑vara Var2 b Dc CONCLUSION

B/C (Knowledge) 2.5812 7.9316
D (Practice) 2.5040 8.0816
E (Attitude) 0.8464 2.5200
a
∑var is the summation of the variances of all items in a
section
b
Var2 is the variance squared for all items
c
Represents the Cronbach’s alpha value
Questionnaire Difficulty and Discrimination
Indices used to determine the item’s difficulty
and discrimination are shown in Table 4. An ide-
al multiple choice-based questionnaire should
have an average difficulty level of 30-70% with
>0.25 discrimination index (Mahjabeen et al.,
2018). In this study, items with 0.21-0.89 diffi-
culty index and ≥0.20 discrimination index were
considered following the suggestions from the
study of Friatma et al. (2019). Results showed
that all validated items fulfilled the criteria of an
ideal multiple-based questionnaire, with majori-
ty having moderate level of difficulty and good
discrimination.
0.7228
0.7395
The developed questionnaire showed evidence
of satisfactory reliability and validity that can be
0.7152
used to develop an evaluation tool for the risk as-
sessment of hypercholesterolemia among Filipi-
no adults. Results have shown that the 48-item
resulting questionnaire can be used to assess
the level of knowledge, attitude and practices of
Filipino adults about cholesterol and other re-
lated information. Associations between knowl-
edge, attitude and practices and characteristic
profiles were observed to have impact on the
final score ratings of the respondents. Higher
rates of KAP scores were observed from partic-
ipants who are female, within the age range of
31-40, with at least college degree, with monthly
household income of >Php20,000 and who were
married with at least one child. The findings also
revealed that knowledge scores were significant
to attitude and practice scores thus, it highlight-
ed the importance of interventions to educate
the community with dietary management and

Issue No. 9 53
the risk of hypercholesterolemia to the develop-
ment of CVD. Further studies can be made to
identify and overcome challenges for increasing
respondent’s knowledge, attitude and practices
on cholesterol and CVD risk management.
ACKNOWLEDGEMENTS
The authors would like to acknowledge the Sci-
ence Education Institute of the Department of
Science and Technology (SEI-DOST) for fund-
ing this study.
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55
Assessment of Knowledge, Attitude, and Practices on
Food Safety and Compliance to Microbiological Safety
Guidelines among Vendors of Commonly Patronized Street
Foods in Poblacion, Batangas City, Philippines
Myla A. Argente a , Normahitta P. Gordoncillo a, Leila S. Africa, PhD a *, Corazon VC. Barba, PhD a,
Josefina T. Dizon, PhD b
a
Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines, Los Baños, Laguna
b
Institute of Governance and Rural Development, College of Public Affairs and Development, University of the Philippines, Los
Baños, Laguna

* Corresponding author: lsafrica@up.edu.ph

ABSTRACT
This cross-sectional study explored the association between the microbial safety of street foods,
using E. coli load as indicator, and vendors’ knowledge, attitude, and practices on food safety and
the environmental conditions of vending stalls in Poblacion, Batangas City in Batangas, Philippines.
Thirty-five (35) street food vendors selling three commonly patronized street foods, namely, grilled
pork intestine (isaw), pork barbecue, and grilled coagulated chicken blood (betamax), served as
study respondents. Results showed that most street food vending sites were located in areas with
no running water supply and handwashing facilities. Moreover, although trash bins were available,
waste segregation was not practiced. Vendors had an average level of food safety knowledge and
good attitude towards food safety, although these did not translate into practice. Pork barbecue was
the safest among the street foods analyzed. Knowledge, attitude, and practice scores of respon-
dents were found to be inversely associated with the E. coli load of the three street foods based
on Spearman’s rank analysis. The environmental conditions of vending stalls showed moderate to
strong association with E. coli load, except for the availability of trash bins, using Cramer’s V. Study
results suggest the need to enhance the knowledge on food safety of selected street food vendors
and to upgrade their skills in proper purchasing, preparation, handling, and vending of street foods
to protect consumer health. Environmental conditions of food vending sites also need to be checked
for compliance with sanitation measures and guidelines.

Keywords: food safety, street foods, knowledge, attitude, practices

INTRODUCTION and role in the cultural and social heritage of

Street foods include a wide range of ready-to-
eat foods and beverages sold and sometimes
prepared in public places, notably streets (Kro-
on and D’Antuono, 2013). They are not only ap-
preciated for their unique flavors, convenience,
societies, but have also become essential in
maintaining the nutritional status of populations.
Afele (2006) stated that street foods do not only
provide a source of inexpensive, convenient,
and nutritious food for both the urban and ru-
ral poor, but also serve as a source of alterna-

56 January - December 2020

tive food varieties that attract tourists and food
enthusiasts. Globally, around 2.5 billion people
are estimated to consume street foods every
day (Food and Agriculture Organization [FAO],
2007). Thus, it is not surprising that the sale
and consumption of street foods are on the rise
and will most probably continue to grow (World
Health Organization [WHO], 1996).
In the Philippines and many other developing
countries, the street food industry plays an im-
portant role in cities and towns, not only eco-
nomically, but also in meeting the food demands
of city dwellers (Cress-Williams, 2001). City au-
thorities, academics, and local NGOs pointed
out that there are about 90,000 street vendors
in Bangladesh (Dhaka); 10,000 in Sri Lanka
(Colombo); 100,000 in Thailand (Bangkok);
50,000 in Singapore; 47,000 in Malaysia (Kua-
la Lumpur); 50,000 in the Philippines (Manila);
and 800,000 in South Korea (Seoul) (Bhowmilk,
2012). Besides offering business opportunities
for developing entrepreneurs, the sale of street
foods is believed to provide a sizeable contri-
bution to the economy of developing countries,
since this can provide employment opportuni-
ties and requires low initial investment.
The consumption of street foods, however, has
become an important public health issue due
to the widespread foodborne diseases brought
about by the mushrooming of street food ven-
dors who lack adequate understanding of basic
food safety principles. Major sources contribut-
ing to microbial contamination are the following:
(1) place of preparation; (2) utensils for cooking
and serving; (3) raw materials; (4) length of time
the cooked foods are exposed to critical tem-
perature; and (5) personal hygiene of vendors
(Maxwell et al., 2000). In addition, street food
vending is perceived to be a major public health
risk due to the lack of basic infrastructure and
services, as well as the difficulty in controlling
the large numbers of street food vending oper-
ations due to their diversity, mobility, and tem-
porary nature. In view of these, people who
Issue No. 9
patronize street foods have been reported to
suffer from foodborne diseases, such as diar-
rhea, cholera, typhoid fever, and food poison-
ing. Unsanitary handling of street foods was
considered a cause of the 2013 foodborne dis-
ease outbreak in Baguio City responsible for a
1,100% increase in acute bloody diarrhea cases
and 23% increase in typhoid fever cases in the
city, as well as a 50% increase in Hepatitis A
cases for the rest of the Cordillera Administra-
tive Region (Agreda, 2013).
Batangas City is also burdened by health is-
sues involving street foods. Anecdotally,
Batangueños who are fond of street foods have
contracted foodborne illnesses, from simple diz-
ziness to hepatitis. Such cases are seldom re-
ported to the City Health Office, which explains
the lack of records and medical attention pro-
vided. Street foods in the city are found outside
school gates, churches, parks, and inside malls.
Preliminary interviews and observation among
selected street food vendors and consumers
showed that the three most patronized street
foods were grilled pork intestine (isaw), pork
barbecue, and grilled coagulated chicken blood
(betamax). Consumers of these foods are usu-
ally adolescents and adults.
The continued development of the city has driv-
en the proliferation of small- to medium- scale
enterprises, including street food vending,
which had become a thriving business and pro-
vided income to more people. This underlines
the importance of considering cleanliness and
safety concerns in consuming street foods. A
review of existing literature indicated that few
studies have dwelled on street food safety in
the Philippines, especially in Batangas, in terms
of microbial and nutritional properties. In addi-
tion, very little is known about how street food
vendors perceive and prioritize food safety. This
study, therefore, explored the knowledge, atti-
tude, and practices of street food vendors and
their association with the microbial safety of the
three commonly patronized street foods.
57
MATERIALS AND METHODS
Research Design
Utilizing a cross-sectional research design, this
study determined the current street food vend-
ing condition in Batangas City. Methods of data
collection used were interview, observation, and
laboratory analysis.
Study Area and Selection of Study Partici-
pants
The study was conducted in the 24 población
barangays of Batangas City (Poblacion 1 to
24) in Luzon, Philippines. It focused on ven-
dors of the three most popular street foods in
Poblacion, Batangas City, namely, grilled pork
intestine (isaw), pork barbecue and grilled co-
agulated chicken blood (betamax). In this study,
“street food vendor” refers to an individual who
sells grilled pork intestine, pork barbecue, and
grilled coagulated chicken blood and who is
knowledgeable about how street food ingredi-
ents are purchased, stored, prepared, and sold
to consumers.
To describe food safety knowledge, attitude,
and practices of street food vendors and the en-
vironmental condition of vending stalls, vendors
selected for this study must (1) sell the three
commonly patronized street foods; (2) have per-
manent stalls in any of the población barangays
(1-24) in Batangas City; (3) provide consent to
take part in the study; (4) agree to have their
products undergo microbial testing. Purposive
sampling was used in this study. From the 70
street food vendors identified in the preliminary
study, 46 were found eligible and were oriented
about the research. Only 35 vendors provided
consent and agreed to participate in the study.
58
Data Collection Instruments and Procedures
Assessment of Food Safety Knowledge,
Attitude, and Practices
Permission to conduct the study was secured
from the Office of the Mayor of Batangas City.
Upon approval, street food vendors were in-
formed about the purpose of the study, assured
of the confidentiality of responses, and asked
to sign an informed consent indicating approv-
al to subject their products to microbial testing.
An interview guide questionnaire was employed
with the following components: (a) vendor’s
socioeconomic profile (b) environmental condi-
tion of the stall; (c) characteristics of the street
foods; (d) nutritional value of the street foods;
(e) knowledge test on food safety for vendors;
(f) items on attitudes regarding food safety; and
(g) self-reported food safety practices. Items
for assessing knowledge, attitude, and practic-
es were based on several studies (Angelilo et
al., 2000; Bolton et al., 2008; Ansari-Lari et al.,
2010); WHO’s (1996) Five Keys to Safer Food
Manual; and FAO’s Guidelines for Assessing
Nutrition-Related Knowledge, Attitudes, and
Practices (Marías and Glasauer, 2014).
The food safety knowledge section, composed
of 20 questions with three possible answers
(“true”, “false”, and “do not know”), was de-
signed to measure the vendor’s understanding
of various food safety aspects. Each correct an-
swer was given one point, while no mark was
given to incorrect or ‘do not know’ answers.
Scores were then converted to percentage, with
score <50% (0-9 points) indicating poor food
safety knowledge; scores between 50 to 75%
(10-15 points) indicating average (adequate)
knowledge; and scores >75% (16-20 points) in-
dicating good knowledge (Angelilo et al., 2000;
Bolton et al., 2008; Ansari-Lari et al., 2010).
Food safety attitude and practices of the se-
lected street food vendors were also evaluated
January - December 2020
using this scoring system. The interview guide
questionnaires were translated into Filipino and
were pretested accordingly. Interrater reliability
or test-retest reliability for the knowledge, atti-
tude, and practices sections were 90%, 89%,
and 95%, respectively.
Environmental Sanitation
Data on the environmental condition of street
food stalls (e.g., availability of running water
supply, handwashing facility, trash bins, and
separate trash bins for different kinds of wastes
for hygienic purposes) were collected through
an observation checklist. The appearance of
major raw materials/ingredients was also ob-
served using sensory characteristics, such as
odor (no foul smell) and color (freshness), as
listed on the observation checklist.
Microbial Analysis of Street Foods
Considering the cost of microbial load testing,
food samples were tested for Escherichia coli
only. The presence of E. coli in food suggests
poor hygiene during food preparation, handling,
and storage; lack of reheating; and improper
vending temperatures (Umoh and Odoba, 2009;
Tambekar et al., 2011). With only E. coli to test,
the study ensured that precautions in the proto-
col for testing were followed, such as standard
collection and handling of food samples and
the conduct of triplicate analyses to detect and
count the microbial load of the microorganism.
Food samples were tested at the Lipa Quality
Control Center (LQCC), a Food and Drug Au-
thority-recognized laboratory under its Labora-
tory Recognition Program.
Microbial analyses of food samples sold for E.
coli detection were done in triplicate. For each
test, food samples weighing 50 g were collected
randomly from the stores of respondents from
3:00-6:00 in the afternoon and were placed in
separate containers with assigned codes. While
Issue No. 9
in transit, samples were kept in a cooler box
packed with ice cubes. LQCC was commis-
sioned to do the E. Coli analysis. The laboratory
used the pour plate method in identifying E. coli
load in the food samples. In this method, melted
cooled agar is added to each food sample and
is aseptically dropped into separate petri films
(Feng et al., 2002). A sample with no E. coli load
(0) indicates that the food has an acceptable
amount of E. coli and is safe for consumption.
On the other hand, a food sample with an E.
coli load (≥ 1 CFU/gram or colony forming unit)
means that the food is unsafe (International
Commission on Microbiological Specifications
for Foods, 1998).
Data Analysis
Descriptive statistics (frequency, percentage
distribution, mean, standard deviation, median,
and range) were used to analyze vendors’ so-
cioeconomic profile, environmental condition,
and characteristics of the three commonly pa-
tronized street foods in Poblacion, Batangas
City.
Spearman’s rank-order correlation was used to
determine the association between street ven-
dors’ knowledge, attitude, and practices and the
microbial safety of the three commonly patron-
ized street foods. The degree of association is
very weak if r = 0.01-0.19; weak if r = 0.20-0.39;
moderate if r = 0.40-0.59; strong if r = 0.60-0.79;
and very strong if r = 0.80-1 (BMJ Publishing,
n.d.). Cramer’s V, on the other hand, was used
to determine the association between the mi-
crobial safety of the three commonly patronized
street foods and the environmental condition of
the street food vending stalls. The degree of as-
sociation is very weak if v = 0.01-0.10; moderate
if v ≥ 0.10-0.30; and strong if v ≥ 0.30 (Kutztown
University of Pennsylvania, n.d.).
RESULTS AND DISCUSSION
Socioeconomic Characteristics of Street
59
Food Vendors Table 1. Socioeconomic profile of street food
vendors
Majority of respondents (66%) were in the 40-
49- and 30-39-year-old age groups. The young- SOCIOECONOMIC VARIABLES N %
est street food vendor was 25 years old and the Age
eldest was 67, with a median age of 44 years <30 4 11
old. Majority (69%) were female, who made and
30-39 9 26
sold street foods to help their husbands provide
40-49 14 40
for family expenses instead of just staying in the
50-59 6 17
house. Sixty percent (60%) of the selected ven-
≥60 2 6
dors finished secondary level of education and
none reached college level. This indicates that Total 35 100

more vendors in this group have relatively low Median: 44 (25-67)

level of education. Similarly, a study conducted Sex
in Accra revealed that less educated persons, Male 11 31
particularly women, engaged in street food Female 24 69
vending (Maxwell et al., 2000). All respondents Total 35 100
have not attended any food safety training for Highest Educational Attainment
the past six months. Only one (1) had attended
Elementary 9 26
training through her own initiative several years
Secondary 21 60
ago. Most respondents (60%) acquired knowl-
Vocational 5 14
edge on street food vending through observa-
Total 35 100
tion, either with relatives or friends engaged in
the street food business. Some respondents Did not attend any food safety 35 100
training in the past six months
(29%) said that knowledge on street food vend-
Acquisition of knowledge on street food vending
ing was acquired through their parents, while
Observation 21 60
very few (11%) were taught by their co-workers.
Parents 10 29
In addition, none of them had undergone formal
training or education on preparing and selling Co-workers 4 11

street foods (Table 1). Total 35 100

Length of Experience in Street Food Vending (years)
More than one-third (37%) of respondents have Less than 1 year 1 3
been selling street foods for 15-21 years. The 1-7 7 20
longest experience in street food vending was 8-14 6 17
36 years, while the shortest was 6 months or 15-21 13 37
less than one year. The per capita income from 22-28 5 14
street food vending of nearly half of the selected
29-35 2 6
vendors (46%) was PhP 5,000.00-PhP 10,00.00
>35 1 3
per month, with a median per capita income of
Total 35 100
Php 11,000.00 and a range of Php 5,000.00-
PhP 23,300.00. Median (Range): 18 (<1-36)
Per Capita Income from Street Food Vending (PhP)
5,000-10,000.00 16 46
10,001-15,000.00 8 23
15,001-20,000.00 7 20
20,001-25,000.00 4 11
Total 35 100

60 January - December 2020

Characteristics of the Three Commonly
Patronized Street Foods
Majority of grilled pork intestine and pork barbe-
cue sold weighed 21-30 g/serving, while most
(69%) grilled coagulated chicken blood samples
weighed 31-40 g/serving. Specifically, serving
sizes of the three commonly patronized street
foods were as follows: grilled pork intestine, 20-
40 g; pork barbecue, 20-45 g; and grilled co-
agulated chicken blood, 35-50 g. The smallest
serving size for both grilled pork intestine and
pork barbecue was 20 g and 35 g for grilled
coagulated chicken blood. On the other hand,
the biggest serving size for grilled pork intestine
was 40 g, 45 g for pork barbecue, and 50 g for
grilled coagulated chicken blood (Table 2).
Roughly all grilled pork intestines and grilled
coagulated chicken blood were sold at prices
ranging from PhP 5.00 to PhP 10.00/serving,
although one vendor sold it for more than PhP
20.00/serving. For grilled coagulated chicken
blood, one store sold it for less than PhP 5.00/
serving while another sold it for PhP 16.00-PhP
20.00/serving.

Table 2. Characteristics of the three commonly patronized street foods

GRILLED COAGULATED
GRILLED PORK INTESTINE PORK BARBECUE
VARIABLES CHICKEN BLOOD
N % N % n %
Serving Size (g)
41-50 0 0 1 3 11 31
31-40 1 3 0 0 24 69
21-30 30 86 31 89 0 0
≤20 4 11 3 8 0 0
Median (Range): 25 (20-40) 25 (20-45) 38 (35-50)
Selling Price (PhP)
>20.00 1 3 1 3 0 0
16.00-20.00 0 0 0 0 1 3
11.00-15.00 0 0 29 83 0 0
5.00-10.00 34 97 5 14 33 94
<5.00 0 0 0 0 1 3
Median (Range): 5.00 (5.00-35.00) 15.00 (10.00-40:00) 5.00 (3.00-20.00)
Cost/gram (PhP/g) 0.20 0.60 0.13
Appearance of Raw Material/Ingredient
Fresh 35 100 35 100 5 14
Pre-cook, Coagulated 0 0 0 0 30 86

The lowest selling price per serving of grilled
pork intestine was PhP 5.00 while the highest
selling price was PhP 35.00. For grilled coag-
ulated chicken blood, PhP 3.00/serving was
the lowest selling price while PhP 20.00/serv-
ing was the highest. Most vendors (83%) sold
pork barbecue at a price range of PhP 11.00-
PhP 15.00, with the lowest selling price at PhP
10.00/serving and the highest selling price at
PhP 40.00/serving.
Using the median serving sizes and the median
selling prices of the three commonly patronized
street foods, price per gram was estimated as

Issue No. 9 61
follows: PhP 0.20/g for grilled pork intestine,
PhP 0.60/g for pork barbecue, and PhP 0.16/g
for grilled coagulated chicken blood. The varied
selling prices of street foods among vendors
may be due to differences in production costs
and serving sizes.
All raw materials used in preparing the three
commonly patronized street foods were pur-
chased from the public market. Aside from the
availability of raw materials for street foods,
the public market was also accessible to ven-
dors, even as early as two o’clock in the morn-
ing. Vendors also had their own suki or regular
source from whom they buy raw materials at
a discounted price, especially if purchased in
bulk. Nearly all (86%) of them purchased pork
intestine, pork, and chicken blood every day,
which they claimed ensures the freshness of in-
gredients. Respondents who did not purchase
raw materials daily (14%) said it was tiring and
difficult to do. To avoid spoilage, these respon-
dents claimed that they ensure proper storage
of purchased ingredients.
During the actual purchasing of raw materials,
it was observed that pork intestine and pork
were bought fresh. There were no signs that
these raw materials were stale. All suppliers
claimed that raw materials came fresh from the
slaughterhouse. In the case of chicken blood,
however, only 14% of respondents purchased
fresh blood while majority (86%) purchased
pre-cooked coagulated chicken blood. Respon-
dents who bought raw blood said this ensured
the freshness and quality of the ingredient,
even if preparation was more tedious compared
to purchasing pre-cooked coagulated chicken
blood. In addition, fresh or raw blood was more
affordable (PhP 20.00-PhP 25.00/kilo) com-
pared to pre-cooked coagulated chicken blood
(PhP 45.00-PhP 55.00/kilo). Vendors who usu-
ally buy pre-cooked blood mentioned that it was
a time-saving practice, and that food safety and
quality were not compromised since they have
trusted suppliers. They also reboil pre-cooked
62
blood to add flavorings, such as sugar and bay
leaf to improve taste.
In terms of the type of preparation, both grilled
pork intestine and grilled coagulated chicken
blood sold were pre-cooked before grilling and
selling. Only 34% of selected street food ven-
dors pre-cooked pork barbecue prior to selling.
Majority (66%) of street food vendors grilled the
barbecue on site because, according to them,
pork meat tends to be tough if pre-cooked and
later reheated.
Environmental Condition of Street Food
Stalls
Almost one-third (32%) of the 35 street food
stalls were located inside a compound that has
roof and satisfactory hygienic condition. All food
stalls had either display cabinets or covered
containers where foods were kept. Other food
stalls were located in areas that were kept clean
and litter-free (17%); at the public market (17%);
near an open canal (14%); close to a garbage
dumpsite (14%); and near tricycle/jeepney ter-
minals (6%). The last four locations were prone
to smoke and dust contaminations. In addition,
during peak hours of operation, street food ven-
dors found it difficult to maintain the cleanliness
of the vending site regardless of their location,
resulting in dirty surroundings. Street food ven-
dors were also not so particular with the cleanli-
ness of the location as long as there are poten-
tial consumers (Table 3).
Almost all (89%) street food stalls had no avail-
able running water supply, as well as handwash-
ing facilities. The remaining 11% with available
running water supply and handwashing facilities
were part of a group of street food stalls locat-
ed inside a compound. Respondents said it was
difficult to have available running water supply
since the stalls were mostly located at side-
walks of busy streets, near tricycle and jeepney
terminals, and other places with no access to
running water supply. Hence, water used for
January - December 2020
food preparation was taken from their respec-
tive homes. Lack of available running water also
resulted in the unavailability of clean water for
handwashing, food preparation, and cleaning of
utensils and the immediate area.
Based on observation and interviews with the
selected street food vendors, nearly all (91%)
street food stalls had trash bins. Only 31% of
these, however, had available trash bins for
waste segregation. In addition, most available
trash bins were not covered and some had
leaks.
Table 3. Environmental condition of street food
stalls
Level of Food Safety Knowledge, Attitude,
and Practices of Street Food Vendors
Results of the knowledge test on food safety
among the selected street food vendors ranged
from 7 to 20, with a median score of 12, indicat-
ing an average level of food safety knowledge.
After comparing their actual responses with
the correct answers, more than half of vendors
(54%) obtained average scores. This could be
attributed to the length of experience in the food
vending business, since most respondents had
engaged in this industry for more than 3 years.
Some vendors (14%), however, scored low
on the knowledge test, which could be due to
the low educational attainment of respondents
(Tabl­e 4).

ENVIRONMENTAL CONDITION N %
Table 4. Distribution of street food vendors
Location of the food stall
based on food safety knowledge scores
Inside a compound 11 32
Near the public market 6 17
N %
Kept clean and litter-free 6 17
Knowledge
Too close to an open canal 5 14
Poor 5 14.3
Too close to garbage dumpsite 5 14
Average 19 54.3
Near the tricycle/jeepney terminal 2 6
Good 11 31.4
Total 35 100
Total 35 100
Availability of running water supply
Median (Range):12 (7-20)
Available 4 11
Attitude
Not Available 31 89
Poor 0 0
Total 35 100
Average 11 31
Availability of handwashing facility
Good 24 69
Available 4 11
Total 35 100
Not Available 31 89
Median (Range): 190 (153-231)
Total 35 100
Practice
Availability of trash bins
Poor 0 0
Available 32 91
Average 13 37
With separate trash bins for different 31
kinds of wastes 10 Good 22 63
No separate trash bins for different Total 35 100
22 69
kinds of wastes
Not Available 3 9 Median (Range): 132 (103-158)

Total 35 100

Issue No. 9 63
Respondents had a median food safety attitude
score of 190, with a range from 153 to 231, in-
dicating good attitude towards food safety. With
regard to score distribution, 69% had good atti-
tude towards food safety while almost one-third
(31%) had average attitude scores. None of the
street food vendors exhibited poor attitude to-
wards food safety (Table 4).
The selected vendors had a median self-
assess­ed food safety practices score of 132,
with a range from 103 to 158, indicating that
they general­ly perceived themselves as hav-
ing satisfact­ory practices on food safety. Spe-
cifically, 63% of vendors perceived themselves
as having good food safety practices while the
remaining 37% as having adequate practices.
None of the respondents perceived having poor
food safety practices (Table 4). The good rat-
ings on attitude and perceived practices could
be explained by the nature of the questionnaire,
wherein most respondents chose socially ac-
ceptable answers. Results of their actual prac-
tices based on an observation checklist showed
poorer scores compared to their perceived
practices. What they claimed they were doing
may be true on paper but not in reality.
Classification of the Three Commonly
Patronized Street Foods using E. coli as
Indicator
Majority (71%) of the pork barbecue sampled
from those sold by respondents were safe or
had no E. coli, while the remaining 29% were
found to be contaminated with the microorgan-
Table 5. Classification of the three commonly patronized street foods using E. coli as indicator
PORK BARBECUE
CLASSIFICATION
N %
Safe 25 71
Not Safe 10 29
Total 35 100
*values are means of three trials
64
ism (Table 6). Sampled grilled pork intestine
and coagulated chicken blood showed opposite
results, with more samples (54% and 74%, re-
spectively) found to be contaminated with E. coli
than those found safe for consumption (46%
and 26%, respectively). In addition, the median
counts of E. coli load for grilled pork intestine
and coagulated chicken blood both exceeded
the value recommended by the International
Commission on Microbiological Specifications
for Foods (1998) (0 = safe; ≥1 not safe), making
them generally unsafe for consumption. More-
over, results indicated that the risk of E. coli
contamination was more likely to occur in grilled
coagulated chicken blood and less likely in pork
barbecue (Table 5).
The ingredients used could be one of the caus-
es of contamination of grilled pork intestine and
grilled coagulated chicken blood. Both street
foods use internal organs (intestine and blood)
as main ingredient, which naturally contains
harmful microorganisms such as E. coli. Major-
ity of vendors purchased pre-cooked chicken
blood to save time for preparation. Since they
had no knowledge regarding how the ingredi-
ents were prepared, the food quality and safety
were not assured. Vendors stated that unlike
pork barbecue, which was mostly cooked on-
site, the other two street foods were usually
brought to the stalls pre-cooked. Thus, these
street foods had not undergone prolonged heat-
ing, which may have resulted in under-cooking.
For grilled coagulated chicken blood, prolonged
heating was avoided since they tended to be
tough when heated for a long time.
GRILLED PORK GRILLED COAGULATED
INTESTINE CHICKEN BLOOD
N % n %
16 46 9 26
19 54 26 74
35 100 35 100
January - December 2020
Association of Street Food Vendors’
Knowledge, Attitude, and Practices with
Microbial Safety
Knowledge, attitude, and practices on food
safety of the selected street food vendors were
inversely associated with the E. coli load of the
three commonly patronized street foods (Table
6). This means that the higher the scores on
knowledge, attitude, and practices, the lower
the level of contamination. Thus, selected street
food vendors who are knowledgeable and have
good attitude and practices on food safety are
likely to produce safe street foods. Conversely,
street food vendors with poor knowledge, atti-
tude, and practices on food safety are likely to
produce foods contaminated with E. coli.
Table 6. Association of knowledge, attitude,
and practices with E. coli count of street foods
STREET
FOODS KNOWLEDGE ATTITUDE PRACTICE
Grilled Pork
-0.77 -0.61
Intestine
Pork -0.69 -0.45
Barbecue
Grilled
Coagulated
-0.59 -0.55
Chicken
Blood
Degree of association: r = 0.8-1, very strong; r = 0.6-0.79,
strong; r = 0.4-0.59, moderately strong; r = 0.2-0.39,
weak; r = 0.0-0.19, very weak or no relationship
As discussed previously, most street food
vendors in this study had an average level of
knowledge on food safety. While they reached
elementary and secondary levels, none of them
had tertiary education or attended food safety
training for the past six (6) months. These fac-
tors may have contributed to the level of knowl-
edge of street food vendors on food safety, since
low level of education is likely to promote lack
of appreciation for food handling practices and
presents potential risk to food safety (Nurudeen
et al., 2014). As a result, very few respondents
obtained correct answers regarding the use
Issue No. 9
of the same cutting board for raw and cooked
foods (40%); proper temperature for cooking
meat (23%); and presence of microbes in the
body parts of food handlers (40%). These food
safety aspects are critical to food safety and
could explain why majority of street food sam-
ples were found to be contaminated with E. coli.
In the study conducted by Susanna et al. (2015)
in Indonesia, results revealed that the level of
knowledge of food handlers was the primary
contributing factor to food contamination. Food
handlers who had poor knowledge about food
borne diseases were three times more suscepti-
ble to E. coli contamination. In addition, a study in
Southeastern Nigeria noted that food handlers’
knowledge about food safety and sanitation was
strongly correlated to E. coli contamination and
that their knowledge was in turn related to their
educational level (Musa and Akande, 2003). In
various studies conducted to assess the food
safety knowledge of street food vendors, it has
been observed that vendors generally have
poor levels of food safety knowledge (FAO,
-0.55
2013; Rane, 2011). The relatively low level of
-0.40 education among food handlers seemed to be a
factor contributing to their lack of knowledge on
food safety, which consequently increases the
-0.42
risk of E. coli contamination of foods.
Street food vendors’ attitude exhibited a mod-
erate inverse association with the E. coli load
of the three commonly patronized street foods.
This could be attributed to the attitude of the
street food vendors during purchasing. Almost
all respondents failed to check the sensory
characteristics of the main ingredient (pork in-
testine for isaw, pork for barbecue, and chicken
blood for betamax). Ingredients were purchased
from their trusted suppliers already packed in
plastic bags ready for pickup. When asked why
they did not inspect the ingredients, respon-
dents said they trusted their suppliers because
they have been regular patrons since starting
their businesses. Likewise, the characteristics
of the ingredient could also be a factor. Street
65
food vendors usually purchased coagulated or
pre-cooked chicken blood to save time in prepa-
ration. Quality and safety were not guaranteed,
however, since they did not see how the ingre-
dients were prepared.
Vendors’ practices in terms of food safety also
showed a moderate inverse association with the
E. coli load of the three commonly patronized
street foods. This can be due to the respon-
dents’ inconsistency in performing food safety
practices related to personal hygiene, purchase,
storage, food preparation, and vending. Street
food vendors did not regularly wash hands af-
ter touching any body part. Avoiding sneezing
or coughing over the food, particularly when it is
ready to be served, was also not regularly prac-
ticed by the respondents. Both may contribute
to the presence of E. coli in the food (Blood and
Curtis, 1995), indicating poor manufacturing
practices and inadequate hygiene standards.
Study results agree with the findings in Indone-
sia (Susanna et al., 2015) that established the
association between food handling practices of
canteen workers and E. coli contamination in
foods sold from food stalls in canteens around
the campus. Pathogens present in street-vend-
ed foods come from different sources and prac-
tices, such as improper food handling. Utensils
and equipment may also lead to microbial cross
contamination of food with S. aureus, E. coli,
and Shigella due to contaminated water, dish-
cloth, and handlers (WHO, 1989). This was also
Table 7. Association between the environmental condition of street food vending and microbial safety
of street foods
AVAILABILITY
STREET FOODS LOCATION OF RUNNING
WATER SUPPLY
Grilled Pork Intestine 0.85 0.73
Pork Barbecue 0.79 0.45
Grilled Coagulated Chicken 0.23 0.64
Blood
Degree of association: v = 0.01-0.10, very weak; v = > 0.10-0.30, moderate; v = > 0.30, strong
66
observed among selected street food vendors
during the interview.
Association of Environmental Condition of
Street Food Vending with Microbial Safety
Table 7 shows the association between the en-
vironmental condition of street food vending and
microbial safety of the three commonly patron-
ized street foods. Based on the results, E.col­i
load was associated with location. Safety of
grilled pork intestine and pork barbecue showed
strong association, while safety of grilled coag-
ulated chicken blood exhibited moderate asso-
ciation. This suggests that street foods sold at
clean and conducive vending sites were less
likely to be contaminated with E. coli, while
those sold at dirty areas were most likely to be
contaminated.
Based on observation, although street food
vending locations were different categorically,
they share one common characteristic – having
vending sites unconducive to food preparation
and selling. These included locations that were
either too close to an open canal or a garbage
dump site, inside a compound, or near tricycle
or jeepney terminals. Only six (6) street food
vendors (32%) were able to keep their food
stalls clean and litter-free (Table 5). During peak
hours of operation, selected street food vendors
found it difficult to maintain the cleanliness of
food stalls, resulting in dirty surrounding and
contaminated street foods.
AVAILABILITY
AVAILABILITY
OF HAND AVAILABILITY
OF SEPARATE
WASHING OF TRASHBINS
TRASH BINS
FACILITY
0.73 0.17 0.42
0.45 0.03 0.26
0.64 0.96 0.31
January - December 2020
Availability of running water supply and hand-
washing facilities were also associated with the
E. coli load of street foods sampled, with street
food vendors more likely to produce safe foods
when there is available running water supply
and handwashing facilities.
In this study, four (4) out of 35 (11%) street food
stalls had running water supply and handwash-
ing facilities, which the vendors did not fully uti-
lize, particularly during handwashing. Instead,
street food vendors preferred wiping their hands
using cloth or basahan that was also employed
for cleaning surfaces used in food preparation.
According to respondents, frequent handwash-
ing, especially when tired from preparing street
foods, might result in pasma, which they claimed
was not good for their health. Water supply and
handwashing facilities were used by street food
vendors for cleaning cooking and serving uten-
sils and by consumers to wash their hands after
eating street foods.
Statistical results revealed a very weak associ-
ation between availability of trash bins and E.
coli load of pork barbecue. It could be inferred
that the availability of trash bins at food stalls
of the selected street food vendors does not
prevent E. coli contamination of pork barbecue.
When it comes to the availability of separate
trash bins to segregate wastes by type and
its relation to E. coli load, only pork barbecue
showed moderate association. Microbial safety
of grilled pork intestine and grilled coagulated
chicken were both strongly associated with the
availability of separate trash bins for different
kinds of wastes. This could be due to improper
waste disposal practices of street food vendors.
Although some (31%) have separate trash bins
as observed during the interview, the trash bins
were not covered while some have leaks. In
addition, trash bins were located near the food
preparation area, which can affect the safety of
food samples.
Issue No. 9
CONCLUSION AND
RECOMMENDATIONS
In terms of environmental condition, most street
food vendors surveyed in this study had stalls
located inside a compound, had no available
water and handwashing facilities, and had avail-
able trash bins but were not segregated for dif-
ferent kinds of wastes, indicating that they do
not practice waste segregation. Respondents’
level of food safety knowledge was average,
while food safety attitude and practices were
rated good.
Using E. coli as indicator of microbial safety,
study results indicated that majority of pork bar-
becue sold by street food vendors had no E. coli
content and are safe for consumption, while the
opposite was true for grilled pork intestine and
grilled coagulated chicken blood.
Knowledge, attitude, and practices of street
food vendors were inversely associated with the
E. coli load of the three commonly patronized
street foods. An association was found between
the environmental condition of the street food
vending site with E. coli load, although the level
of association was weak between the availabil-
ity of trash bins and pork barbecue (v = 0.028).
Street food vending is of great importance to
the community, especially in terms of provid-
ing employment, income, and inexpensive and
nutritious foods to the population. As such, the
following recommendations are forwarded to-
wards improving the condition of street food
vending, as well as ensuring food safety to pro-
tect consumer health.
1. The city government of Batangas
should conduct training every six
months to improve the knowledge,
attitude, and practices of street food
vendors and address issues on per-
sonal hygiene, purchase, safe storage,
and proper food handling during food
67
 preparation and vending. Street food
vendors can benefit from trainings that
may be provided by the local govern-
ment unit on a regular basis by gaining
knowledge and improving attitude and
practices on the aforementioned criti-
cal dimensions of food and microbial
safety.
2. Allocation of spaces conducive to food
preparation and selling, with available
running water supply and handwash-
ing facilities and trash bins that are
covered and without leaks, can be
done to improve the environmental
condition of street food vending sites.
3. There is a need to examine local rules
and regulations on street food vend-
ing, such as compliance to health and
sanitary permits. Monitoring and eval-
uation can aid in ensuring food safety.
4. An exhaustive test that includes Sal-
monella, Bacillus cereus, and Staph-
ylococcus aureus will capture the mi-
crobial safety condition of street foods
more accurately. In addition, swab
samples from preparation boards, wa-
ter sources, and hands of food han-
dlers should also be tested to deter-
mine the sources of microorganisms.
5. For future research, a bigger sample
size should be covered to have a bet-
ter picture of the street food vending
condition. Random sampling of street
food vendors can be applied if the ob-
jective is to come up with generaliza-
tions about the study population.
6. Further studies may be conducted cov-
ering the entire Batangas City and may
explore the microbial aspects of other
street foods offered by street food ven-
dors/street peddlers.
68
ACKNOWLEDGMENT
Special thanks to the Department of Science
and Technology (DOST) Accelerated Science
and Technology Human Resource Development
Program (ASTHRDP) for the full financial sup-
port and scholarship grant.
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70 January - December 2020

Grain Quality of Milled Rice in Various Supermarkets in
Dasmariñas City, Cavite
Arvin Paul P. Tuaño a *, Kristina Tamyl M. Lasam b, Christian Jeshua M. Vicente b
a
Institute of Chemistry, College of Arts and Sciences, University of the Philippines Los Baños, College, Laguna
b
Department of Chemistry, College of Humanities and Sciences, De La Salle Medical and Health Sciences Institute,
Dasmariñas City, Cavite

* Corresponding author: aptuano@up.edu.ph

ABSTRACT
All open-bin milled rices (n = 44) sold in selected supermarkets along Emilio Aguinaldo Highway in
Dasmariñas City, Cavite were collected in July-August 2017 and subjected to grain quality analysis,
specifically those affecting rice cooking and eating quality. Rice with intermediate apparent amylose
content (AC) (mean AC 21.4%) predominated this sample set, followed by high AC. Alkali spreading
value (ASV) showed 21 out of 44 samples to have intermediate gelatinization temperature (GT)
with mean ASV of 4.5. AC-GT combinations showed that supermarket milled rices in Dasmariñas,
Cavite were predominantly of the intermediate AC-intermediate GT type which have soft texture
when cooked. This was followed by high AC-intermediate GT type which have medium texture. Gel
consistency (GC) test showed that most of the high-AC samples were hard on cooling but the overall
mean GC of 58 mm corresponded to medium GC. Optimum cooking time (OCT) was found to be
around 17-19 min. Market price was found negatively correlated with AC and OCT while ASV and
price had a highly positive correlation. OCT was significantly positively correlated with AC but was
negatively correlated with ASV. Determining the grain quality of market rice samples in supermarkets
or public markets is of significance especially in market milled rice grading and clustering relative
to rice end-use quality and price. Results of this study serve as baseline data on Philippine market
milled rice quality. The survey started in 2012 at PhilRice Los Baños and was geared towards helping
Filipino consumers and inspectors recognize common rice quality types in the local market.

Keywords: apparent amylose content; AC-GT combination; alkali spreading value; gelatinization
temperature; gel consistency; market price; milled rice; optimum cooking time; supermarket

INTRODUCTION of proteins and 5.63 g of fats per capita con-

Rice is the most commonly consumed staple
food included in the diet among Filipinos (Ju-
liano, 2010). The Philippines has gained the
highest percentage increase in milled rice pro-
duction in 2014, with an average of 5.05% since
the year 2009 (Galvez, 2014). Rice primarily
provides dietary carbohydrates meeting the ca-
loric requirements of the Filipino consumers. It
supplies around 1,117.16 g of calories, 23.47 g
sumption per day (Bersales, 2015). Rice, there-
fore, is considered one of the most significant
cereals of great interest especially in developing
countries like the Philippines (Juliano, 2007).
Consumers now tend to choose the kind of rice
with the best eating quality based on their pref-
erences (Juliano, 2010; Juliano, 2019). Physical
appearance of market rice is the primary factor
for the consumers’ choice followed by its cook-
ing and eating quality (Unnevehr, 1986; Juliano
et al. 1989; Tuaño et al., 2016).

Issue No. 9 71
Rice starch, comprising 80-90% of the milled
rice grain, is composed of a highly branched
glucan fraction called amylopectin and an es-
sentially linearly glucan portion termed amylose
(Juliano, 2007; Juliano and Tuaño, 2019). The
key determining factor of Philippine rice end-
use quality is the apparent amylose content
(AC). Philippine rice can be categorized based
on AC: waxy (0–2%), low (10–17%), interme-
diate (17–22%), and high (>22%) AC (Tuaño
et al., 2015). AC affects the hardness or soft-
ness of the rice once cooked. Nonwaxy rices
having low AC result in soft cooked rice while
those with high AC result in harder, dry and flaky
cooked rice. In contrast, waxy rice which con-
tains around 0-2% AC and mainly amylopectin
is stickier when cooked as compared to non-
waxy rice (Juliano, 2007; Tuaño et al., 2014).
Waxy rice is commonly known as glutinous rice
or “malagkit” in the Philippines. Gelatinization
temperature (GT) is another functional property
of the rice grain which denotes the temperature
of irreversible swelling of native starch granules
in hot water. GT is usually measured via the
alkali spreading value (ASV) in rice breeding
programs. ASV is inversely proportional to GT,
wherein low GT has ASV 6–7, intermediate GT
has ASV 4–5 and intermediate-high to high GT
has ASV 1–3 (Juliano, 2007; Juliano, 2010).
In the Philippines, consumers usually buy milled
rice with intermediate to low AC due to the soft-
ness of cooked rice which Filipinos generally
prefer. However, there are few who prefer the
high-AC ones because it provides longer sati-
ation (Trinidad et al., 2014; Tuaño et al., 2016).
Unnevehr (1986) has shown that consumers in
Indonesia, Thailand, and the Philippines prefer
market rices that are properly milled, more pol-
ished, and have good aroma. It has been shown
that aside from the market price, whiteness of
the grain as well as percentage of whole grains
are the primary factors affecting the milled rice
choice of the Filipino consumers (Juliano et al.,
1989; Mangaoang et al., 2002). Satiety factor,
taste, age, and aroma may also affect con-
72
sumers’ decision in purchasing rice. Tuaño et
al. (2016) revealed that intermediate AC has
been of the predominant rice type in the Phil-
ippine market followed by high AC. However,
until now, there has been no report providing
information on the grain quality profile of market
rices in Cavite, particularly in Dasmariñas City.
This study aimed to evaluate the grain quality
of milled rices collected from selected super-
markets along Emilio Aguinaldo Highway, Das-
mariñas City, Cavite – the main national road of
the city. It focused on determining physicochem-
ical properties of supermarket milled rice sam-
ples specifically AC, GT via the alkali spreading
value (ASV), gel consistency (GC), and optimum
cooking time (OCT). Correlations of these grain
quality traits and the market price of the sam-
ples in this study were also determined. Grain
quality data from this study serve as additional
baseline information to be included in the Phil-
ippine market rice quality survey which started
in 2012 at PhilRice Los Baños. The survey aims
to help Filipino consumers, market rice quality
inspectors, and interested stakeholders in prop-
erly identifying rice quality types in the market
and eventual policy recommendations related to
milled rice grading, rice quality clustering, and
market price of milled rice.
MATERIALS AND METHODS
Rice Sample Collection and Preparation
Forty-four (44) supermarket milled rice samples
were collected from all open-bins in selected
supermarkets along Emilio Aguinaldo Highway
in Dasmariñas City, Cavite, namely, Savemore
Salitran, Puregold Dasmariñas, Waltermart Su-
permarket, Robinsons’ Pala-pala and SM Das-
mariñas. Rice samples (250 g) were purchased
and collected in July-August 2017. Open-bin
rices were mixed thoroughly to ensure sample
homogeneity prior to collecting 250-g represen-
tative sample. Price per kg and brand names/
market labels of the samples were noted. A
January - December 2020
portion (8 g) of each of the rice samples was
ground to pass through 60-mesh sieve using a
cyclone mill, transferred into in a polyethylene
plastic bag, and stored in a freezer at -10°C
until further use in physicochemical analysis.
The rest of the milled grains were also stored
separately in a refrigerator until further use. All
reagents used were analytical grade reagents
and distilled water was used in this study, unless
otherwise specified.
Apparent Amylose Content Determination
Apparent amylose content (AC) was analyzed in
triplicate following Juliano et al. (2012) method
and the proposed AC ranges for Philippine rice
by Tuaño et al. (2015). In a 100-mL volumetric
flask, 100 mg of Avebe potato amylose V stan-
dard and each of the milled rice flour samples
were weighed and 1 mL 95% ethanol was add-
ed to wet the sample. The flasks were carefully
swirled just enough to avoid clumping. Then, 1N
sodium hydroxide (NaOH) (9 mL) was added to
each mixture, covered, and left to stand for 16 h.
Afterwards, samples were diluted to 100 mL with
distilled water and mixed well. Working amylose
standard solutions were prepared (i.e. 0, 5, 10,
15, 20, 25, and 30% amylose) from the previ-
ously prepared Avebe potato amylose standard
and certain amount of 0.09N NaOH. From these
solutions, aliquots (5 mL) were transferred into
another set of 100 mL volumetric flasks. Exactly
1 mL of 0.9N ammonium chloride (NH4Cl) and
approximately 50 mL distilled water, and sam-
ples were mixed thoroughly. Then, 2 mL iodine
solution (0.15% iodine [I2] in 1.5% potassium io-
dide [KI]) was added, followed by dilution to 100
mL with distilled water, and mixed thoroughly.
After mixing, absorbance of the colored solu-
tion was measured at 620 nm using Shimadzu
UV-1800 (Shimadzu Corp., Japan) within 20 to
60 min. For waxy rice samples which yielded
yellowish-brown solutions after addition of io-
dine, samples were allowed stand for 2 h and
absorbance was measured similarly. Standard
calibration curves were generated and AC of the
Issue No. 9
milled rice samples was expressed as percent
AC (milled rice basis).
Alkali Spreading Value Determination as an
Index of Gelatinization Temperature
Gelatinization temperature (GT) type was deter-
mined via the alkali spreading value (ASV) test.
Triplicate six whole grains of milled rice were
placed in separate 60 x 15 mm plastic petri
dishes. Then, 1.7% potassium hydroxide (KOH)
was added ensuring that all the grains were
submerged separately in the solution. Samples
were allowed to stand for 23 h at room tempera-
ture. Degree of grain disintegration was scored
using the 7-point scale described by Little et al.
(1988) and GT type was noted for each sample
following the ranges used for Philippine waxy
and nonwaxy rices (Tuaño et al., 2014).
Gel Consistency Test for Rices with High
Apparent Amylose Content
Gel consistency (GC) test was based on the
method of Cagampang et al. (1973) and was
applied for high samples AC only (Juliano,
2007). Triplicate 100-mesh milled rice flour
samples (100 mg) were weighed and trans-
ferred in 13 x 100 mm culture tubes and wet-
ted with 2 mL 95% ethanol having 0.03% bro-
mothymol blue and mixed thoroughly using a
vortex mixer. Subsequently, 2 mL of 0.2N KOH
was added to each tube, mixed using a vortex
mixer, and cooked in a boiling water bath for 8
min to ensure complete rice starch gelatiniza-
tion. Afterwards, sample were allowed to cool to
room temperature for 5 min and cooled in an ice
bath for another 20 min. The tubes were then
laid flat horizontally on the laboratory table with
a ruled white cross-section paper and left for 1
h undisturbed. GC classification was made after
scoring the length of the cooled blue gel starting
from the bottom of the tube up to the gel front.
Rice samples were classified as hard GC (28-
40 mm), medium GC (41-60 mm), and soft GC
(61-100 mm) (Cagampang et al., 1973; Juliano,
2010).
73
Ranghino Test for Optimum Cooking Time
Determination
In a 250-mL beaker, distilled water (135 mL) was
placed under extreme heat until it vigorously
boiled. Then, 5 g of whole milled rice grains was
poured into the beaker. Samples were allowed to
cook for 10 min in vigorously boiling water, then,
10 grains were taken out every after 1 min using
a plastic spoon. The grains were pressed in be-
tween two glass petri dishes and opaque center
was noted on each grain. Once the pressed,
grains showing no opaque uncooked centers
were considered cooked and noted. Repeated
pressing and opaque center determination was
continued until such time that 90% of the grains
tested showed no opaque centers. Final time in
min was noted and termed as minimum cooking
time (Ranghino, 1966). Optimum cooking time
(OCT) was calculated by adding 2 min to the
minimum cooking time. Ranghino test was done
on all milled rice samples in triplicate and results
were expressed as mean values rounded to the
nearest whole number in minutes.
Statistical Analysis
All data were subjected to analysis of variance
(ANOVA) and post-hoc least significant different
(LSD) test at p < 0.05 using the Statistical Tool
for Agricultural Research (STAR) Software Ver-
sion 2.0.1. Linear correlation coefficients were
also determined and all data were presented as
mean ± standard deviation (SD), unless other-
wise specified.
RESULTS AND DISCUSSION
Physicochemical Properties and Price of
Supermarket Milled Rices in Dasmariñas
City, Cavite
Out of the five (5) supermarkets surveyed along
Emilio Aguinaldo Highway in Dasmariñas City,
Cavite, mean prices per kg (Php) of milled rices
74
in Savemore Salitran (Savemore), Waltermart
Supermarket (Waltermart), Robinsons’ Pala-Pa-
la (Robinsons) and SM Dasmariñas were found
to have no significant differences with each oth-
er but were significantly lower than those col-
lected from Puregold Dasmariñas (Puregold)
(Table 1). Prices per kg of milled rices in all the
supermarkets surveyed ranged from Php 40.00
to Php 110.00. Puregold had the lowest mean
price per kg while Robinsons had the highest.
The grand mean price per kg for all supermar-
kets in this study was Php 61.04 (Table 1). In
terms of mean apparent amylose content (AC),
milled rice samples from Savemore, Robin-
sons, and SM Dasmariñas had high AC while
those from Puregold and Waltermart had inter-
mediate AC. Interestingly, the mean AC of rice
samples from Waltermart was noted to be the
lowest among all the supermarkets surveyed
(Table 1). The mean AC (19.5%) of Waltermart
samples was significantly lower than the mean
AC of rices from other supermarkets surveyed
(Table 1). This may be due to high frequency
of low-AC and waxy rices in this sample set.
Also, intermediate-AC rices in this supermar-
ket were mainly around 20% AC (Supplemen-
tal Table 1). The grand mean AC was found to
be 21.4% in all supermarkets (Table 1). There
were 16 samples having high AC and 6 sam-
ples were waxy rices. The grand mean ASV of
milled rices across all supermarkets was found
to be 4.7 ranging from 3.1 to 6.6. GS Supreme
from Savemore had the lowest mean ASV 3.1
while Japanese and Jasmine rices from Robin-
sons had the highest mean ASV of 6.6 (Table 1;
Supplemental Table 1). Mean ASV of milled rice
samples collected from Waltermart, Robinsons,
and SM Dasmariñas were significantly higher
than the mean ASV of Savemore and Purego-
ld samples, but their GT types all belonged to
intermediate GT (Juliano, 2007; Tuaño et al.,
2014). All 44 samples, regardless of supermar-
ket source, had similar mean optimum cooking
time (OCT) of ~18 min with an overall range of
17-19 min and grand mean of 18 min. Hard gel
consistency (GC) was prominent in 3 supermar-
January - December 2020
kets, namely Savemore, Puregold, and Robin-
sons while SM Dasmariñas samples had mainly
medium GC. Surprisingly, no high-AC samples
were present in Waltermart which indicated that
Waltermart have softer cooked rices available in
open bins as compared to the other supermar-
kets surveyed in this study (Table 1).
Considering nonwaxy milled rice samples alone
(n = 38), prices per kg in all supermarkets sur-
veyed ranged from Php 40 to Php 103 (Table 2).
Robinsons and Puregold had the highest and
lowest mean price per kg, respectively. In terms
of AC, Waltermart had significantly lower mean
AC among all supermarkets surveyed and AC
of Dasmariñas supermarket nonwaxy rices
in this study ranged from 16.7 to 25.1%. Rice
with the lowest AC was found in Waltermart (i.e.
Amparo’s Pure Dinurado) while the highest was
from Robinsons (i.e Whole grain empire) (Sup-
plemental Table 1). Generally, the mean AC of
nonwaxy milled rices was intermediate similar
to the grand mean AC when all samples in this
study were considered.
Mean ASV of samples from Waltermart, Rob-
insons, and SM Dasmariñas were significantly
higher than those in Puregold and Savemore,
but interestingly their GT types were all inter-
mediate (Table 2). All nonwaxy rices had mean
optimum cooking time of 18 min with an overall
range of 17-19 min. The same GC types were
observed wherein SM Dasmariñas had mainly
medium GC type while Puregold, Savemore,
and Robinsons had mainly hard GC type. Over-
all, the gel length of the supermarket rice sam-
ples in this study ranged from 27 mm to 99 mm
and a grand mean GC of 35 mm was noted.
Waltermart samples were not analyzed for GC
since it had no high-AC samples (Table 2; Sup-
plemental Table 1). Previous study of Tuaño et
al. (2016) reported a grand mean AC of 20.9%
and grand mean ASV of 5.4 in nonwaxy rices,
which showed similarity in this study since both
mainly have intermediate-GT type and inter-
mediate-AC type observed in nonwaxy rices.
Issue No. 9
However, cooking time has not been reported
and samples had lower grand mean price per
kg (Php 51.95) which ranged from Php 25.00
to Php 124.50. It also showed that the lowest
priced rice was that of a local variety while im-
ported rices were priced the highest.
Supermarket Milled Rices Classified per
Apparent Amylose Content Type
Among the 44 milled rice samples collected,
21 (48%) were intermediate-AC type, 16 (36%)
were high-AC type, and the remaining were
classified as low-AC (L) or waxy (W) (Table 3).
The intermediate-AC samples had an AC range
of 17.2-22.0% with an average AC of 20.6%
whereas the high-AC types had an AC range of
22.2-25.1% with an average AC of 23.4% (Table
2). On the other hand, four waxy rice samples,
collected from Savemore, Waltermart, Robin-
sons, and SM Dasmariñas, which were initially
analyzed as very low AC, were reclassified as
waxy since these samples actually had predom-
inantly opaque grains (Figure 1; Table 3; Sup-
plemental Table 1). This initial misclassification
may be due to some contaminating nonwaxy
grains present in these “malagkit” rice samples
collected which might have caused the relative
increase in AC than a typical waxy rice (0-2%)
(Supplemental Table 1). AC obtained for these
samples were around 2.0-4.0%. From the 21
intermediate-AC rice samples, the range was
17.2-22.0% with a mean AC of 20.6% and only
one was found to be low AC (Table 3).
The most expensive AC type was found to be
waxy samples with a mean price of Php 92.83
ranging from Php 69.00 to Php110.00, followed
by high AC (mean price per kg of Php 59.12 with
a range of Php 45.00-70.00), intermediate AC
(mean price per kg of Php 57.10 with a range
of Php 40.00-103.00), and low-AC (Php 53.00).
High-, intermediate- and low-AC types were
found to be the same but were significantly low-
er than the waxy milled rices in terms of their
mean prices per kg. ASV of all the samples,
75
regardless of AC type, ranged from 3.1 to 6.6
with an overall mean of 4.8 and were not signifi-
cantly different. Similarly, optimum cooking time
(OCT) was from 17 min to 19 min (mean OCT
of 18 min) for all samples. Only high-AC rices in
this study were analyzed for gel consistency. Al-
though gel length ranged from 27 mm to 99 mm,
the mean GC was 35 mm indicating that texture
was generally hard upon gel cooling.
Tuaño et al. (2016) reported that intermedi-
ate-AC was the most abundant AC type in re-
tail stores and supermarkets in the Philippines.
The set in this study had a mean AC of 21.4%
(n = 44) similar to the mean AC of 20.9% (n =
388) reported by Tuaño et al. (2016). GT type of
milled rices in Dasmariñas City was intermedi-
ate with mean ASV of 4.8 similar to the results
of Tuaño et al. (2016). A survey of Philippine
farmers’ specialty rices in Tuaño et al. (2015)
showed that 51% had intermediate AC, 37%
had low AC, and 12% had high AC. This may be
due to the change in the Philippine rice breeding
objective from high-AC types in the 1980’s to in-
termediate-AC with some low-AC rice varieties
in the year 2000 onwards (Juliano et al., 1989;
Mangaoang et al., 2002; Juliano, 2010; Juliano,
2019).
Supermarket Milled Rices Classified per
Gelatinization Temperature Type
Alkali spreading test showed that of the open-
bin nonwaxy milled rice samples, 32 (80%) had
intermediate GT, 5 (18%) had low GT and only 1
had intermediate-high GT (Table 4). Waxy rices
had either low or intermediate-high GT (Supple-
mental Table 1). Intermediate-GT types had a
lower limit ASV of 3.6 with an upper limit of 5.4
and an average ASV of 4.5. Low-GT types had
a mean ASV of 6.0 that varied from 5.6 to 6.6.
Generally, the grand mean ASV was 4.5 which
corresponded to intermediate-GT type similar to
the study of Tuaño et al. (2016) which reported
a grand mean ASV of 5.4 for samples collected
from selected retail stores and supermarkets in
76
the Philippines. High GT among Philippine waxy
and low-AC rices reportedly showed actual GT
values higher than 74°C as verified by differen-
tial scanning calorimetry of starch (Tuaño et al.,
2014). Based on the AC per GT type, samples
with intermediate and low GT had statistically
similar AC values, significantly lower than the
mean AC of high-GT rices (Table 4). Optimum
cooking time (OCT) was observed to have no
significant difference among all GT types. Inter-
estingly, this was in contrast with the previous
study of Cuevas et al. (2010) which reported
that GT is associated with the cooking time of
rice. This needs further verification maybe by
separating the samples in this previous report
into different amylose classes. In terms of mean
price per kg, rices with intermediate-high GT
and those with intermediate GT were not signifi-
cantly different. However, low-GT rices tended
to be more expensive possibly due to the high
price of Japanese rice, with a mean price per kg
of Php 103.00 that might have caused the in-
crease in mean price of low-GT samples in this
study (Supplemental Table 1).
Apparent Amylose Content-Gel Temperature
Combinations of Supermarket Rices
Philippine rices are commonly differentiated
based on apparent amylose content-gelati-
nization temperature (AC-GT) combinations
(Roferos et al., 2006; Juliano, 2010). Cluster 1
which corresponds to soft cooked rice is com-
prised of rices with intermediate AC-intermedi-
ate GT (I-I) and low AC-low GT (L-L) combina-
tions. Cluster 2, which yields medium-textured
cooked rice, is comprised of rices with high
AC-intermediate-high GT (H-I), high AC-inter-
mediate GT (H-IH), and intermediate AC-low GT
(I-L) combinations. Lastly, clusters 3 and 4, are
mainly used to denote hard textured cooked rice
types having high AC-low GT combination (H-L)
with varying GC (Roferos et al., 2006).
Out of 44 open-bin milled rice samples, 18 were
classified as I-I, 13 were H-I, and the remaining
January - December 2020
samples were either H-IH, H-L, I-L, L-H or waxy
with either high or low GT (W-H or W-L, respec-
tively) (Table 5). Mean price per kg for H-IH, I-I,
and L-H samples were significantly lower than
those W-L, W-H, and I-L samples while high-AC
rices, regardless of GT combined with it, had no
significant difference in price. All AC-GT combi-
nations with high AC classifications and those
in waxy rices were not significantly different in
mean price per kg. On the other hand, mean
price of I-I and that of I-L rices were significantly
different.
Interestingly, I-I had a significantly higher mean
AC over I-L which was in contrast with the
above trends. This might be due to the mean
AC of I-I that ranged from 19% to 22% unlike in
I-L which had an AC range of 17-19% (Table 5;
Supplemental Table1). This indicates that milled
rices with intermediate AC and low GT tend to
have relatively lower amounts of amylose in the
grain as compared to those with intermediate
GT confirming the previous report among inter-
mediate-AC Philippine indica modern varieties
in Tuaño et al. (2011). Mean ASV for H-L, I-L,
and W-L were the same but significantly lower
than the mean ASV for H-I and I-I. On the other
hand, H-IH had the lowest mean ASV among
all AC-GT combinations observed in this study.
Optimum cooking time (OCT) was the same
for all the following AC-GT combinations: H-IH,
H-L, L-H, W-H, and W-L. However, the I-L com-
bination tended to have the lowest mean OCT of
17.7 min (Table 5).
These results on the distribution of the collect-
ed Dasmariñas supermarket samples into the
different AC-GT combinations were similar to
the reports of Tuaño et al. (2015) and Tuaño et
al. (2016) where the major AC-GT combination
was found to be I-I corresponding to cluster 1
with soft cooked rice texture according to the
proposed Philippine grain quality classification
Roferos et al., 2006; Juliano, 2010; Tuaño et al.,
2015). In addition, reclassification of intermedi-
ate GT into high GT among low-AC and waxy
Issue No. 9
rices were both done in this study and the pre-
vious report of Tuaño et al. (2014). This reclas-
sification of Philippine rice under the said AC
types was verified via analysis of actual GT by
differential scanning calorimetry of rice starch.
Thus, similar to previous reports, low-AC and
waxy rices in this study having ASV 4-5 should
be classified as high GT and not intermediate
GT (Tuaño et al., 2014).
Supermarket Milled Rices with High
Amylose Classified per Gel Consistency
Type
The high-AC samples (16 out of 44) in this
study were subjected to gel consistency test
and majority were classified as hard GC (Ta-
ble 6). The prolonged storage after milling may
have affected GC (Roferos et al., 2006; Juliano,
2010). However, grand mean GC was medium
(58 mm) probably due to two samples with vary-
ing GC from medium to soft. Also, mean GC of
hard gel samples was close to 40 mm. Thus,
there might be high chances that values of soft-
GC and medium-GC samples led to an overall
medium GC type for this sample set. Similarly,
the reported mean GC was also medium (53
mm) for the nonwaxy Philippine milled rices in
local retail stores and supermarkets (n = 148)
as reported by Tuaño et al. (2016). Prices of all
high-AC milled rices varying in GC analyzed in
this study did not show a consistent trend. Inter-
estingly, the only medium GC rice was priced
the highest. The price per kg, ASV, and optimum
cooking time were not significantly different for
all the high AC rice samples. They were all in-
termediate-GT (Table 6). Studies have shown
that high AC-low GT were classified as hard
GC type and high AC-intermediate GT would
fall under medium GC type. This may due to the
differences in the amount of long chain amylo-
pectin (LCA) (Fredriksson et al., 1998; Aoki et
al., 2006; Tuaño et al., 2011) in these samples
and this needs verification among Philippine
market milled rice samples. It has been report-
ed that high-AC low-GT milled rices would yield
77
the hardest GC as affected by the usually high
amount (>10%) of LCA with >1000 glucose
units long (Takeda et al., 1987; Han and Ha-
maker, 2001; Juliano, 2007; Tuaño et al., 2014).
However, interestingly, this particular study re-
ported that high AC-intermediate GT samples
had hard GC and only two high AC-low GT ones
(i.e. Jasmine and Cherry Rose) had hard GC
(Supplemental Table 1). It would be promising to
determine the LCA amounts in these high AC-in-
termediate GT supermarket rices having hard
GC relative to cooked rice texture. In addition,
these observations may also be due to several
factors affecting GC and texture of milled rice
such as protein content and room temperature
storage conditions (Roferos et al., 2006; Cam-
eron et al., 2005).
Supermarket Milled Rices Clustered per
Usual Price Range and their Properties
The collected rice samples were classified ac-
cording to the usual price range that most con-
sumers would select from, in multiples of Php
5.00. Majority of supermarket samples in Das-
mariñas City, Cavite ranged from Php 50 to Php
55 per kg (Table 7). The highest price range
(Php 90–110) rice was mainly composed of 3
waxy and 1 intermediate-AC rices (i.e. Japa-
nese rice from Robinsons). This could be due to
an imported rice sample that was sold in open-
bins of the said supermarket. As shown by Tu-
año et al. (2016), Japanese rice commonly had
a price range per of Php 80 to Php 118.50 per
kg in Philippine urban supermarkets. Waxy rices
had a price range of Php 76-110 with mean price
of Php 96 per kg. Intermediate-AC types, on the
other hand, were found to be the least expen-
sive among all samples (Table 7; Supplemental
Table 1). Also, most of the milled rice samples
in Dasmariñas supermarkets under Php 50-55
per kg are classified as intermediate AC. This
suggests that the typical open-bin supermarket
milled rices most Filipino consumers in the city
buy within this price range have intermediate
AC which yield soft-to-medium cooked texture.
78
Waxy samples, on the other hand, were more
expensive than nonwaxy samples in this study
and had higher mean ASV than the other AC
types, across all price ranges. The waxy rices
with the highest price per kg range also had the
mean OCT as compared to the rest (Table 7).
Correlations among Physicochemical
Properties and Price of Supermarket Rices
Results have shown that among all the collect-
ed supermarket milled rice samples (n = 44) in
Dasmariñas City, Cavite, price and AC were
significantly negatively correlated (Table 8).
However, no significant correlation among non-
waxy samples (n = 38) and high-AC samples
was noted in contrast to optimum cooking time
having a significant negative correlation with
price among nonwaxy rices. Optimum cooking
time and price had no significant relationship
when all samples and high-AC samples were
considered. Price and ASV were significantly
positively correlated but did not reach statistical
significance among high-AC samples alone. AC
correlated positively and significantly with OCT
among nonwaxy samples only but showed no
correlation with ASV among all groups analyzed
(Table 8). Negative correlation between ASV
and OCT was significant in both groups of non-
waxy samples and all samples in this study. GC
showed no correlation with the other parame-
ters analyzed. Tuaño et al. (2016) also showed
significantly negative correlation between AC
and price while the latter price was positively
and significantly correlated with ASV similar to
the findings of the present study.
CONCLUSION AND
RECOMMENDATIONS
This study analyzed 44 milled rice samples col-
lected from open-bins of five selected supermar-
kets in Dasmariñas City, Cavite in terms of AC,
GT as indexed by ASV, GC, and OCT. Majority
of Dasmariñas supermarket milled rices were
January - December 2020
intermediate AC, followed by high-AC. GT type
of the supermarket rice samples was mainly in-
termediate. The main AC-GT combination was
intermediate AC-intermediate-GT correspond-
ing to cluster 1 which yields soft cooked rice tex-
ture. Optimum cooking time of the samples was
around 18 min and mostly comparable across
supermarkets and AC types. GC of high AC-in-
termediate GT rices was mainly hard similar to
typical high AC-low GT rices commonly having
hard GC as indicated by the short length (i.e.
≤40 mm) of the cooked gel upon cooling. Price
per kg was significantly negatively correlated
with AC and OCT similar to the correlation not-
ed between OCT and ASV among all rice sam-
ples analyzed in this study. In contrast, results
showed that only price and ASV had a signifi-
cant positive correlation among all the samples
evaluated for grain quality in this study. Further
grain quality studies using larger and more di-
verse set of supermarket samples across many
regions of the country would strengthen the cor-
relations reported in the present work. To eluci-
date holistically the cooking and eating quality
of supermarket milled rices in the Philippines,
other grain quality parameters may be also be
explored and analyzed. Sensory evaluation
methods may also be employed. However, they
are expensive, time-consuming, and requires
higher sample amount.
Issue No. 9
ACKNOWLEDGEMENTS
The authors gratefully acknowledge Antonieta
D. Peñaloza and Wilson E. Rivano of the Rice
Chemistry and Quality Laboratory (RCQL), Phil-
ippine Rice Research Institute (PhilRice) Los
Baños for providing technical assistance. APPT
was the former laboratory head of RCQL and a
former Supervising Science Research Specialist
at PhilRice Los Baños (2008-2016) spearhead-
ing the conceptualization and implementation
of the Philippine market rice grain quality sur-
vey project collaboratively conducted in various
regions of the country. This research article is
dedicated to the late Dr. Bienvenido O. Juliano,
world-renowned cereal chemist and National
Scientist, who pioneered the work on the chem-
istry and grain quality of Philippine rice and of
world rices. His mentoring and technical advice
during the conduct of this study are gratefully
acknowledged. APPT, KTML, and CJMV would
also like to thank the Chemistry Laboratory of
the College of Humanities and Sciences, De La
Salle Medical and Health Sciences Institute, for
allowing the use of some laboratory facilities and
reagents. The technical assistance of Guiller L.
Sarmenta and Dalton R. Fortin in the conduct
of this study is hereby thankfully acknowledged.
79
80
Table 1. Summary of range and mean of prices and physicochemical properties of milled rice samples (n = 44) collected from selected su-
permarkets in Dasmariñas City, Cavite in July-August 2017.

Optimum CTe Gel Length

Price per kg (Php) ACa(%) AC ASVc GT GC
Supermarket n (min) (mm)
Typeb Typed Typef
Range Mean Range Mean Range Mean Range Mean Range Mean
Savemore Salitan 10 49.00 - 89.00 60.60 a 4.0-23.7 22.1 a H 3.1 - 4.5 3.9 b I 18 - 19 18 a 28 - 42 33 H
Puregold Dasmariñas 4 40.00 - 69.00 50.25 b 2.0-22.5 21.2 a I 4.1 - 4.2 4.2. b I 18 - 19 18 a 32 32 H
Waltermart 8 45.00 - 110.00 66.28 a 2.1-21.6 19.5 b I 4.0 - 5.8 4.9 a I 18 - 19 18 a - - -
Supermarket
Robinson’s Pala-Pala 12 55.00 - 103.00 67.48 a 2.0-25.1 22.1 a H 4.4 - 6.6 5.3 a I 17 - 18 18 a 29 - 40 32 H
SM Dasmariñas 10 49.00 - 89.00 60.60 a 3.0-24.1 22.2 a H 4.1 - 5.6 5.0 a I 18 - 19 18 a 27 - 99 44 M
Total/Grand Mean 44 40.00 - 110.00 61.04 2.0-25.1 21.4 I 3.1 - 6.6 4.7 I 17 - 19 18 27 - 99 35 H
Means in the same column followed by the same letter are not significantly different at p < 0.05 using Least Significance Difference (LSD) test
a
AC- apparent amylose content.
b
AC Types: H (High) - > 22.0; I (Intermediate) - 17.1 - 22.0; L (Low) - 10.1; 17.0; VL (Very Low) - 2.1 - 10.0; W (Waxy) - < 2.0.
c
ASV - alkali spreading value.
d
GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate High (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
e
CT - cooking time.
f
GC - gel consistency; GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 – 100.

January - December 2020

Issue No. 9
Table 2. Summary of range and mean of prices and physicochemical properties of nonwaxy milled rice samples (n = 38) collected from
selected supermarkets in Dasmariñas City, Cavite in July-August 2017.

Price per kg (Php) ACa (%) AC ASVc GT Optimum CTe Gel length (mm) GC
Supermarket n
Range Mean Range Mean Typeb Range Mean Typed Range Mean Range Mean Typef

Savemore Salitan 9 49.00 - 70.00 57.44 b 20.1 - 23.7 22.1 a H 3.1 - 45 3.9 b I 18 - 19 18 a 28 - 42 32 a H
Puregold Dasmariñas 3 40.00 - 47.00 44.0 c 19.5 - 22.5 21.2 a I 4.1 - 4.2 4.2 b I 18 - 19 18 a 32 32 a H
Waltermart 6 45.00 - 66.25 53.38 b 16.7 - 21.6 19.5 b I 4.3 - 5.8 4.9 a I 18 - 19 18 a - - -
Supermarket
Robinson’s Pala-Pala 11 55.00 - 103.00 64.52 a 17.2 - 25.1 22.1 a H 4.4 - 6.6 5.2 a I 17 - 18 18 a 29 - 40 32 a H
SM Dasmariñas 9 49.00 - 7 0.00 57.44 b 19.4 - 24.1 22.2 a H 4.1 - 5.6 4.9 a I 18 - 19 18 a 27 - 99 44 a M
Total/Grand Mean 38 40.00 - 103.00 55.36 16.7 - 25.1 21.4 I 3.1 - 6.6 4.6 I 17 - 19 18 27 - 99 35 H
Means in the same column followed by the same letter are not significantly different at p < 0.05 using Least Significance Difference (LSD) test
a
AC- apparent amylose content.
b
AC Types: H (High) - > 22.0; I (Intermediate) - 17.1 - 22.0; L (Low) - 10.1; 17.0; VL (Very Low) - 2.1 - 10.0; W (Waxy) - < 2.0.
c
ASV - alkali spreading value.
d
GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate High (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
e
CT - cooking time.
f
GC - gel consistency; GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 – 100.

81
82
Table 3. Comparison of range and mean prices and physicochemical properties of milled rices with different apparent amylose content
(AC) collected from selected supermarkets in Dasmariñas City, Cavite in July-August 2017.

Price per kg (Php) AC (%) ASVb GT Optimum CTd (min) Gel length (mm) GC
AC Typea n
Range Mean Range Mean Range Mean Typec Range Mean Range Mean Typee

High 16 45.00 - 70.00 59.12 b 22.2 - 25.1 23.4 a 3.1 - 6.6 4.6 a I 18 - 19 18.0 a 27-99 36 H
Intermediate 21 40.00 - 103.00 57.10 b 17.2 - 22.0 20.6 b 3.7 - 6.6 4.8 a I 17 -1 9 18.0 a - - -
Low 1 53.00 53.00 b 16.7 16.7 c 4.8 4.8 a I 18 18.0 a - - -
Waxy 6 69.00 - 110.00 92.83 a 2.0 - 4.0 2.5 d 3.9 - 6.0 4.9 a I 18 - 19 18.0 a - - -
Means in the same column followed by the same letter are not significantly different at p < 0.05 using Least Significance Difference (LSD) test
a
AC – apparent amylose content; AC Types: High - > 22.0; Intermediate – 17.1 – 22.0; Low – 10.1 – 17.0; Very Low – 2.1 – 10.0; Waxy - < 2.0.
b
ASV - alkali spreading value.
c
GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate High (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
d
CT - cooking time.
e
GC - gel consistency; GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 – 100.
f
VL was reclassified to W due to nature/appearance of actual samples – opaque waxy grains. W was used to denote them in the manuscript unless otherwise specified.

January - December 2020

Issue No. 9
Table 4. Comparison of range and mean prices and physicochemical properties of milled rices with different gelatinization temperature
(GT) types collected from selected supermarkets in Dasmariñas City, Cavite in July-August 2017.

Price per kg (Php) ASVb ACc (%) Optimum CTe (min) Gel Length (mm)
GT Typea n AC Type GC Typef
Range Mean Range Mean Range Mean Range Mean Range Mean
IH 1 50.00 50.00 b 3.1 3.1 c 23.5 23.5 a H 18 18.0 a 28 28 a H
I 32 40.00 - 70.00 56.41 b 3.6 - 5.4 4.5 b 16.7 - 25.1 21.8 ab I 18-19 18.2 a 27 - 99 37 a H
L 5 49.00 - 103.00 68.20 a 5.6 - 6.6 6.0 a 17.2 - 24.1 20.0 b I 17-18 17.9 a 30 - 40 35 a H
Means in the same column followed by the same letter are not significantly different at p < 0.05 using Least Significance Difference (LSD) test
a
GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate High (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
b
ASV - alkali spreading value.
c
AC – apparent amylose content.
d
AC Types: H (High) - > 22.0; I (Intermediate) – 17.1 – 22.0; L (Low) – 10.1 – 17.0; VL (Very Low) – 2.1 – 10.0; W (Waxy) - < 2.0.
e
CT - cooking time.
f
GC - gel consistency; GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 – 100.

83
84
Table 5. Comparison of range and mean prices and physicochemical properties of milled rices with different apparent amylose content
(AC)- gelatinization temperature (GT) combinations collected from selected supermarkets in Dasmariñas City, Cavite in July-August 2017.

AC-GT Price per kg (Php) ACb (%) AC ASVd GT Optimum CTf (min) Gel Length (mm) GC
n
Combinationa Typec Typee Typeg
Range Mean Range Mean Range Mean Range Mean Range Mean
H-IH 1 50.00 50.00 d 23.5 23.5 a H 3.1 3.1 d IH 18 18.0 ab 28 28 a H
H-I 13 45.00-70.00 59.15 cd 22.3-25.1 23.4 a H 3.6-5.3 4.5 bc I 18-19 18.2 a 27-99 37 a H
H-L 2 55.00-67.75 61.38 cd 22.2-24.1 23.2 a H 5.7-6.6 6.3 a L 18 18.0 ab 30-40 37 a H
I-I 18 40.00-69.00 54.61 d 19.5-22.0 21.0 b I 5.1-3.7 4.6 bc I 18-19 18.2 a - 35 a -
I-L 3 49.00-103.00 72.75 bc 17.2-19.4 18.0 c I 5.6-6.6 6.0 a L 17-18 17.7 b - - -
L-H 1 53.00 53.00 d 16.7 16,7 c L 4.8 4.8 b I 18 18.0 ab - - -
W-H 3 69.00-100.00 86.00 ab 2.0-4.0 2.7 d Wh 3.9-4.2 4.0 c I 18-19 18.1 ab - - -
W-L 3 89.00-110.00 99.67 a 2.0-3.0 2.4 d Wh 5.6-6.0 5.8 a L 18 18.0 ab - - -
Means in the same column followed by the same letter are not significantly different at p < 0.05 using Least Significance (LSD) test.
a
AC types (first letter): H – high; I – intermediate; L – low; W – waxy; GT types (second letter): IH – intermediate-high; I – intermediate; L – low.
b
AC – apparent amylose content.
c
AC Types: High - > 22.0; I (Intermediate) – 17.1 – 22.0; L (Low) – 10.1 – 17.0; VL (Very Low) – 2.1 – 10.0; W (Waxy) - < 2.0.
d
ASV - alkali spreading value.
e
GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate High (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
f
CT - cooking time.
g
GC - gel consistency; GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 – 100.
f
VL was reclassified to W due to nature/appearance of actual samples – opaque waxy grains. W was used to denote them in the manuscript unless otherwise specified.

January - December 2020

Issue No. 9
Table 6. Comparison of range and mean prices and physicochemical properties of milled rices with high apparent amylose content (AC)
and varying gel consistency (GC) collected from selected supermarkets in Dasmariñas City, Cavite in July-August 2017.

Price per kg (Php) Gel Length (mm) ACb (%) ASVd Optimum CTf (min)
GC Typea n AC Typec GT Typee
Range Mean Range Mean Range Mean Range Mean Range Mean
Hard 14 45.00 - 70.00 58.70 b 27 - 40 31 c 22.2 - 25.1 23.3 a H 3.1 - 6.6 4.7 a I 18 - 19 18.0 a
Medium 1 70.00 70.00 a 42 42 b 23.6 23.6 a H 3.8 3.8 a I 19 19.0 a
Soft 1 50.00 50.00 b 99 99 a 23.1 23.1 a H 5.2 5.2 a I 18 18.0 a
Means in the same column followed by the same letter are not significantly different at p < 0.05 using Least Significance (LSD) test.
a GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 – 100.
b AC – apparent amylose content.
c AC Types: H (High) - > 22.0; I (Intermediate) – 17.1 – 22.0; L (Low) – 10.1 – 17.0; VL (Very Low) – 2.1 – 10.0; W (Waxy) - < 2.0.
d ASV - alkali spreading value.
e GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate High (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
f CT - cooking time.

85
86
Table 7. Comparison of mean prices, range and mean physicochemical properties of milled rices varying in market price range collected
from selected supermarkets in Dasmariñas City, Cavite in July-August 2017.

Mean ACa (%) ASVc Optimum Cte Gel Length (mm)

Price n Price AC Typeb GT Typed GC Typef
Range Range Mean Range Mean Range Mean Range Mean
(Php)
40-45 3 43.33 20.5 - 22.5 21.5 abc I 4.2 - 4.2 4.2 b I 18 - 19 18.2 a 32 32 H
46-49 4 48.25 19.4 - 20.6 20.0 bc I 4.1 - 5.6 4.7 b I 18 18.2 a - - -
50-55 14 53.07 24.1 - 16.7 21.8 ab I 3.1 - 5.7 4.7 b I 18 - 19 18.4 a 28 - 99 40 H
56-59 4 58.75 21.6 - 22.4 21.9 ab I 4.2 - 5.1 4.7 b I 18 - 19 18.0 a 33 33 H
60-65 5 63.40 20.0 - 25.1 22.2 ab H 4.2 - 5.3 4.8 b I 18 18.0 a 30 - 34 32 H
66-69 6 67.33 2.0 - 23.7 18.3 c I 3.6 - 6.6 4.9 b I 18 - 19 18.1 a 28 - 40 34 H
70-75 2 70.00 23.6 - 23.9 23.7 a H 3.8 - 4.9 4.3 b I 18 - 19 18.0 a 27 - 42 35 H
76-89 2 89.00 3.0 - 4.0 3.5 d Wg 3.9 - 5.6 4.8 b I 18 18.3 a - - -
90-110 4 103.25 2.0 - 17.2 5.8 d Wg 4.0 - 6.6 5.6 a L 17 - 19 18.7 a - - -
Means in the same column followed by the same letter are not significantly different at p<0.05 using Least Significance Difference (LSD) test
a
AC – apparent amylose content.
b
AC Types: H (High) - > 22.0; I (Intermediate) – 17.1 – 22.0; L (Low) – 10.1 – 17.0; VL (Very Low) – 2.1 – 10.0; W (Waxy) - < 2.0.
c
ASV - alkali spreading value.
d
GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate High (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
e
CT - cooking time.
f
GC - gel consistency; GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 – 100.
g
VL was reclassified to W due to nature/appearance of actual samples – opaque waxy grains. W was used to denote them in the manuscript unless otherwise specified.

January - December 2020

Table 8. Correlation coefficients among physicochemical properties of milled rice samples collected
from selected supermarkets in Dasmariñas City, Cavite in July-August 2017.

Milled rice samples

Parameters
All samples (n=44) Nonwaxy samples (n=38) High-ACa samples (n=16)
Price vs ACa - 0.730* - 0.107 ns 0.113 ns
Price vs ASVb 0.367 .416 * 0.148 ns
Price vs optimum CTc - 0.229 nns - 0.356 ** 0.172 ns
Price vs GCd n/a n/a - 0.210 ns
ACa vs ASVb - 0.167 ns - 0.280 ns - 0.034 ns
ACa vs optimum CTc 0.148 ns 0.346 ** 0.084 ns
AC vs GC
a d
n/a n/a - 0.151 ns
ASVb vs optimum CTc - 0.380 ** - 0.414 * - 0.339 ns
ASVb vs GCd n/a n/a 0.208 ns
Optimum CTc vs GCd n/a n/a - 0.129 ns
* - significant correlation at 1% level.
** - significant correlation at 5% level.
ns - not significant.
n/a - not applicable.
a
AC - apparent amylose content.
b
ASV - alkali spreading value.
c
CT - cooking time.
d
GC - gel consistency.

Issue No. 9 87
 Supplemental Table 1. Summary of price and physicochemical properties of milled rices (n = 44) collected from various supermarkets in

88
Dasmariñas City, Cavite in July-August 2017. ‘

Gel
Price per ACa of Milled AC Optimum CTg
Supermarket/Sample ASVc GT Typed AC-GT Typee Length GC Typef
kg (Php) Rice (%) Typeb (min)
(mm)
Savemore Salitran (10)
California (Whole Grain) 59.00 22.4 ± 0.19 H 4.2 I H-I 33 ± 1.15 HARD 19 ± 1.15
Denurado Special Mabango) 63.00 22.3 ± 0.91 H 4.2 I H-I 34 ± 1.53 HARD 18 ± 0.58
Jasmine (Mabango) 70.00 23.6 ± 0.83 H 3.8 I H-I 42 ± 2.52 MEDIUM 19 ± 0.58
GS Supreme 50.00 23.5 ± 0.96 H 3.1 IH H-IH 28 ± 0.58 HARD 18 ± 0.00
h i i
Malagkit Premium 89.00 4.0 ± 0.30 VL 3.9 I VL-H - - 18 ± 0.58
Milarosa (Whole Grain) 66.00 23.7 ± 0.57 H 3.6 I H-I 28 ± 1.73 HARD 19 ± 0.58
Platinum (Sinandomeng) 53.00 20.5 ± 0.18 I 3.7 I I-I - - 18 ± 0.00
Noble Star (Sinandomeng) 55.00 20.1 ± 0.47 I 4.1 I I-I - - 18 ± 0.00
Passion (Maalsa) 52.00 22.0 ± 0.65 I 4.3 I I-I - - 18 ± 0.00
Commodore (Maalsa) 49.00 20.4 ± 1.24 I 4.5 I I-I - - 18 ± 0.58
Puregold Dasmariñas (4)
Equal Dinurado Rice 47.00 19.5 ± 1.00 I 4.1 I I-I - - 18 ± 0.00
Equal Sinandomeng Rice 40.00 21.7 ± 0.93 I 4.2 I I-I - - 18 ± 0.00
Equal Long Grain Rice 45.00 22.5 ± 0.61 H 4.2 I H-I 32 ± 1.53 HARD 19 ± 0.58
Malagkit 69.00 2.0 ± 0.09 W 4.2 Ii W-Hi - - 18 ± 0.00
Waltermart Supermarket (8)
Amparo’s Sinandomeng 48.00 20.6 ± 0.80 I 4.6 I I-I - - 18 ± 0.00
Amparo’s Pure Dinurado 53.00 16.7 ± 0.34 L 4.8 Ii L-H - - 18 ± 0.00
Amparo’s C4 Dinurado 50.00 20.3 ± 0.73 I 5.4 I I-I - - 18 ± 0.00
Amparo’s Malagkit Bilog 110.00 2.1 ± 0.17 VLh 5.9 L VL-L - - 18 ± 0.00
Amparo’s Malagkit Haba 100.00 2.1 ± 0.14 VLhI 4.0 Ii VL-H - - 19 ± 0.58
Amparo’s Regular Mill 45.00 20.5 ± 1.14 I 4.3 I I-I - - 19 ± 0.58
Amparo’s Maharlika 58.00 21.6 ± 1.20 I 4.8 I I-I - - 18 ± 0.00
Amparo’s Thai Jasmine 66.25 17.3 ± 0.16 I 5.8 L I-L - - 18 ± 0.00

January - December 2020

 Robinson’s Pala-Pala (12)
Sagada Rice (Dinurado) 55.00 21.4 ± 0.27 I 4.8 I I-I - - 18 ± 0.00

Issue No. 9
Malakit White Rice 100.00 2.0 ± 0.04 W 6.0 L W-L - - 18 ± 0.00
Snow White Rice 55.00 22.9 ± 0.61 H 4.9 I H-I 31 ± 0.58 HARD 18 ± 0.00
Jasmine Rice 67.75 22.2 ± 0.96 H 6.6 L H-L 40 ± 0.58 HARD 18 ± 0.00
Magic Star Whole Grain 59.00 21.8 ± 0.25 I 4.8 I I-I - - 18 ± 0.00
Japanese Rice 103.00 17.2 ± 0.39 I 6.6 L I-L - - 17 ± 0.00
Whole Grain Empire 62.00 25.1 ± 0.95 H 5.3 I H-I 30 ± 1.15 HARD 18 ± 0.58
Cherry Rose Rice (Sinandomeng) 55.00 24.1 ± 0.08 H 5.7 L H-L 30 ± 0.00 HARD 18 ± 0.00
C - 18 Rice 55.00 23.2 ± 0.63 H 4.7 I H-I 29 ± 1.00 HARD 18 ± 0.00
Dinurado Kukuyo 64.00 22.0 ± 0.62 I 4.8 I I-I - - 18 ± 0.58
Global Fresh Isabela 69.00 21.1 ± 0.31 I 4.4 I I-I - - 18 ± 0.00
Best Seller Rice 65.00 21.7 ± 0.28 I 4.5 I I-I - - 18 ± 0.58
SM Dasmariñas (10)
Noble Star (Sinandomeng) 55.00 23.3 ± 0.39 H 5.1 I H-I 29 ± 1.00 HARD 18 ± 0.00
GS Supreme (Regular) 50.00 23.1 ± 0.92 H 5.2 I H-I 99 ± 1.73 SOFT 18 ± 0.00
Denurado Special (Mabango) 63.00 20.0 ± 0.95 I 5.1 I I-I - - 18 ± 0.00
Commodore (Maalsa) 49.00 19.4 ± 0.33 I 5.6 L I-L - - 18 ± 0.00
Jasmine (Mabango) 70.00 23.9 ± 0.86 H 4.9 I H-I 27 ± 0.58 HARD 18 ± 0.58
Passion (Maalsa) 52.00 20.3 ± 1.09 I 4.9 I I-I - - 19 ± 0.58
Milagrosa (Whole Grain) 66.00 23.5 ± 0.50 H 4.7 I H-I 33 ± 2.31 HARD 18 ± 0.00
California (Whole Grain) 59.00 21.8 ± 0.51 I 5.1 I I-I - - 18 ± 0.58
Malagkit Premium (Malagkit) 89.00 3.0 ± 0.05 VLh 5.6 L VL-L - - 18 ± 0.00
Platinum (Sinandomeng) (Mabango) 53.00 24.1 ± 1.00 H 4.1 I H-I 33 ± 2.08 HARD 18 ± 0.00
Means in the same column followed by the same letter are significantly different at p < 0.05 using Least Significance Difference (LSD) test.
a
AC - apparent amylose content.
b
AC Types - H (High) -> 22.0; I (Intermediate) - 17.1 - 22.0; L (Low) - 10.1 - 17.0; VL (Very low) - 2.1 - 10.0; W (Waxy) -< 2.0.
c
ASV - alkali spreading value.
d
GT - gelatinization temperature; GT Types: High (H) - ASV 1 - 2; Intermediate (IH) - ASV 3; Intermediate (I) - ASV 4 - 5; Low (L) - ASV 6 - 7.
e
AC Types (first letter): H - high; I - intermediate; L - low; W - waxy; GT types (second letter): IH - intermediate high; I - intermediate; L - low.
f
GC - gel consistency; GC Types: Hard (H) - 28 - 40; Medium (M) - 41 - 60; Soft (S) - 61 - 100.
g
GT - cooking time
h
VL was reclassified to W due to nature/appearance of actual samples - opaque waxy grains. W was used to denote them in the manuscript unless otherwise specified.

89
i
I GT of low and waxy rices was reclassified to H GT in AC-GT combination to correspondwith differential scanning colorimetry (DSC).
Figure 1. Milled waxy rice samples from (A) Savemore, (B) Waltermart, (B) Robinsons, and (D) SM
Dasmariñas, initially analyzed to be very low apparent amylose content (AC)-types but reclassified
as waxy rices.

90 January - December 2020

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92 January - December 2020

Producers’ Cooperative in Agro-eco-tourism Development:
The Case of the Guimaras Mango Growers and Producers
Development Cooperative (GMGPDC) in Guimaras,
Philippines
Noe John Joseph E. Sacramento a *, Dhino B. Geges b
a
College of Social Sciences, University of the Philippines Cebu, Cebu City / School of Public Policy, Chiang Mai University,
Chiang Mai, Thailand
b
Department of Social Development Services, College of Human Ecology, University of the Philippines, Los Baños, Laguna

* Corresponding author: nesacramento@up.edu.ph

ABSTRACT
Producers’ cooperative, with the local government unit (LGU), civil society organizations (CSOs),
and community groups play a critical role in local economic development. This case study identi-
fies Guimaras Mango Growers and Producers Development Cooperative’s (GMGPDC) roles in the
agro-eco-tourism development of a mango farming industry in the Philippines. The study used key
informant interviews, and group discussions with cooperative members, officers, and local govern-
ment officials to elicit the roles of GMGPDC in agro-eco-tourism development. The study explains
cooperative initiatives towards mango farming, and agro-eco-tourism development that are vital to
the local economy. It also highlights cooperative empowerment, inclusiveness, and collaboration as
values forged within the multi-stakeholder dynamics central to attaining agro-eco-tourism develop-
ment. At the same time, it also captures internal, and external challenges concerning the cooperative
that needs substantive attention. This study emphasizes the essentiality of organizing cooperatives
to represent a more people-oriented organization; thus, addressing concerns over elites overtaking
local industries, and agro-eco-tourism development. Expanding the collaboration with LGU, CSOs,
and community groups is crucial to forging inclusive, and empowering steps and actions central to
the mission. Lastly, the study provides recommendations to the GMGPDC, LGU, CSOs, and commu-
nity groups that can help further address agro-eco-tourism development challenges.

Keywords: agro-eco-tourism, collaboration, development, empowerment, inclusiveness, mango

farming, producers’ cooperative

INTRODUCTION in the East Asia Pacific region, the decline in

In Southeast Asia, rural communities consider
agriculture vital to statehood and nation’s life.
As a tropical country situated in the region, the
Philippines has relied heavily on agricultural
produce to satisfy its economic needs (Heritage
Foundation, 2020). Considering that the country
is one of the developing and dynamic economies
poverty rate to 16.6 percent in 2018 from 23.3
percent recorded in 2015 (World Bank, 2021) can
be attributed to the impact of agriculture. Forty
percent of Filipino workers in the agricultural
industry devote their time to crop cultivation,
contributing to an average of 20 percent of the
Gross Domestic Product (GDP) (CIDA-LGSP,
2003). The highest recorded GDP growth of
the agriculture sector was in 2017 at 4 percent

Issue No. 9 93
compared to the previous years, -1.2 percent,
and 0.1 percent in 2016, and 2015, respectively
(Sanchez, 2020). Despite the contractions in
agricultural outputs (0.5%), and employment in
the sector (3.8%) in 2018 (World Bank, 2018),
it significantly forecasted stable GDP growth in
agriculture at 0.9 in 2018, and in the years to
come (Sanchez, 2020). This static movement
of agricultural development is one of the
problems in the country that can be ascribed
to “the uneven distribution of resources, stiff
competition from cheaper food imports, and
periodic droughts and floods that devastated
crops and livelihoods” (CIDA-LGSP, 2003),
which is still relevant to date.
Agriculture in the country emphasizes commercial
crop production as it “assists both the agricultural
export industry, and the domestic demand and
consumption” (Sanchez, 2020). The commercial
crops that served as a major contributor to
agricultural production in the country include
rice, corn, coconut, sugar, pineapple, banana,
coffee, and mango (Espino & Atienza, n.d.;
Eusebio, 2019). Meanwhile, mango production
significantly contributed to the agricultural
output of the country. The Philippines had
continuously increased its mango production
in the past three years, from 9.46 million metric
tons in 2017 to 9.47 million metric tons in 2018,
and 9.56 million metric tons in 2019 (PSA,
2020). On the other hand, the Western Visayas
Region has contributed a 4.5 to 5 percent share
in mango production from 2017 to 2018 (PSA,
2020). Within the region, Guimaras Province’s
mango produce is considered the best quality
renowned in the country, and internationally
(Gomes, 2019; Pabuayon, n.d.). The mango
production in the province increased as the
demands improve, from 156,900 mt in 2017 to
157,100 mt in 2018, and 159,100 mt in 2019. The
increase in production can also be substantially
attributed to tourist influx during the annual
Manggahan festival (ABS-CBN News, 2017;
PCAARRD, n.d.). Hence, mango fruit production
development, and tourists’ patronization helped
94
put forward the agro-eco-tourism initiatives by
the local government, and the mango farming
community (Ganzon & Fillone, 2013; Province
of Guimaras, 2020).
Barbuddhe and Singh (2014, p. 5) defined agro-
eco-tourism
“… as the symbiotic association of farm-
ing sector, tourism industry, and farm
business. It is indeed the economic ac-
tivity that occurs when people link travel
with agricultural products, services or ex-
periences to cater to the needs of mutual
demands” (Barbuddhe & Singh, 2014, p.
5).
This novel concept is within the vision of the
Guimaras province to become the “agro-eco-
tourism capital of the region with empowered,
self-reliant, resilient and healthy families enjoy-
ing a progressive economy and safe environ-
ment anchored on the principles of sustainable
development” (Province of Guimaras, 2020).
Agro-eco-tourism can be differentiated from
agritourism, and agrotourism as the former “is
a form of tourism which capitalizes on rural
culture as a tourist attraction” and the latter is
concerned about “reinforcing the employment
potential of the sector with increased local hir-
ing, and sourcing, and significant opportunities
in tourism-oriented toward local culture and
the natural environment” (Barbuddhe & Singh,
2014, p. vi). In achieving the province’s vision,
the people involved in the mango industry sector
have a vital role in representing the voices, inter-
ests, and demands that characterize them. The
cooperation, and involvement among the sector
of mango producers, and community of farmers
are significant, not only towards addressing the
demand needed in the local tourism, but also to-
wards increasing participation of the local com-
munity, especially the poor and disenfranchised;
thus, ensuring a more inclusive and sustainable
local agro-eco-tourism development.
January - December 2020
The establishment of mango cooperatives has
been identified as one of the key initiatives to
attain the mango production, and tourism econ-
omy goals. Cooperatives, as defined,
“is an autonomous and duly registered
association of persons, with a common
bond of interest, who have voluntarily
joined together to achieve their social,
economic, and cultural needs and aspi-
rations by making equitable contributions
to the capital required, patronizing their
products and services and accepting
a fair share of the risks and benefits of
the undertaking in accordance with uni-
versally accepted cooperative principles”
(Republic of the Philippines, 2009, RA
9520- Art. 3).
Currently, the Cooperative Development Au-
thority (CDA) stated that the country has 18,065
operating cooperatives (CDA, 2018).
Specifically, developing producers’ cooperative
in the mango industry is vital in cultivating an
empowering, inclusive, and collaborative sense
of responsibility among stakeholders, especially
the farmers, towards the province’s agro-eco-
tourism development. The CDA classified 308
cooperatives as producers’ cooperative (Inter-
national Cooperative Alliance [ICA], 2019). Ac-
cording to Nebraska Cooperative Development
Center (NCDC), “producer cooperatives are
created by producers, and owned and operated
by producers, and they are organized to pro-
cess, market, and distribute their own products”
(NCDC, 2021). Additionally, RA 9520 defined it
as
“one that undertakes joint production
whether agricultural or industrial. It is
formed and operated by its members to
undertake the production and processing
of raw materials or goods produced by
its members into finished or processed
products for sale by the cooperative to its
Issue No. 9
members and non-members” (Republic
of the Philippines, 2009, RA 9520- Art.
23 Sec. 3).
Hence, the producers’ cooperative in the man-
go industry of the province of Guimaras is an
important stakeholder towards ensuring an em-
powered, and organized sector in promoting
their products to the market that will benefit the
local economy and tourism development.
Community members form cooperatives to pro-
vide the necessary support, especially when
the marketplace fails to provide the essential
services, and goods at a fair price, and good
quality. Cooperatives aim to enhance econom-
ic opportunities and improve people’s quality
of life through empowerment. It also seeks “to
strengthen bargaining power, maintain access
to competitive markets, capitalize on new mar-
ket opportunities, obtain needed products and
services on a competitive basis, improve in-
come opportunities, reduce costs, and man-
age risk” (Ortmann, & King, 2007, p.18). They
also create employment opportunities (Birchall,
2004; Casadesus-Masanell & Khanna, 2003:
Majee & Hoyt, 2011), and build capital in com-
munities where they are located (Majee & Hoyt,
2011). Recent statistics show that in 2016, the
CDA recorded 226,400 individuals were given
jobs by cooperatives (ICA, 2019). To note, the
producers cooperative in the country alone has
employed 13,000 individuals in 2016.
Meanwhile, Johnson (2010) mentioned that
modern politics increasingly devolve econom-
ic responsibilities to cooperatives; thus, these
organizations are being astounded with over-
whelming obligations. Despite this, cooperatives
situated in rural areas continue to improve, be-
cause of the awakening consciousness among
farmers; continuous market development; and
the government’s key role and concern for pol-
icy support (Liu, 2015), while it increases the
income of farmers and continuously develop
the rural economy. Considerably, organizing a
95
cooperative can bring a social impact vital to the
community’s life. Majee and Hoyt (2011) point-
ed out that “cooperatives bring people together
to meet a shared need through the operation
of a democratically controlled business.” As it
functions, they train and educate their members
(Fairbairn et al., 1995; Hoyt, 2004; Majee &
Hoyt, 2009; Majee & Hoyt, 2011), and promote
group effort to address individual and commu-
nity needs. In a report by ICA (2019), the CDA
recounted that in 2016, there are 1,045,397
Filipinos who are members of cooperatives in
the country. The ability of cooperatives to attract
more people to be involved as members means
that the social capital, and the fabric of commu-
nity life are being strengthened.
Some studies on Philippine cooperatives focus
on the streamline ensuring access of people
to essential services such as water distribution
(Peria, 2016); positive impacts of cooperative
membership to member’s welfare, and house-
hold consumption expenditures (Jimenez et
al., 2018); and the convergence of cooperative
stakeholders towards enterprise development,
capacitation, and sustainability (Duque & Di-
zon, 2018). Only few focus on the importance of
producer cooperatives in agricultural industries
in sustaining local enterprises, and economies,
because available literature focuses mainly on
defining cooperatives’ performance or market-
ing capacity (Araullo, 2006; Quilloy, 2015; Sum-
alde, & Quilloy, 2015).
Moreover, the lack of attention, and interest
in investing capital for agro-eco-tourism in the
country’s government’s investment priorities;
and the lack of interest in mobilizing producers’
cooperative impede the agro-eco-tourism de-
velopment in the country (Agriculture Monthly,
2019). Other salient concerns relating to agro-
eco-tourism development include “a) absence
of capacity building of local government units
and for farm owners to take on functions of tour
operators to improve markup in favor of farm-
ers and their seasonal workforce; b) inadequate
96
knowledge on manpower needs, sustainable
practices, and lack of data on sustainable farm
tourism; c) absence or lack of marketing support
or corresponding financial incentives, including
those for joint promotions, participation in trade
fairs and exhibits, standardization of farm tour-
ism brands, and assistance in distribution and
marketing of farm products; d) lack of infrastruc-
ture support to develop farm to market roads,
access roads to the farms, and ultimately wid-
ening (these) to accommodate farm tourism
capacity;” among others (Agriculture Monthly,
2019). On the other hand, Montefrio and Sin
(2019) pointed out that in the case of the Phil-
ippines, an elitist type of agritourism “emerged
to become susceptible to patronage politics that
favors old, and new landed elites. And exclude
underprivileged small farmers” (Montefrio & Sin,
2019, p. 1339). Furthermore, this phenomenon
can be understood historically, and culturally
as a feudalistic notion of the country’s colonial
past (Constantino & Constantino, 1975). While
the concept of agro-eco-tourism is very much
new that it is considered as a hybrid idea of
responsibility towards the environment along-
side sustainable agricultural and tourism devel-
opment (Barbuddhe & Singh, 2014, p. 7), the
phenomenon described by Montefrio and Sin
(2019) in the case of agritourism in the country
is relevant, and germane to the newly coined
term, agro-eco-tourism. In this paper, we argue
that cooperation has a substantial impact on
ensuring empowered, inclusive, and collabo-
rative community participation and the working
sectors in achieving agro-eco-tourism develop-
ment. Notwithstanding the claim that “agritour-
ism governance is mired in state-private sector
politics, and that it is dominated by particular ac-
tors, such as the landed elites in the case of the
Philippines” (Montefrio & Sin, 2019, p. 1339),
we attempt to address this by asserting that
there are mechanisms, such as cooperative or-
ganization, to maintain, promote, and advance
the welfare of the crop producers, and the com-
munity in general.
January - December 2020
This study analyzes how the producers’ co-
operative is involved in the agro-eco-tourism
economy in a mango farming community in
the province of Guimaras in the Philippines. As
such, the study (a) defines the purpose, nature,
and dynamics of the Guimaras Mango Grow-
ers and Producers Development Cooperative
(GMGPDC); (b) discusses the participation of
GMGPDC in the local mango agro-eco-tourism
economy and how it helps in the development
of the community in general; and (c) discusses
the emergent issues and challenges of the co-
operative concerning its role in the local mango
agro-eco-tourism economy. Towards the end,
the study will be providing recommendations
as measures to be considered by the coopera-
tive, the LGU, CSOs, and community groups in
strengthening the mango sector, and the com-
munity towards agro-eco-tourism development.
METHODOLOGY
Conceptual Framework and Theoretical
Underpinnings
The study traced how cooperatives play a vital
role in an empowered, inclusive, and collabora-
tive involvement in achieving agro-eco-tourism
development alongside various external actors
(refer to Figure 1). As defined, this novel term
differs from agrotourism and agritourism (Bar-
buddhe & Singh, 2014). Essentially, agro-eco-
tourism “would secure a multifunctional, sus-
tainable, and competitive agriculture; maintain
the landscape, and the countryside; contribute
to the vitality of rural communities; respond to
consumer concerns, and demands regarding
food quality, and safety, environmental protec-
tion, animal welfare, etc.” (Barbuddhe & Singh,
2014, p. 6). This study highlights the follow-
ing selected agro-eco-tourism objectives: “a)
harmonious integration of diversified farming
activities with tourism for sustainable econom-
ic returns, and ecology; b) local employment
generation; c) delivering aesthetic goods, and
Issue No. 9
services; d) environmental protection, and man-
agement; e) eco-tourism industry development;
f) infrastructure development, and community
development leading to socio-economic trans-
formation” (Barbuddhe & Singh, 2014, p. 7).
To posit the identified agro-eco-tourism objec-
tives, the study highlighted crucial roles of the
cooperative through thematic review of prima-
ry and secondary data from key informant in-
terviews, group discussion, and printed reports
from the government. Based on the identified
gaps from Montefrio and Sin (2019), it is essen-
tial to underscore that cooperatives in modern
economies increasingly become actors towards
pursuing the marginalized groups’ interests
through empowerment (Kalmi, 2003; Noruzi &
Westover, 2010 cited in Aref, 2011). In rural
communities, cooperatives are an integral part
of developing the community’s social, and eco-
nomic facets, especially in pursuing the inter-
ests of local industries, and tourism. While the
study site is focused on the province of Guim-
aras located in the central Philippines, it spe-
cifically considers the Guimaras Mango Grow-
ers and Producers Development Cooperative
(GMGPDC) case towards agro-eco-tourism
development. Agro-eco-tourism is commonly
understood in the Philippines as a farm busi-
ness and tourism service offered to tourists,
alongside being mindful about protecting, pre-
serving, and developing the environment (Recio
et al., 2014; Sznajder et al., 2009). To further
elucidate on the contribution and roles of the
cooperative, Aref & Gill (2009) mainly consid-
ered the individual (the people), community (the
informal groups and networks within the com-
munity), and organizational (established formal
organizations on tourism and farming) empow-
erment as vital factors that help in establishing
and developing the local economy. Meanwhile,
external actors such as the government, civil
societies organizations, and private entities are
important contributors to enabling the coopera-
tive to perform its role.
97
 Figure 1. The Role of Cooperatives in Agro-eco-tourism Development
Sources (as modified): Aref and Gill (2009); Barbuddhe and Singh (2014)
Similarly, the study considered Majee and Hoyt’s
(2009) assertion that cooperatives propel com-
munity development as residents allocate their
economic, social, and political resources, to
improve the local community’s economic devel-
opment process (Fairbairn et al., 1995; Majee
& Hoyt, 2009; Freshwater et al., 2005 cited in
Majee & Hoyt, 2011). Further, the paper argues
that while cooperatives aim to socially, and eco-
nomically help farming communities, establish-
ing networks within, and outside the community
is crucial towards technical, and financial capital
development to prevent tendencies for organi-
zational deterioration, and mission drift.
Research Design and Instrumentation
This study utilized the case study meth-
od to unpack GMGPDC as an entity and hinged
on the defined conceptual framework. Accord-
ing to Yin (2003), a case study research com-
prises an all-encompassing methodology that
will thoroughly analyze the problem or subject in
focus; furthermore, the method is suitable for re-
98
search work that has a clear guiding theoretical
position. It is vital to investigate contemporary
phenomena, and cover contextual conditions
(Yin, 2003). This type of study was fit to help
the researchers uncover realities, and current
situation of the GMGPDC in Guimaras. Morov-
er, the method enabled us to carefully analyze
the cooperative dynamics, specifically how the
cooperative helps sustain the local agricultural
economy, and how it impacts the community’s
development.
Data Gathering, Analysis, and Presentation
The study used both secondary, and primary
data gathering methods. For the secondary data
gathering, the researchers retrieved annual re-
ports of the Provincial Economic Development
Office (PEDO), Provincial Office for Agricultur-
al Services (POAS), Department of Agriculture
(DA), Bureau of Plant and Industry (BPI), and
from the website of the province of Guimaras
on data regarding the local agro-eco-tourism
economy. The primary data collection methods
January - December 2020
employed were Key Informant Interviews (KII),
and group discussions using a semi-structured,
open-ended interview guide. All participants
were oriented on the data gathering processes
and protocols; and all research-related activities
such as actual interviews, recordings, and tran-
scriptions were conducted with consent of all
the research participants. The KII participants
were purposively selected based on informant’s
engagement with GMGPDC along with mango
industry governance and agro-eco-tourism de-
velopment, and its availability for an interview.
The pool of KIIs include the president of the
GMGPDC, the Provincial Office for Agricultur-
al Services Chief, the Provincial Planning and
Development Officer, a Provincial Legislative
Board Member, and the Vice Governor; a total
of five KII participants. Meanwhile, eight GMGP-
DC officers participated in the group discussion.
The study used qualitative data analysis (QDA)
to examine the data, identify themes from the
transcriptions, and to code the arguments.
RESULTS AND DISCUSSION
This section discusses three major themes.
Firstly, the section presents the background, val-
ues, and roles of GMGPDC in the local agricul-
tural and tourism economies. Then, it highlights
the interventions done by the local government
in collaboration with the GMGPDC in line with
the initiative to boost the mango agro-eco-tour-
ism industry. Lastly, it presents the critical is-
sues affecting GMGPDC in performing its roles
towards sustaining and attaining local agro-eco-
tourism development in the province and possi-
ble recommendations for the GMGPDC, LGU,
and civil societies or community groups.
The Guimaras Mango Growers and
Producers Development Cooperative
(GMGPDC)
On May 22, 2007, a group of mango growers,
farmers, and producers organized, and estab-
Issue No. 9
lished the Guimaras Mango Growers and Pro-
ducers Development Cooperative (GMGPDC).
The Cooperative Development Authority (CDA)
of the Philippines has registered and recog-
nized the cooperative. Their mission is to facil-
itate sharing best farming practices, collective
marketing, and access to government support
services. At the same time, they envision their
cooperation to help make a well-established
organization of mango growers, and producers
in the province of Guimaras that provides equi-
table access to benefits, and services to their
members. To note, the organization is also the
lone producers’ cooperative that focuses on
the mango industry of the province. It started
with 50 mango growers, traders, and contrac-
tor-sprayers. They currently plan to expand their
membership by including the mango baggers
and harvesters.
The producers’ cooperative was able to start
its financial operation by pooling a small capi-
tal through a yearly membership fee. On top of
this, the producers’ cooperative sourced out a
portion of their funds from various enterprises
during the annual mango festival. These enter-
prising activities include bulk buying, and selling
of mango produce to domestic, and internation-
al markets. The producers’ cooperative also
managed to get financial support from national
government agencies; specifically, they were
able to source funds from the Department of
Agriculture Bureau of Plant Industry (DA-BPI)
for constructing the building that serves as their
packaging housel and from the Department of
Trade and Industry for the vapor heat treatment,
and other processing equipment, and supplies.
The Local Government Unit (LGU) also extends
financial support to the producers’ cooperative
to support their capital and other expenses. An
international player also supports the producers’
cooperative; the Philippine Rural Development
Project (PRDP) under the World Bank (WB)
granted a counterpart to the LGU to finance the
cooperative’s business plan that can help devel-
op the industry further.
99
To date, GMGPDC works hand-in-hand with the
government for promoting their advocacies, es-
pecially concerning mango farming, and agro-
eco-tourism. At the local level, the Provincial
Office for Agricultural Services (POAS) close-
ly coordinates with the cooperative for major
projects and programs, as well as for activities
during the mango festival. In 2017, the LGU
of Guimaras extended technical, and financial
help, and formally recognized the GMGPDC
as an organization, and cooperative of mango
growers and producers through a provincial res-
olution.
Aside from the above-mentioned partners,
it also partnered with the Guimaras National
Crop Research, Development, Production, and
Support Center (GNCRDPSC), a special office
under the Bureau of Plant Industry (BPI) that
focuses on various crop research, specifically
on mangoes. Various higher academic institu-
tions, and secondary schools in the region have
coordinated with the cooperative for some pro-
grams and projects. GMGPDC also collaborat-
ed with food factories to process mango-based
products to establish direct transactions with the
farmers-producers, and expand linkages and
networks with the market. Some of the food fac-
tories include the popular Trappist Food Prod-
ucts, and local food processing company Mc-
Nester. This collaboration minimizes producers’
losses whenever there is a surplus of supply
of produced mangoes. As an intermediary, the
producers’ cooperative buys the farmers’ man-
go produce at a reasonable price, and thinks of
innovative ways to sell the mangoes at a larger
market. In return, the producers’ cooperative
uses the profit to fund their financial programs,
and projects to assist members.
GMGPDC also encountered challenges as an
organization. In 2007, they faced a low cooper-
ative membership, fell short of financial resourc-
es, and also lacked active participation from ex-
isting members. As of 2018, GMPDC has around
100
70 active cooperative members. The producers’
cooperative is able to expand their membership
through reaching out to other mango farmers
and producers; actively conducting educational
campaigns to orient interested growers about
the benefits of being a cooperative member.
As a cooperative member, they can expect to
work, and contribute within bounds of equality,
and social justice as they all promote individ-
ual, and industry welfare. Moreover, members
can expect that the cooperative will encourage,
and facilitate meaningful participation; and that
members will be empowered through being giv-
en opportunities for decision-making. In terms
of maintaining external partnerships, the coop-
erative gives importance to the community’s
collaboration, and existing formal organizations
that can help build, and develop the tourism,
local economy, and the mango industry. All of
these efforts are anchored on contributing to the
organization’s primary objective, and advocacy
– help the mango farming industry in the island
province of Guimaras.
Specifically, GMGPDC aims to support the grow-
ers and producers in the processes and needs
of production and assist the mango economy
in meeting its domestic and international de-
mands; most notably, when demand for mango
peak during the annual Manggahan festival that
happens every mid-April until the last week of
May. Since then, the producers’ cooperative has
been striving to provide services for its mem-
bers, which are necessary to increase mango
production, and help the local government in the
local industry’s development and progress. The
producers’ cooperative also enjoins initiative in
providing services to non-members in training
them on Good Agricultural Practices (GAP) in
mango production. The Guimaras mangoes
were granted a trademark registration under
the Intellectual Property Office Philippines (IP-
OPHL) to maintain the identity, and excellent
quality mangoes off for trade from the province.
January - December 2020
GMGPDC’s Organizational Values Towards
Cooperation
Three GMGPDC organizational values emerged
as critical in attaining its goals and objectives.
These emerging core values that shape the
organization’s actions, and form part of their
democratic framings are empowerment, inclu-
siveness, and collaboration. Instilling democrat-
ic principles is vital to empower these sectors
to implement grassroots activities (Zaimova et
al., 2012), and the inherent values, and culture
of self-help (Lake & Leviten-Reid, 2015) with-
in cooperatives that spur social well-being and
support. These producers’ cooperatives that are
composed of farmers, and smallholders appeal
to a strong push for representation to advance
their interest (Moraru, 2018), and at the same
time, to empower them. Furthermore, produc-
ers’ cooperatives provide ways for local com-
munities to inclusively enhance self-sufficiency,
strengthen farmer’s household economy by
providing market access and competition, ad-
vance operations through technological innova-
tions, and encourage democratic decision-mak-
ing and leadership (Hermida, 2008). Crucially,
collaboration is also an important component
of materializing whatever objectives and goals
a certain initiative has. In the case of produc-
ers’ cooperatives, community life development
is certainly achievable by activating people’s
participation in agricultural, and tourism devel-
opment (Effifom, 2014), and collaboration with
state, and non-state actors. This dynamic col-
laboration is possible, because pursuing the
community interests as goals (i.e., activities that
benefit society at large like the provision of gen-
eral interest services) (Borzaga et al., 2014) is
central and common to producers’ cooperative
and among these actors.
Empowerment, Inclusiveness, and the
Agro-eco-tourism Economy
To date, the GMGPDC has been promoting
mango economy for more than 10 years now,
Issue No. 9
and the producers’ cooperative has already
undertaken measures to improve the agro-eco-
tourism industry in the province (see Table 1).
The Guimaras province has become a more
well-known tourist destination for its sweet man-
goes, and the LGU still sees opportunities for
improving the agricultural industry to further
elevate the province’s economy. The GMGP-
DC extends help to the farmers, especially by
providing inputs for production, and facilitating
the marketing of their products. The organiza-
tion also ensures that products are transported
well to identified markets, and that products are
marketed so as to ensure that all farmers are
provided with essential services needed. More-
over, the producers’ cooperative also shares ex-
pertise, and knowledge to their members to help
build capacities of small growers, and farmers
for small and medium enterprises (SME), and
mango food productions. Table 1 categorizes,
and summarizes the roles, and initiatives of
GMGPDC towards sustainable local agro-eco-
tourism development as discussed with the KII,
and group discussion participants.
Peric and Djurkin (2013) assert that coopera-
tives’ development, and successful manage-
ment can significantly contribute to commu-
nities’ economic, environmental, and social
sustainability, especially in rural areas. Notably,
when the GMGPDC participated in the market-
ing of mango products, and uplifted mango tour-
ism in the province. As an example, the orga-
nization actively promotes its products through
involving its members in the annual Manggahan
Festival. Their participation in the annual festi-
val serves as an opportunity to showcase, and
sell their mango products. It genuinely helped
the existing organizations who took charge of
agro-eco-tourism activities, and development
in the province. Aside from the annual festival,
GMGPDC also represents the province in vari-
ous agri-trade expos to further promote tourism
development, at the same time building connec-
tions with future investors, and markets of man-
go products.
101
Table 1. Roles and Initiatives of GMGPDC towards Sustainable Local Agro-eco-tourism Develop-
ment

Technical • Technical assistance to farmers and mango growers and farmers to increase the volume
of production
• Provision of fertilizers and inducers to aid the mango production
• Provision of transport facilities for small mango producers from farm to market
• Spearhead strategic and business planning to cooperative members and mango farmers
• Facilitate training for smallholder farmers, and businesspersons on mango-based food
products
Economic/ Business • Linkages and connection to market and traders to secure the sale of mango produce
• Connection with mango food products factories to ensure sale and use of production
surpluses
• Establish mango and agricultural trade fairs during Manggahan festival to increase the
visibility of the cooperative
• Participate in national and international agri-trade fair and expos to showcase agriculture
and tourism
Administrative/ Political • Coordinate with LGU on development programs and projects for the mango sector
• Regular conduct of meeting and training for mango farmers and growers to advance
knowledge and skills in mango farming
• Represent mango growers and farmers to the provincial legislative body
• Initiated to establish a price council to monitor and regulate and control mango price in
the market

The GMGPDC participates in local administra-
tive, executive, and legislative bodies as part
of improving both its internal, and external gov-
ernance mechanisms. As part of improving its
internal governance structure, the organization
conducts regular meetings, and conducts vari-
ous training. These activities prove to be helpful
in upscaling skills, facilitating innovation, and
boosting morale of members.
Interestingly, the GMGPDC is the sole mango
organization in the province, and the coopera-
tive has used this advantage by actively repre-
senting, and leading mango-related initiatives,
and by partnering with local authorities to ef-
fectively address concerns. One of the officers
mentioned that:
“Oo, may ara, kay halimbawa ang local
quarantine sang Guimaras kami na ac-
tually nag-initiate nag-ubra kami sang
resolusyon, gin-forward namon sa Com-
mittee on Agriculture sa Sanggunian so
siya ang Chairman sang Committee on
Agriculture gindala ya na sa session so
amo na na-approve ang local quarantine
lang.” [Yes, there is. For example, the lo-
cal quarantine of the province. We initiat-
ed the resolution and forwarded it to the
committee on agriculture of the Sanggu-
nian (council), who brought it up to the
session, and it was approved.]
Cooperative President
Members of the producers’ cooperatives must
be empowered to take the lead in addressing
their needs. Liu (2015) mentioned that in de-
veloping modern agriculture, it is imperative to
instigate a modern vision, and quality among
many farmers to achieve support, and address
their concerns. By ensuring adequate represen-
tation of the sector and the cooperative, local
authorities provide the appropriate avenue for
the sector to express, and discuss critical is-
sues and needs. Thus, representation is essen-
tial to the development of the agro-eco-tourism
economy, and the local community. In principle,
cooperatives and their practices directly im-
pact economic, and community development
through cooperation as a mechanism that em-
bodies democratic ways of decision-making,
consultation, and participation, which is different
from that of the market (Beltrán-Tapia, 2012).

102 January - December 2020

Collaboration with Government and
Non-Government Institutions
Essentially, the collaboration between cooper-
atives, government, and non-government bod-
ies flourished to address the needs of the local
economy, agro-eco-tourism, and community
development. Majee and Hoyt (2011) claimed
that social capital is important to cooperatives
as it is drives development of the organization.
Strengthening existing social networks and
building new ones is imperative for the organi-
zation’s financial and technical needs. Hence,
supporting the networks for improving social
capital enhancement is essential. The KIIs, and
group discussions conducted provided details
on initiatives by GMGPDC (Table 2) in collabo-
ration with government partners, and non-gov-
ernment organizations to address immediate
needs for local agro-eco-tourism economy, and
community development.

Table 2. GMGPDC Initiatives in Collaboration with Government and Non-Government Institutions for
Agro-eco-tourism Development

Focus Initiatives Partners

Development Planning and • Participation in the Committee on Agriculture LGU, Provincial Legislative Board, Provin-
Organizing and the Provincial and Development Plan cial Office for Agricultural Services, Pro-
• Strategic planning and capacity building for vincial Planning and Development Office,
the GMGPDC; Strengthening the leadership Provincial Economic Development Office
and organization of GMGPDC
• Entrepreneurial training and business
planning
Development Projects and • Proposal and implementation of the World Bank, LGU, Department of Agricul-
Facilities Philippine Rural Development Project (Farm ture, Bureau of Plant and Industry, Provin-
to Market Roads) to facilitate easy access cial Office for Agricultural Services
and marketing
• Establishment of Post-Harvest Facilities to
expand and maintain the shelf life of harvest
Production Inputs and • Delivery of planting materials, inducers, and LGU, Provincial Office for Agricultural Ser-
Materials Provisions necessary substance for production use to vices, Guimaras National Crop Research
facilitate good quality harvest and Development, Production, and Support
• Technical skills training and business Center
practices sharing to aid small farmers and
producers
Advertisement, Promotion, • Roadshows and Agriculture Trade Expo Department of Tourism, Malls and Trade
and Marketing • Participation in national and international Centers (i.e., Robinsons, SM, etc.), local
conventions for agriculture and mango beach and in-land resorts
industries
• Coordination and promotion for the sale of
mango fruit and mango food products to
local resort owners
Data Source: Summarized from KII and Group Discussion

“TTi subong ang local government dako
na ang pagtan-aw sa mga mango grow-
ers subong komparar san-una kay sini
lang gani last year nag-lobby kami sa
province kay tungod nag-failure kami sa
productions tungod sa weather condition
so nag-grant sila samon 1 million. Bale
assistance sa production so way man
na interest, depende na na samon kung
pano namon na ipalakaton.” [Now, the
local government looks up to the man-
go growers more than ever. This year,
because of the production failure due
to weather conditions, we lobbied to the
province, and they grant us 1 million
pesos. This is assistance for produc-
tion, and it is up to us how we will use it]
Cooperative Member A

Issue No. 9 103

 “Ang GNCRDPSC, kay kung every time
may problema kami sa mangga hapos
gid magkadto dira, kung mamangkot ka
ano nga solusyon ma-offer nila. Kadamo
actually sang mga technical solutions
nga gina-offer nila sa amon. Ti kung may
mga seminars nga related sa mangga
kami man gihapon ang ginagaan priori-
ty.” [In times that we have problems con-
cerning mango production, it is effortless
to reach out to the GNCRDPSC to ask
for solutions. They have a lot of technical
solutions to offer to us. If there are semi-
nars, they are giving us a priority]
Cooperative Member B
Because of the producers’ cooperative ability
to lead, and organize mango production in the
island, various institutions have invested their
trust, and showed interest to help. This, in turn,
further encourages, and capacitates the orga-
nization to perform their roles, and help in the
mango economy. Considering that farmers are
essential workers who produce the needed
supply, local authorities direct their attention to
the sector to allow the industry’s development.
Some local officials said that:
“Yes, because we have the so-called
over-site function. So, for example, we
authorize the spending of funds because
their work is vital to the economy. We
have the over-site function to look or dig
deeper into what happened to the funds
that were expended by that association..”
Provincial Vice-Governor
“Kag may assurance ang Mango Grow-
ers Cooperative nga dapat suportahon
nila ang programa sang Provincial Gov-
ernment sa mangga naton kay kung kis-a
ginakulang kita sa supply.” [We also got
an assurance from the Mango Growers
104
Cooperative that they will be supporting
the programs of the Provincial Govern-
ment on the mango industry, especially
that sometimes, we lack mango supply]
Provincial Board Member on Agriculture
The yearly supply of mangoes is a significant
concern of the local agro-eco-tourism economy,
this is why the LGU took an extra effort to col-
laborate with the producers’ cooperative to meet
the market demands, especially during the an-
nual mango festival. According to Shrestha et
al. (2012), the collaboration of local and nation-
al stakeholders, governmental and non-gov-
ernmental organizations, “can strengthen their
technical, managerial, and financial resources,
thus contributing to long-term sustainability.”
With this, stakeholders strengthen the cooper-
ative and mango producers’ capacity for service
delivery to meet the production demands and
help the community significantly.
Organizational Challenges and Ways
Forward
The GMGPDC identified multiple issues that in-
hibit the organization to perform its roles, and
their capacity to sustain the local agro-eco-
tourism. The major issues are categorized into
organizational dynamics; financial capacities;
and production systems. Primarily, GMGDPDC
identified its organization’s dynamics as a crit-
ical factor to operationalize, and deliver princi-
ples, objectives, and goals of the cooperative
that benefits its members, and the broader com-
munity. To emphasize the importance of a func-
tioning cooperative dynamics, the cooperative
president shared that:
“Hapos lang ni tani ang coop padlaganon
kung tanan lang nga officials ga function.
Kis-a gwa mo one-man army ka ti wala
gid” [It is uncomplicated to run the coop-
January - December 2020
 erative if all the officials are functioning.
Sometimes, it becomes a one-person
army.]
Cooperative President
Another challenging aspect of maintaining the
cooperative is the need to manage finances
in a manner that capitalizes on the expensive
production cost. As evident from their historical
accounts, investing in mango production is a
high-risk financial decision, especially as pro-
duction is heavily affected by weather, weather
conditions, and pest infestations. Some of the
cooperative members said:
“Baw damo gid. Number one, capital gid
eh. Kinanglanon mo gid na kay dako ang
investment sang mangga. Dason market
mo. Sa subong ang post-harvest namon
nga problem nasabat na sang coop ya.”
[The number one is capital. We need
significant investment for the mangoes,
then the market. As of now, the problem
for post-harvest is already solved by the
cooperative]
Cooperative President
“Sa tuod-tuod lang kay problemado man
kami sa financial, ang amon lang guro
na-extend sa members technical assis-
tance sa mga miyembro nga nagakinan-
glan. Kag usually informal lang nga con-
versation, ga-exchange ideas lang kami
pero kami way kami gadinalok sa busi-
ness practices gina-share lang namon
sila kay mga miyembro man.” [Honestly,
we are also financially constrained, and
the things that we can extend are tech-
nical assistance to other members who
need it. Usually, during informal conver-
sations, exchange of ideas, and sharing
of business practices with other mem-
bers]
Cooperative Member C
There are other issues that members of the
producers’ cooperative and from the govern-
ment highlighted during the group discussion
and interview. Various critical problems ham-
per the development of GMGPDC include the
execution of the producers’ cooperative’s roles
towards mango agro-eco-tourism and delivery
services to mango farming community range
from membership, organization, participation,
and dynamics (see Table 3).

Table 3. Key Issues and Concerns od GMGPDC

Areas Key Issues

• Dysfunctional officers and weak leadership
Organizational • Low membership from small and medium producers
Dynamics • Lack of participation and commitment from members
Internal

• Members focus on personal business and competition; a conflict of interest to the

purpose of cooperation
Financial Capacities • Lack of financial transparency
Technical Capacities • Lack of mango cooperative database for data storage and record
• Overly devolved responsibilities and obligations from the government for agro-eco-tour-
ism development that causes organizational fatigue
Governance and • Weak implementation of policies and regulation for mango production and quarantine
External

Policy measures
• Lack of deployed regulators from the taskforce to enforce mango quarantine measures,
and other clauses mandated by the ordinance
• Lack of interest from the younger generation to involve in mango farming, which may
Sustainability later lead to a lack of workforce in mango production

Issue No. 9 105

Hence, this confirms that those claimed by
Effiom (2014) are relevant issues to the case
of the Guimaras mango industry. Some of the
challenges met by GMGPDC, as Effiom (2014)
mentioned, include poor internal management,
and lack of trained staff on operational functions
in the cooperative that hinders its full operation
and delivery of services. Another is the issues
on the limited financial resources on the part of
members in paying their regular membership
contribution, and for some reason, they hardly
cope with the production costs. In this vein, the
cooperative also finds this one of the factors of
financial constraints in the organization’s oper-
ation, which goes back to the internal manage-
ment difficulties mentioned earlier. Moreover,
dishonesty in terms of pursuing personal over
collective interest was cited as a factor that
hinders the cooperative in moving forward.
Members of the cooperative have professed
that there are instances where the cooperative
was misrepresented. Instead of pursuing what
could benefit the collective, some of the mem-
bers were using the cooperative’s name to take
advantage of the networks for marketing their
own produce beyond the fair priced as agreed
within the organization. The loophole within
the members’ internal dynamics (referred to
the misrepresentation and dishonesty) has led
some investors and capitalist to take advan-
tage of this weakness and turn it into something
that benefits them. Big capitalists and inves-
tors in the market turn to frustrate cooperative
advancement and growth to protect their own
business and absence of communality among
members (Effiom, 2014). Generally, the mem-
bers also acknowledged the organization’s
weakness in terms of financial management,
operations, and leadership, which have led to
the pilling of salient issues and concerns. Peric
& Djurkin (2013) point out that the critical prin-
ciples towards development in the cooperative
are not limited to social goals and democratic
governance. Perhaps, operational democratic
principles and real participation of members in
decision-making, and constant concern for the
106
local community are vital to organizations (Peric
& Djurkin, 2013). A participatory approach in an
organization is essential to maintaining a holis-
tic dynamic.
Nevertheless, the collaboration and connec-
tion of networks, supporting Majee and Hoyt’s
(2011) claim, is a clear manifestation that GMG-
PDC addresses tourism and economic develop-
ment. Despite the issues concerning the organi-
zation and the mango economy, the cooperative
initiatives translate to the success of rural agri-
culture and tourism (Aref & Gill, 2009). Besides,
the mango farming community of the province
of Guimaras develops along with its mango
economy and tourism since there is an indirect
relationship between tourism development and
rural communities, especially in agriculturally
driven societies (Fleischer & Tchetchik, 2005).
CONCLUSION
The local agricultural cooperative in the man-
go industry in Guimaras, Philippines is an es-
sential driver towards addressing challenges
and delivering goals and objectives set for the
development of the local agricultural economy.
The study provided a clear understanding of the
roles of GMGPDC towards the agro-eco-tourism
economy and mango farming community in the
province of Guimaras. Necessarily, there were
initiatives that the cooperative has undertaken
together with various organizations and gov-
ernment agencies to respond to the needs of
the mango industry and address the concerns
of mango farmers and producers. Notwithstand-
ing, internal and external issues and concerns
were raised, ranging from organizational and
technical matters relevant to the cooperative as
it responded to the mango industry.
Regardless, the study infers that the networks
identified between government and non-gov-
ernment institutions, and the cooperative are
instrumental towards developing the coopera-
January - December 2020
tive, sustaining the agro-eco-tourism economy,
and pursuing sustainable growth among man-
go farming communities. The GMGPDC is in-
clusively empowered while it collaborates with
various institutions, and improves the mango
farming sector. It is important to note that coop-
eratives are vital to rural communities, especial-
ly in addressing agricultural development and
tourism concerns. Barton (2000), and Ortmann
and King (2007) even support that cooperatives
generally aim to obtain inputs and services at
lower costs than getting it somewhere else at a
higher price. Similarly, cooperatives help mar-
keting the products at a good yet profitable rate
that can be beneficial to the members. While
successful agro-eco-tourism development usu-
ally determined by substantive capital input,
marketing, reliance on external advice, and fi-
nance (Connell et al., 2015), the study empha-
sized that development cooperatives in rural
agricultural industries assist this by enabling
sector and local communities to promote hu-
man, social, and economic developments (Te-
odosio, 2009). More importantly, the process of
empowerment, inclusiveness, and collaboration
ensures that the GMGPDC as a producers’ co-
operative, organized and initiated by and with
the farmer-producers in the mango industry of
the province of Guimaras, exemplified poten-
tials in addressing the concern over an elitist
type of agri-eco-tourism, to a more community,
and sector-oriented agri-eco-tourism develop-
ment initiatives. Irrespective, there is still a dire
need to ensure that the existing gaps and key
issues identified should be further addressed
to achieve a pro-people-oriented development
genuinely aspired in our local communities.
RECOMMENDATIONS
RECOMMENDATIONS
The findings commended how the GMGPDC
works towards the local agro-eco-tourism econ-
omy; it cannot be neglected that the coopera-
tive’s challenges are crucial in forwarding and
Issue No. 9
attaining its mission towards the mango farming
community and the agro-eco-tourism devel-
opment. Hence, we generated crucial recom-
mendations that the three actors, namely the
GMGPDC, LGU, and the civil societies or the
community groups, may consider to achieve fur-
ther a more empowered, inclusive, and collabo-
rative participation of the producers’ cooperative
the development of agro-eco-tourism economy
and the mango industry in the province of Gui-
maras.
To GMGPDC
Our recommendations to GMGPDC encom-
pass elements on organizational concerns;
social capital; networks, and partnerships; and
transparency on fiscal information. These rec-
ommendations focus on improving salient col-
laborative governance, and dynamic organiza-
tions measures; all of which are anchored on
the recognized importance of the GMGPDC as
a stakeholder, and as a driver of agro-eco-tour-
ism in the province.
First, the cooperative’s organizational concerns
can be addressed by establishing a substantive
agenda for strategic planning, scenario-based
foresight, and SWOT analysis on various chal-
lenges concerning them. This will help GMGP-
DC identify crucial concerns that urgently need
their attention. Second, as membership is an
essential social capital, the cooperative may ad-
dress this by expanding its reach, and organiz-
ing local chapters or groups per municipality to
promote their organization. Through community
forums, the organization can extensively expand
its reach for information dissemination towards
educating the people and the target population
on the contribution and importance of the pro-
ducers’ cooperative of the Guimaras mango in-
dustry. Third, while networks with government
units, and private groups have been well es-
tablished locally, the cooperative may consider
extending the networks through representation
in trade expos, and proactively participating
107
in regional, national, and international forums
with other cooperatives to facilitate exchange
innovative ideas, and best practices. These net-
works will later help in boosting the cooperative
and mango industry’s reach for agro-eco-tour-
ism. And last, the cooperative may advance the
transparency on fiscal information, initiatives
such as programs and projects, coop activities,
and products and services using modern media
platforms. Though annual reports are taken up
during general assemblies, it is equally neces-
sary to strengthen its visibility by developing a
website, and social media account to promote
cooperative services, and products. Through
this, GMGPDC can extend its reach to its mem-
bers, potential individual members, groups, and
other organizations to establish future networks.
To Local Government Unit (LGU)
Our recommendation for the LGU focuses on
strengthening its role as a state actor within the
agro-eco-tourism development framework, and
on its local mandate to facilitate sustainable de-
velopment in the area. The agro-eco-tourism
development in the province is the state’s ini-
tiative in collaboration with various stakehold-
ers; thus, it is equally important for the state
to be accountable to several responsibilities in
strengthening the producers’ cooperative’s ca-
pacity.
First, in order to strengthen both the GMGP-
DC’s existing contributions, and the local tra-
jectory towards agro-eco-tourism, the LGU
must ensure proper implementation of all local
ordinances, as well as related natural resource
management policies. Proper implementation
can be operationalized by effective coordina-
tion within, and among concerned government,
and non-government units; and ensuring that
social and environmental safeguards are tak-
en into consideration. While the current mea-
sures have already extensively reached the
local barangays, the provincial LGU may also
consider extra measures such as conducting an
education drive to inform the people about the
108
mango industry’s existing ordinance. Secondly,
the LGU may expand its efforts by intensifying
its networks with international partners, mainly
targeting cities and private organizations to pro-
mote the industry and tourism activities in the
province. They can tap, and learn from other
cities, and LGUs that they were able to estab-
lish partnerships with. Local Government Units
(LGU) are at the forefront of establishing net-
works, and with assistance from the community
groups, and civil societies, the cooperative can
connect with these groups, and mainstream the
needed assistance for agro-eco-tourism devel-
opment. Last, the LGU may consider providing
additional technical assistance and funding
along with ensuring transparency on adminis-
trative (on programs and qualifications of ben-
eficiaries) processes; and fiscal policies, such
as the the release of finances (who receives the
funding and amount), and financial reports.
To Civil Society Organizations and
Community Groups
The civil society organizations and community
groups are considered third sectors that act as
reinforcers of development initiatives needed by
local communities towards addressing social,
and economic well-being. Here, the study rec-
ommends to concentrate on consultation, advo-
cacy, and coordination as fundamental roles of
civil societies, and community groups towards
the producers cooperative. While these groups
mostly coordinate funding for private entities’
programs, it is equally important to consult, and
get to know the cooperative, and farming com-
munity’s priorities. Civil societies organizations
and community groups may consider forging
strong linkages with the local government, and
the cooperative to facilitate forums and consul-
tations before planning for possible community
needs.
Moreover, as the province, together with GMG-
PCD, aims for agro-eco-tourism development,
community groups, and CSOs may also assist
by expanding the campaign to promote the
January - December 2020
province in national and international societies
where these entities are connected. Civil soci-
ety organizations, and community groups may
also coordinate with the LGUs to find possible
partners, and funders in crafting proposals for
programs and projects that will help the mango
agro-eco-tourism industry. Lastly, while the role
of GMGPDC is a key element in agro-eco-tour-
ism development, CSOs may assist by forging
linkages with local communities for community
development projects, while also engaging the
cooperative to promote further the organiza-
tion’s information dissemination, and program
implementation.
ACKNOWLEDGEMENT
We sincerely appreciate the constructive com-
ments and suggestions of the two reviewers,
and the help of the language editor to improve
this paper. Also, thanks to the Guimaras Man-
go Growers and Producers Development Co-
operative (GMGPDC), and to the officials and
employees of the province of Guimaras for their
valuable contribution to this study.
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Issue No. 9 113

A Study on Media Utilization and Preference for Food and
Nutrition Information of Selected College Students in the
University of the Philippines Los Baños
Mayque Coleen T. Ladigohon a , Marie Faye R. Nguyen-Orca a, Joyce P. Parco a *
a
Institute of Human Nutrition and Food, College of Human Ecology, University of the Philippines, Los Baños, Laguna

* Corresponding author: jpparco1@up.edu.ph

ABSTRACT
Media has always been utilized as source of information, including that of food and nutrition. This
study sought to analyze students’ media utilization and preference for food and nutrition information
and their relationship with students’ socio-economic profile and nutritional status. With a descriptive
cross-sectional research design, a survey was carried out among 70 students residing at the Vet-
erinary Medicine Dorm of the University of the Philippines Los Baños using self-administered ques-
tionnaire. Assessment of their nutritional status was also conducted. Data were analyzed through a
combination of descriptive and inferential statistics. Majority of the respondents were female (74%);
and junior standing (43%) with a household income not exceeding Php 350,000. In terms of nutri-
tional status, only one student was obese, 12 were underweight, 6 were overweight, and 51 were
mainly classified as normal. Most of the students (84.3%) had sought information related to food and
nutrition. The prevailing reason they seek such information was for health purposes. Overall, findings
revealed that cellular phone and the Internet were the media channels most commonly used by the
students. Most of them preferred the Internet, cellular phone, and television as channels for their food
and nutrition information needs. Through the Chi-Square Test of Independence, significant associa-
tions were found among these variables: household income and utilization of media channels such
as cellular phone, books, and the Internet; and media preference and utilization of all media channels
except for cellular phone and the Internet. These findings lend a basis for developing communication
strategies aimed at promoting food and nutrition among college students.

Keywords: media utilization, media preference, food and nutrition information, nutritional status

INTRODUCTION and fastest growing type of media, provides dif-

Media is a collective term that refers to com-
munication channels through which informa-
tion and messages are disseminated. Differ-
ent types of media include print and broadcast
media, as well as the Internet. Print media may
cover newspapers, magazines, books, and oth-
er printed materials. Another type of media is
broadcast media which generally refers to tele-
vision and radio. The Internet, which is the latest
ferent platforms on which various forms of com-
munication may take place. Using media as a
tool for communication brings about a lot of ben-
efits. Through the utilization of media, one can
obtain useful information which is a key element
needed in the development of one’s knowledge
(Oswalt, 2010; Biagi, 2012).
Nutrition plays a significant role in people’s lives
and affects them in varied ways depending on
the types of food that they eat. Malnutrition is

114 January - December 2020

defined as not getting enough or getting more
than enough of a nutrient or energy in signifi-
cant amounts over time. Food choice is affect-
ed by different factors such as food preference,
habit, ethnicity, society, economy, the positive
and negative associations that a person relates
to food, emotional comfort that a person gets
from food among others. The right foundation
for good health is choosing the right kind of
food that results in a varied and balanced diet
(Rolfes, Pinna and Whitney, 2009). College stu-
dents are observed to be prone to malnutrition
since they are at a stage where they are influ-
enced by many factors which affect their eat-
ing patterns and behaviors. Unhealthy dieting
behaviors among adolescents are high which
frequently causes eating disorders such as an-
orexia nervosa, bulimia nervosa, and binge-eat-
ing disorder. There are studies which show that
health-related factors and lifestyles are associ-
ated with weight gain and obesity of college stu-
dents and that nearly 32% of college students
are either overweight or obese (Magoc, Toma-
ka, and Thompson, 2010; Pedersen and Ket-
cham, 2009; Perusse-Lachance, Tremblay, and
Drapeau, 2010). According to the 8th Annual
National Nutrition Survey, 3 out of 10 adults are
overweight. In most cases, the likelihood of a
female being obese or overweight is higher than
that of a male (FNRI, 2014).
Even though there are already existing nutri-
tion information, it does not necessarily mean
that people are aware of it. The process of dis-
seminating information encounters many prob-
lems that hinder information from reaching its
target audience. Therefore, information should
be disseminated to the audience through a me-
dium that they commonly use. Media plays a
major role in educating, informing, and creating
awareness for health practices. Also, it serves
as an extensive source of nutrition-related in-
formation for the public. Availability and chang-
es of messages relating to food and nutrition
conveyed in media directly influence health
practices. Moreover, there are researches that
present the relationship between media and the
Issue No. 9
establishment of desirable food, nutrition, and
health practices (Hindin, Contento, & Gussow,
2004; Houts, Doak, & Loscalzo, 2006; Ngimwa,
Ocholla, & Ojiambo, 1997). This makes uni-
versities, colleges, and its students a potential
target audience for the promotion of information
regarding food and nutrition. However, little is
known about the information-seeking behavior
of students on different media. Thus, the focal
questions of this study: how do college students
utilize media and what are their preferred media
for food and nutrition information? This study
looked into their preferred and utilized media
channels in seeking health and nutrition infor-
mation and elicited relationships of these to their
socio-economic profile and nutritional status.
METHODOLOGY
This study adapts a descriptive cross-section-
al research design. Data were gathered using
a survey and analyzed through descriptive and
inferential statistics. The study was conducted
in the University of the Philippines Los Baños,
Laguna, particularly at the Veterinary Medicine
Residence Hall. Respondents of the study con-
sisted of male and female students aged 16-29
years old. The sample size was determined us-
ing OpenEpi ver. 3 where the reference popula-
tion used was 376 (dorm at full capacity), with
hypothesized frequency at 30%±10, and 10%
precision. The sample size generated at 95%
confidence level was 67, thus the sample size
applied was 70 to maintain sample size integrity
in case of drop-outs. The 70 students were se-
lected through convenience sampling where the
students were asked for their voluntary consent
to participate in the study.
Data collection was done using a self-admin-
istered questionnaire. The questionnaire con-
sists of questions regarding the socio-economic
characteristics of the respondents (age, gender,
household income, etc.); reasons for seeking in-
formation related to food and nutrition; frequen-
cy of media utilization; and media preference for
115
food and nutrition information. Soon after, the
height and weight of the students were mea-
sured and recorded to determine the nutritional
status of the students. The computation of the
nutritional status of the students was based on
the formula provided by the World Health Or-
ganization (WHO): Body Mass Index (BMI) =
(weight in kilograms) / (height in meter2). The
computed BMI was classified based on the
WHO cutoff points shown in Table 1.
Table 1. WHO BMI cutoff points
BMI Classification
< 18.5 Underweight
18.5 – 24.9 Normal
25 – 29.9 Overweight
30 – 34.9 Obese I
> 35 Obese II
Descriptive analysis was used for analyzing and
interpreting the sociodemographic and econom-
ic data, media utilization (whether the students
seek for food and nutrition–related information
or not and their reasons), and frequency of me-
dia use for seeking information related to food
Figure 1. Socio-economic and demographic characteristics of the respondents
116
and nutrition. For the analysis of relationship
between variables (sociodemographic and me-
dia utilization and preference of the students;
media utilization and preference of the students;
media utilization and nutritional status of the
students), the obtained data were cross-tabu-
lated and analyzed through Chi-Square Test of
Independence.
RESULTS AND DISCUSSION
Profile of UPLB college students
Majority of the study’s respondents were female
(74%), 19 years of age (29%), and had junior
standing (43%). The household income of the
students was identified based on the tuition
brackets under the University’s Socialized Tui-
tion System (STS). Majority of the respondents
(40%) had household income ranging from Php
325,000 – 600,000 (Figure 1). The tuition brack-
ets under the UP STS are as follows: Bracket A
– above Php 1 million; Bracket B – Php 500,001
to Php 1 million; Bracket C – Php 250,001 to
Php 500,000; and Bracket D – Php 135,001 to
Php 250,000.
January - December 2020
Nutrition information-seeking behavior The data shown in Figure 2 suggested that
the most common reason for seeking food and
When asked if they have sought information nutrition information was for health purposes
about food and nutrition, majority of the respon- (57.1%). This result echoed the study done by
dents (84.3%) reported that they had sought in- Sultan et al. (2017), where they observed that
formation related to food and nutrition; only 11 the health information-seeking behavior of stu-
out of 70 (15.7%) reported not having sought in- dents was greatly influenced by personal and
formation related to food and nutrition (Table 2). family sickness. For those who did not seek
information (15.7%), one reason they identi-
fied was that there was no incident that drove
Table 2. Nutrition information-seeking behavior them to seek information (10%); while others
of respondents (6%) reported that seeking information is not
important for them (Figure 2). It is important to
Information note, however, that even though many students
Frequency Percentage
seeking have sought information about food and nutri-
Yes 59 84.3 tion, useful information can be obtained if the
No 11 15.7 information seeker has the skill to search pre-
TOTAL 70 100 cise and relevant information (Ganaie & Khazer,
2014).

Figure 2. Reasons for seeking/not seeking information related to food and nutrition

Media utilization the least utilized (37.1%) by the respondents.

The students who sought nutrition information
were asked about the type of media channels
that they utilize and their frequency of using them
(Figure 3). The results revealed that radio was
However, broadcasting useful information about
food and nutrition should not be discontinued
since radio has been widely used as a chan-
nel for nutrition education due to its affordability
and accessibility. In low income countries, using

Issue No. 9 117

radio to disseminate nutrition information has
shown to build capacity and broaden the reach
for interventions aimed at improving nutrition-re-
lated behaviors (USAID, 2017). On the other
hand, cellular phone (24.3%) and the Internet
(34.3%) were used on a daily basis. Universi-
ty students are known to be active users of the
Internet and social networking sites, specifically
for communication (Horgan & Sweeney, 2012).
Figure 3. Media utilization of the respondents
Media utilization vis-à-vis household income
Major factors influencing the choice of media is
related to awareness, information literacy, or-
ganizational and environmental issues, source
characteristics, and demographics (Ganaie &
Khazer, 2014). Thus, utilization of each media
channel and the annual household income of the
respondents were assessed (Figure 4). Most of
the respondents whose household income was
classified as Bracket C had never used radio
for seeking information on food and nutrition.
Whereas, majority whose household income
were classified as Bracket D and E2 uses radio
118
Since they are mostly glued to these media
channels, it may have influenced the high uti-
lization in seeking food and nutrition-related in-
formation. Students consult an array of informa-
tion sources to satisfy their information needs.
Meanwhile, the majority of the respondents use
posters, charts, and/or booklets for less than
once a month to obtain information on food and
nutrition.
at least 2-3 times per week. On the other hand,
students from Bracket C utilized television for
information daily. Interestingly, the association
between the use of both the Internet and cellular
phone were significantly associated with income
(p-value=0.013 and p-value=0.010, respective-
ly). This indicates that although the Internet and
cellular phone are commonly used by most of
the students, disparity can still be observed
among income classifications. Meanwhile, the
use of books as a source of nutrition information
was also found to be associated with income. In
addition, most of the students who utilize books
daily are those from Bracket C income category.
January - December 2020
 Figure 4. Media utilization of each platforms and annual household income (income bracket
C to E2 from inner to outer circle)

Issue No. 9 119

Media utilization and nutritional status the respondents reside. These findings were
not surprising since preference for a particu-
It was noted that the main reason for seeking lar source of information is based on personal
nutrition information was for health reasons. knowledge and availability of resources. Main
Thus, the nutritional status of the students was reasons may include ease of access, conve-
evaluated and tested if it had association with nience, and information literacy skills (Desta
their media utilization. The nutritional status of et al., 2017). In terms of relationship between
all the respondents is shown in Table 3. Notably, the variables, except for internet and cellular
majority of the respondents (72.9%) fall under phones, utilization of all the other platforms are
normal nutritional status. However, the rest of significantly associated with preference—radio
the students classified as underweight (17.1%), (p<0.001); television (p=0.001); poster/charts/
overweight (8.6%), and obese (1.4%) must not booklets (p=0.020); magazine (p=0.030); books
be discounted. Among the 70 students, the nu- (p<0.001); and newspaper (p<0.001).
tritional status of the 59 who sought nutrition in-
formation were compared with their utilization of
Table 4. Media preference of respondents who
the different media channels (Figure 5). More-
seek food and nutrition information.
over, the results on the test done with the two
variables showed that there was no association
established between nutritional status and the Rank Weighed
Media Platform Mean SD
Order Score
use of media channels. Overall, students hav-
Radio 8 1.68 0.819 99
ing normal nutritional status used all types of
Television 3 3.25 0.993 192
media with varied frequency depending on the
Cellular phone 2 4.53 0.728 267
media. As expected, usage of cellular phones
Internet 1 4.76 0.468 281
and the Internet were the same across nutrition-
al status. Poster/Chart/ 4 2.42 1.148 143
Booklets
Magazines 6 2.07 1.032 122

Table 3. Nutritional status of the respondents Books 5 2.31 1.163 136

Newspaper 7 1.86 1.042 110

Classification Frequency Percent

Obese II 1 1.4
Table 5. Media preference of respondents who
Overweight 6 8.6 do not seek food and nutrition information.
Normal 51 72.9
Underweight 12 17.1 Rank Weighed
Media Platform Mean SD
Order Score
Total 70 100
Radio 5 2.09 1.300 23
Television 3 3.55 0.688 39
Media utilization and preference Cellular phone 2 4.09 0.944 45
Internet 1 4.54 0.674 51
The Internet, closely followed by cellular phone,
Poster/Chart/ 4 2.73 1.104 30
and television emerged as the preferred media Booklets
by the respondents whether they had sought in- Magazines 5 2.09 0.701 23
formation about nutrition and food or not. The Books 5 2.09 0.831 23
identification of television as one of the most Newspaper 6 1.54 0.674 18
preferred media can be attributed to its avail-
ability and accessibility in the dormitory where

120 January - December 2020

 Figure 5. Media utilization of each platforms and nutritional status

Issue No. 9 121

CONCLUSION AND
RECOMMENDATIONS
Nutrition information necessary in promoting
healthy lifestyle is present in several media
channels. The primary objective of this study was
to analyze the media utilization and preference
about food and nutrition information among col-
lege students at the VetMed Residence Hall in
the University of the Philippines Los Baños. Out
of the 70 students surveyed, 59 sought informa-
tion about food and nutrition. The respondents
identify health reasons, academic purposes,
and for awareness as their reason for seeking
such information. These findings imply that
most of the students are mindful of their health.
The results revealed that the most common me-
dia channels utilized by the students are cellular
phones and the Internet. These two were also
the most preferred media. Students use cellular
phones as their major means of communication
so as the Internet for their academic and social
undertakings. Therefore, the content generators
about food and nutrition must create contents,
campaigns, and/or services that would appear
on digital media channels and platforms. How-
ever, income of students was found to be asso-
ciated with media utilization while nutritional sta-
tus was not. This implies that although most of
the information is posted on the Internet, other
media channels must not be neglected as some
still have limited access to the Internet because
of their economic status. Relevant nutrition in-
formation in different media channels and plat-
forms should be more interesting to attract more
users that would consequently improve eating
and lifestyle habits. Factors that influence me-
dia utilization and preference will add further to
this topic. Moreover, studies on the reliability
and accuracy of nutrition information across dif-
ferent media should also be considered.
122
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ing behaviour of postgraduate students
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doi:10.1177/0266666917744824
Food and Nutrition Research Institute. (2014).
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mation. CIN: Computers, Informatics,
Nursing, 30(8), 402–408. doi:10.1097/
nxn.0b013e3182510703
Magoc, D., Tomaka, J., & Thompson, S. (2010).
Overweight, obesity and strong at-
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physical activity in a predominantly
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doi:10.1177/0017896910379362

Ngimwa, P., Ocholla, D. N., & Ojiambo, J. (1997).

Media Accessibility and Utilization by
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al Information & Library Review, 29(1),
45-66. doi:10.1006/iilr.1997.0031

Oswalt, A. (2010). Children and Media Issues

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2017, from https://www.mentalhelp.net/
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troduction/

Pedersen, P. J., & Ketcham, P. L. (2009). Ex-

ploring the climate for overweight and
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setting. Journal of American College
Health, 57(4), 465-480.

Pérusse-Lachance, É., Tremblay, A., & Drapeau,

V. (2010). Lifestyle factors and other
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Rolfes, S.R., Pinna, K., & Whitney, E. (2009).

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Issue No. 9 123

January - December 2020
Volume 9 No. 1
 The Journal of Human Ecology is a scholastic peer reviewed publication of the
College of Human Ecology (CHE) in the University of the Philippines Los Baños (UPLB).
EDITORIAL BOARD
JOHE January - December 2020
9th Issue, Volume 1
Cheamson Garret K. Boongaling
Department of Community and
Environmental Resource Planning
College of Human Ecology,
University of the Philippines Los Baños
Editor-in-Chief
Aimee Sheree A. Barrion, PhD
Institute of Human Nutrition and Food
College of Human Ecology,
University of the Philippines Los Baños
Member
Marison Felicidad R. Dy, PhD
Department of Human &
Family Development Studies
College of Human Ecology
University of the Philippines Los Baños
Member
Greg Tabios Pawilen, PhD
Department of Human &
Family Development Studies
College of Human Ecology
University of the Philippines Los Baños
Member
Emilia S. Visco, PhD
Department of Social Development Services
College of Human Ecology
University of the Philippines Los Baños
Member
Eunice A. del Rosario
Office of the Dean,
College of Human Ecology
University of the Philippines Los Baños
Managing Editor
Elizabeth M. Casabuena
Office of the Dean,
College of Human Ecology
University of the Philippines Los Baños
Admin Matters and Circulation
Rikki Lee B. Mendiola
Issue Editor/Layout Artist
ISSUE REVIEWERS
Erica B. Tabuac, RND, PhD Reynaldo L. Magpantay, Jr.
Laguna State Polytechnic University Polytechnic University of the Philippines
Sta. Mesa Manila
Elaine Lorilla-Bañares
Manila Tytana Colleges Maria Rossa Agatha J. Ermino, RND, MSc
Laguna State Polytechnic University Sta.
Adriann Meneses Quilloy Cruz
University of the Philippines Los Baños
Abigail A. Pabro
Ana Leah Dungog-Cuizon, DPA National Nutrition Council
University of the Philippines
Hazel T. Lat
April M. Perez, PhD Food and Nutrition Institute
Batangas State University Main Campus I
Iris Rowena A. Bernardo, RND, MPH
Shirley G. Cabrera, PhD Polytechnic University of the Philippines
Batangas State University
Joyce P. Parco
Rodesa T. Naupal-Forcadilla University of the Philippines Los Baños
University of the Philippines Los Baños
Alvin M. Manalansan
Alexandra Jean Catindig Palis, PhD Citizen Watch Philippines
University of the Philippines Los Baños
Florinia E. Merca, PhD
Karla Monique L. Padrelanan University of the Philippines Los Baños
Hamad Medical Corporation
Adoracion P. Resurreccion, PhD
International Rice Research Institute
Irma Ubaldo Danao
University of the Philippines Los Baños
Joan I. Delomen
University of the Philippines Los Baños
Permission Information
No part of this publication may be reproduced or stored in a retrieval system, or transmitted in any form
by any means; electronic, mechanical, photocopying, recording, or otherwise; without prior consent
from the UP Los Baños College of Human Ecology.
Editorial Office
College of Human Ecology
University of the Philippines Los Baños UPLB Campus, Los Baños, Laguna
Telefax No: +6349-536-2682
Email: johe.uplb@up.edu.ph
 Table of Contents

ARTICLES

1 Perceived Nutritional Status, Body Satisfaction and Fad Dieting among Middle-
Adolescent Students of the University of the Philippines Rural High School in Los
Banos, Laguna
Liezl M. Atienza, Sarah Marie A. Don, Marjorie Anne A. Layosa, Gemaima C. Evangelista

12 Knowledge, Attitude, and Practices on Protected Mealtimes among Registered

Nutritionist-Dietitians in Private Tertiary Care Hospitals in Laguna
Tomee Vikki Lei R. Chua, Marie Faye R. Nguyen-Orca, Irma U. Danao

22 Assessment of Lactation Stations in the University of the Philippines Los Baños

Jaidee P. Agne, Divine Grace C. Domingo, Joan I. Delomen, Leila S. Africa, PhD

32 Relationship of Personal Hygiene Score with Sex, Nutritional Status, Morbidity, and
Academic Grades among Primary Grade School Children in a Public Elementary
School in Pila, Laguna
Paul Alteo A. Bagabaldo, Marie Rose A. Bonifacio, Marjorie Anne A. Layosa, Ann C. Cayetano, Leila S. Africa, PhD

47 Development of a Valid and Reliable Questionnaire to Evaluate an Adult’s Knowledge,

Attitude, and Practices on Cholesterol Management
Diorella Marie M. Tria, MSc, Leila S. Africa, PhD, Aimee Sheree A. Barrion, PhD

56 Assessment of Knowledge, Attitude, and Practices on Food Safety and Compliance to

Microbiological Safety Guidelines among Vendors of Commonly Patronized Street
Foods in Poblacion, Batangas City, Philippines
Myla A. Argente, Normahitta P. Gordoncillo, Leila S. Africa, PhD, Corazon VC. Barba, PhD, Josefina T. Dizon, PhD

71 Grain Quality of Milled Rice in Various Supermarkets in Dasmariñas City, Cavite

Arvin Paul P. Tuaño, Kristina Tamyl M. Lasam, Christian Jeshua M. Vicente

93 Producers’ Cooperative in Agro-eco-tourism Development: The Case of the Guimaras

Mango Growers and Producers Development Cooperative (GMGPDC) in Guimaras,
Philippines
Noe John Joseph E. Sacramento, Dhino B. Geges

114 A Study on Media Utilization and Preference for Food and Nutrition Information of
Selected College Students in the University of the Philippines Los Baños
Mayque Coleen T. Ladigohon , Marie Faye R. Nguyen-Orca, Joyce P. Parco
 Editor’s Note

Nobody was prepared for 2020. On March, the World Health Organization rung the alarm that the COVID-19
outbreak has reached the pandemic level. The events that followed were unprecedented. Hospitals were
overwhelmed as cases and deaths continued to rise steeply. Lockdowns and travel restrictions were
employed in every major city and country worse hit by the virus causing major disruptions in the economy
and society as a whole.

The pandemic meant many things for different sectors in our society. For many, it meant loss of jobs and
livelihoods as businesses and other commercial activities dwindled during this time. While not everybody
was significantly impacted economically, everyone was affected emotionally and psychologically as
different stressors emerged during the prolonged lockdown period. For the youth, education and learning
continued to be confronted with challenges, as face to face classes were prohibited and schools resorted
to remote learning. As for our planet, the earth seems to ‘breathe’ and get a break from stress caused by
human activities which was halted by the pandemic.

For us in human ecology, this pandemic emphasized the need for society to understand and pay attention
to complex human-environment relationships that continued to affect us, for better or worse. While the
original source of the viral transmission to humans remains unclear, it was evident that human activities,
particularly engagement in wildlife trade, played a key role for this transmission to occur. Future actions to
prevent another pandemic similar to this from happening depends on how well we understand this human-
environment relationship.

Individually, this pandemic put aside the clutter in our lives and brought to the forefront things that really
matter—our families, social relationships, our health and well-being. It is on this note that we would like to
share with you the 2020 issue of the Journal of Human Ecology. Most of the articles focused on nutrition
and food safety which will give us insights on how we can improve our well-being amidst this global health
crisis.

Enjoy reading the Journal of Human Ecology. And as we have become accustomed to saying, keep safe
everyone!

Cheamson Garret K. Boongaling, EnP, MSc

Editor-in-Chief
Journal of Human Ecology
January-December 2020

Working towards the development of human ecology theories and practices in the Philippines and the world
INFORMATION FOR AUTHORS
The Journal of Human Ecology aims to pub-
lish interdisciplinary research on all aspects of
human-environment interactions, community
development, and other fields of social science
that links with the people, organizations and gov-
ernment to achieve humanecological security.
This peer-reviewed journal publishes original re-
searches focusing on the development of theory
and practice of human ecology in the Philippines
and in the international setting as well.
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Issue No. 9
Journal of Human Ecology
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References
References that appear in the text should appear
in this section and vice versa. Referencing should
follow the American Psychological Association
(APA) citation style. The first line of each citation
is flushed left and the subsequent lines are in-
dented five spaces (hanging indent). The follow-
ing are examples using the APA format.
Book
Single author
Librero, F. A. (2001). How to write a thesis
proposal. UPLB College of Agriculture
Publications Office.
Two or more authors
Razal, R. A. and Palijon, A. M. (2009). Non-
wood forest products of the Philippines.
UPLB College of Agriculture Publications
Office.
If there are four or more authors, all authors
are named the first time the reference is
cited. After this, “et al.” Is used (e.g. Men-
doza et al., 2008).
Portion of the Book
Durst P. B. (2005). In search of excellence:
Exemplary forest management in the
Asia and the Pacific. Deramakot Forest
Reserve: The future is now, pp. 283-290.
FAO, Bangkok
Edited Book
Tesoro, F. T. (Ed.). (2008). The state of
science and technology in the Philippines.
Penguin Books, Madison Avenue, N.Y. USA
Journal Article
Visco, E. S. 2007. Dynamics of conflict
and cooperation for group stability among
selected cooperatives in Region IV, Philip-
pines. European Journal of Social
Sciences 5(3), pp. 120-131.
Proceedings
Mendoza, ME T. (2010). Communities’
response towards toxic and hazardous
substances in Bulacan: Paper presented at
the Philippine Society on the Study
of Nature National Conference. Baguio
City, Philippines 2010.
Thesis
Lagos, D. T. (2010). Risk assessment of
disaster-prone communities in Leyte,
Philippines. MS Thesis. University of Philip-
pines Los Banos, Laguna. 101 pp.
Magazine article
Maxwell, J., M. (2010, February). What
makes a good leader? Time Magazine, 32,
pp. 10-15.
Newspaper article
David, R. D. (2010, September 15). EDSA
spirit lives on. The Philippine Daily Inquirer,
pp. A1, A22.
Document retrieved from World Wide
Web site
American Psychological Association. (1992,
December 1). American Psychological
Association. How to Cite References?
Retrieved on March 2, 2011 from http://
www.apa.org/ethics/code.html
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