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FNRI

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY


LUZON

MARIO V. CAPANZANA, PhD


VISAYAS

Director

MINDANAO

Order of Presentation
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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Introduction Legal Basis Methodology Survey Results Summary Conclusion and Program Implication

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

LEGAL BASIS
EO 128 Section 22.

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

The FNRI is mandated to: Undertake research that defines the citizenrys nutritional status, with reference particularly to the malnutrition problem, its causes and effects, and identify alternative solutions to them; Develop and recommend policy options, strategies, programs and projects; and Disseminate research findings and recommendations

DESIGNATED STATISTICAL ACTIVITY

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

EO 352 :
DESIGNATION OF STATISTICAL ACTIVITIES THAT WILL GENERATE CRITICAL DATA FOR DECISION-MAKING OF THE GOVERNMENT AND THE PRIVATE SECTOR FNRI is designated to conduct the National Nutrition Survey every five (5) years, at the national and regional levels, and to disseminate the results one (1) year after the reference year

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Target 1c: Reduce by half the proportion of people who suffer from hunger 1.8 Prevalence of underweight children underfive years of age 1.9 Proportion of population below minimum level of dietary energy consumption Target 4a: Reduce by two thirds the mortality rate among children under five 4.1 Under-five mortality rate 4.2 Infant mortality rate 4.3 Proportion of 1 year-old children immunised against measles

Outcome:Policy Recommendation
Philippine Food Fortification Act of 2000 (R.A. 8976)

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Asin Law (R.A. 8172) National Policies on Infant and Young Children (A.O. No. 2005-0014) Decade of Healthy Lifestyle (Presidential Proclamation No. 958) Reproductive Health, Responsible Parenthood and Population Development Act of 2007 (House Bill 17) Anti-hunger Mitigation Program (E.O. 616) Child Nutrition Law of 2007 (House Bill 2589) Medium Term Philippine Plan of Action for Nutrition Medium Term Philippine Development Plan

Outcome: Programs of various


government agencies

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Department of Agriculture: Gulayan para sa Masa Department of Health: Araw ng Sangkap Pinoy, Garantisadong Pambata Accelerated Hunger Mitigation Program Vitamin A supplementation of children Task Force on Iron Supplementation and Micronutrient Supplementation Resolution No. 1 Department of Education: Food for School Program Office of Senator Angara Oh! My Gulay (OMG!!)

Outcome: Corporate Programs


Private Sector UNILEVER: Makulay ang Buhay sa Sinabawang Gulay Coca-Cola Company: Little Red House Project CIDS-Kalahi: Feeding Program

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Outcome: Intervention Programs


Implemented by International Organizations
UNICEF: Targeting for CPC Areas Global Alliance for Improve Nutrition (GAIN) WHO / FAO USAID / A2Z WFP: Food Programme in Mindanao World Bank

Home News Diocesan Statements

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

A Pastoral Letter: Ash Wednesday 2010


My Brothers and Sisters in Christ,
Ash Wednesday marks the beginning of the most important period in the Church calendar. The forty-day Lenten season that starts today prepares us for Easter Good deeds and almsgiving consist of self-sacrifice to serve and benefit others.You also encourage compassion and charity in your daily life and strengthen your Christian soul. One such good deed is to respond to a call to feed the hungry children in our community.

..In the last 5 years, the pernicious problem of hunger and malnutrition persists in the Philippines. Initial results of 7th National Nutrition Survey conducted in 2008 show that three out of ten Filipino children are hungry and malnourished! They are underweight and underheight, stunted in their growth. Worse, the acute or severe cases of malnutrition are increasing..
Hunger and malnutrition are very pressing concerns for our society. As Pope Benedict XVI said to world leaders gathered for the UN Food summit in Rome on November 16, 2009, Hunger is the most cruel and concrete sign of poverty.

We appeal to you to support HAPAG-ASA in its efforts to care for hungry and malnourished children of our parishes. We encourage you to give to the HAPAGASA what had been set aside from your fasting. +GAUDENCIO B. CARDINAL ROSALES, D.D. Archbishop of Manila

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

SAMPLING DESIGN AND COVERAGE


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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

17 Regions/ 79 Provinces + NCR

Multi-Stage Stratified Sampling Design

12 3 4
4 replicates from the Master Sample of 2008 Labor Force Survey (LFS)

1st Stage Primary Sampling Unit One barangay or contiguous bgys with at least 500 HHs

2nd Stage Enumeration Area Contiguous area in a barangay with 150-200 HHs (n=3,377)

3rd Stage Households 36,634 LFS households; all household members in sampled households ( n=191,316)

SCOPE AND COVERAGE FNRI


FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

All 17 Regions 79 Provinces & NCR 3,377 Enumeration Areas (EAs)

36,634 Households
191,316 Individuals

BREAKDOWN OF COVERAGE

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

NATIONAL Enumeration Areas Households Individuals

PROVINCIAL

852 5,033 40,649

3,377 36,634 191,316

NUTRITION SURVEY COMPONENTS


Biochemical Nutrition Survey

Anthropometric Survey

Clinical Nutrition & Health Survey

Dietary Assessment Survey (Household & Individual Level) Socio-economics and Food Insecurity Survey

Government Program Participation Survey

General Objective: FNRI


FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

To update the official statistics on the Philippine food, nutrition and health situation

Specific Objectives: FNRI


FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

ANTHROPOMETRY
To assess the nutritional status of 0-10 year-old children, 11-19 yearolds, pregnant and lactating women, and other adults 20 years and over using anthropometric indicators of growth To compare results from previous surveys

ANTHROPOMETRY
Height and weight measurements

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY Measurement of weight using Detecto weighing scale

Measurement of standing height using microtoise and recumbent length (<2 years) using infantometer

Specific Objectives: FNRI


FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

BIOCHEMICAL
To assess anemia among 6 months and over, pregnant and lactating women using hemoglobin To assess iodine status using UIE among 6-12 years old children, pregnant and lactating women To compare surveys results from previous

BIOCHEMICAL

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Collection of blood for hemoglobin determination Urine for Urinary iodine excretion

Blood sample collection using finger prick and venipuncture Urine sample collection

Specific Objectives:
CLINICAL AND HEALTH

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

To determine systolic and diastolic blood pressure of adults, 20 years and over To assess prevalence of diabetes and dyslipidemia using fasting blood sugar and lipid profile data among adults 20 years and over To compare results from previous surveys

CLINICAL AND HEALTH FNRI


FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Blood collection for lipid profile and fasting blood sugar determination

Measurement of blood pressure

Specific Objective:
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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

DIETARY Infant Feeding Practices


To assess current infant feeding practices of Filipino mothers among their 0-23 months old children

DIETARY
Infant Feeding Practices

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Interview on infant feeding practices through face-to-face interview

Specific Objective:

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

SOCIO-ECONOMICS AND FOOD INSECURITY


To describe the socio-economic and demographic characteristics of the sample households and individuals To assess the food insecurity situation using the Radimer Cornell instrument To identify the coping mechanisms of food insecure households

SOCIO-ECONOMICS AND FOOD INSECURITY

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Face-to-face interview

Specific Objective:
GIVERNMENT PROGRAM PARTICIPATION

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

To determine government program participation among households, children, pregnant women, and lactating mothers To gather information on food labeling, use of essential drugs, and on the awareness and usage of food products with Sangkap Pinoy Seal and iodized salt To compare results from previous surveys

GOVERNMENT PROGRAM PARTICIPATION

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Face-to-face interview

GOVERNMENT PROGRAM PARTICIPATION

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Salt Testing

On-the-spot testing of household salt using the rapid test kit (RTK)

Laboratory analysis of salt samples using WYD

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
LUZON

VISAYAS

MINDANAO

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Children, 0 to 5 Years Old

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Cut-off points used in classifying the nutritional status of children, 0-10 years old, based on NCHS/WHO International Reference Standards

Classification
Weight-for-Age/ Height-for-Age/ Weight-for-Height

Cut-off Point

Underweight / Short / Thin Average / Normal Overweight / Tall

<-2SD -2SD to +2SD >+2SD

Percentage distribution of children, 0-5 years old, by nutritional status classification using NCHS/WHO IRS: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

2.0

1.1

2.8

71.8

71.0

90.8

26.2
Wt-for-Age

27.9 6.1
Ht-for-Age
Normal

Wt-for-Ht
Overweight/ Tall

Underweight/ Underheight/ Thin

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Estimated number of malnourished 0-5 year-old children based on NCHS/WHO IRS: Philippines, 2008
Nutritional Status Underweight Underheight Thinness Overweight Prevalence % 26.2 27.9 6.1 2.0 Estimated No. (in million)* 3.35 3.57 0.78 0.26

*Using NSO 2008 Projected Population based on 2000 Census

Percentage of underweight-for-age children, 0-5 years old, by single-age group: Philippines, 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

35 30 25 20 15 10 5 0

30.3

31.3

28.4

26.4

28.1

12.4

0yr.

1yr.

2yrs.

3yrs.

4yrs.

5yrs.

Percentage of underheight-for-age children, 0-5 years old, by singleage group: Philippines, 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

40 35 30 25 20 15 10 5 0

34.2 24.4 27.5

35.7

34.8

8.6

0yr.

1yr.

2yrs.

3yrs.

4yrs.

5yrs.

Percentage of underweight-forheight children, 0-5 years old, by single-age group: Philippines, 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

30

25

20

15

14.0 6.7

10

5.4

4.1

3.7

3.7

0yr.

1yr.

2yrs.

3yrs.

4yrs.

5yrs.

Prevalence of underweight-for-age children, 0-5 years old, by single age group: Philippines, 2003, 2005, 2008

FNRI
40

% prevalence

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY


% prevalence

36.0

35
31.4

30
26.4

28.3

29.4 29.6

25 20 15 10
18.8 15.8 19.2

35
31.2 31.7 30.3

31.3

30 25 20 15 10 5 0 0y
11.7 10.2 12.4

28.9

29.6 28.4

29.2 27.7

24.7

5 25.6 0

3.5

3.6

4.6 26.4

28.7 28.1 27.3

0 to 5 m

6 to 11 m

12 to 17 m

18 to 23 m

2003

2005

2008

1y

2y

3y

4y

5y

2003

2005

2008

Prevalence of stunted-for-age children, 0-5 years old, by single age group: Philippines, 2003, 2005, 2008

FNRI
% prevalence

40 35 30
26.7 34.7

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY


% prevalence
45.0 40.0 35.0 30.0 25.0 20.0 15.0 10.0 5.0 0.0 0y 1y 2y
8.2 5.4 8.6 25.4 24.4 23.5 31.8 27.5 25.5

27.6

25 20
16.1 19.9 20.1

15 10 5
34.2 36.4 6.3 35.7 34.6

9.9 5.5
38.2 36.2 34.8

11.3 7.4

37.9

30.0

3.0

0 0 to 5 m 6 to 11 m 12 to 17 m 18 to 23 m

2003

2005

2008

3y

4y

5y

2003

2005

2008

Prevalence of thin children, 0-5 years old, by single age group: Philippines, 2003, 2005, 2008

FNRI
% prevalence

16
14.7

14
12.7

13.7

13.4

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY


16 14 12
14.0

12 10
8.6 9.8

11.3

8 6
4.5

7.3 6.1

4
2.3 2.5

11.8 12.0

2 0 0 to 5 m 6 to 11 m 12 to 17 m 18 to 23 m

% prevalence

10 8
6.7

6 4 2 0

5.0

4.5

5.0 4.0

5.4 4.2 4.1 3.1 4.0

2003
3.7 2.7 2.9 2.1 3.7

2005

2008

0y

1y

2y

3y

4y

5y

2003

2005

2008

Trends in the prevalence of malnutrition among children, 0-5 years old, using NCHS/WHO IRS: 1990-2008
45 40 35
% prevalence
34.5 39.9 36.8 34.3 34.5 34.0 31.4 34.0 29.9 30.8 32.0 30.6 26.9 29.9 26.3 27.9 26.2

30 25 20 15 10 5 0

24.6

5.0 0.6

6.6 0.7

6.7 0.4

5.2 0.5

6.0 0.4

6.3 1.0

5.3 1.4

4.8 2.0

6.1 2.0

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 underheight underweight thinness overweight

Present trend and challenges ahead in the reduction of the prevalence of underweight-for-age among 0-5 year-old children using NCHS/WHO IRS
40 34.5% 30
29.9% 34.0% 30.8% 32.0%

30.6% 26.9% 26.2% 24.6% 17.2%

20

-0.46%

10

-1.29%

MDG

90

91

95

92

93

96

97

01

98

02

03

07

94

99

04

06

08

09

13

00

10

05

12

14

19

19

19

19

19

19

19

19

20

19

19

20

20

20

20

20

20

20

20

20

11

20

20

20

20

20

20

15

Prevalence of underweight children, 0-5 years old, by region: Philippines, 2008

% Prevalence

Philippines: 26.2

Region

Prevalence of underheight children, 0-5 years old, by region: Philippines, 2008

% Prevalence

Philippines: 27.9

Region

Prevalence of thin children, 0-5 years old, by region: Philippines, 2008


Philippines: 6.1
% Prevalence

Region

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Classification of worldwide prevalence ranges of low weight-for-age and low height-for-age among children, 0-5 yearold (WHO, 1995)
Low heightLow weightPREVALENCE for-age for-age GROUP (Underheight/ (Underweight) Stunting) Low Medium High Very High <10 10 19 20 29 >30 <20 20 29 30 39 >40

Magnitude of underweight children, 0-5 yearold, by province: Philippines, 2008


Phil. Ave.: 26.2
PREVALENCE GROUP Low Medium High Very High

No.
1 11 38 28

%
1.3 14.1 48.7 35.9

Magnitude of underheight children, 0-5 yearold, by province: Philippines, 2008


Phil. Ave.: 27.9
PREVALENCE GROUP Low Medium High Very High

No.
11 21 38 8

%
14.1 26.9 48.7 10.3

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Children, 6 to 10 Years Old

Percentage distribution of children, 6-10 years old, by nutritional status classification using NCHS/WHO IRS: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

1.6 72.8

0.4 66.5

25.6
Weight-for-Age
Normal

33.1
Height-for-Age
Overweight/ Tall

Underweight/ Underheight

Estimated number of malnourished 6-10 year-old children based on NCHS/WHO IRS: Philippines, 2008

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Nutritional Status Underweight Underheight Overweight

Prevalence % 25.6 33.1 1.6

Estimated No. (in million)* 2.58 3.34 0.16

*Using NSO 2008 Projected Population based on 2000 Census

Percentage of underweight-for-age children, 6-10 year-old, by single-age group: Philippines, 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

35

29.2
30 25 20 15 10 5 0

27.6

25.3

22.4

23.6

6yrs.

7yrs.

8yrs.

9yrs.

10yrs.

Percentage of underheight-for-age children, 6-10 year-old, by single-age group: Philippines, 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

40 35 30 25 20 15 10 5 0

34.1

33.8

32.6

33.8 31.0

6yrs.

7yrs.

8yrs.

9yrs.

10yrs.

Percentage of overweight-for-age children, 6-10 year-old, by single-age group: Philippines, 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

1.7
2

1.9

1.8

1.4

1.2

6yrs.

7yrs.

8yrs.

9yrs.

10yrs.

Trends in the prevalence of malnutrition among children, 6-10 years old, using NCHS/WHO IRS: 1990-2008
50 45 40 35 30 25 20 15 10 5 0
44.8 42.8 42.2 39.1 41.1 35.8 34.2 32.5 32.9 25.6 32.0 25.6 33.1

40.8

% p re v a le n e

30.5

28.3

30.2

22.8

0.1

0.2

0.6

0.4

0.8

1.3

1.6

1.6

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

underheight

underweight

overweight

Prevalence of underweight children, 6-10 years old, by region: Philippines, 2008


40 35 30
% Prevalence
33.0 34.0 32.2 23.9 19.2 18.1 14.5 20.0 24.7 31.6 30.6 27.2 26.2 27.8 25.6 26.9

25 20 15 10 5 0

23.6

Philippines: 25.6

Region

Prevalence of underheight children, 6-10 years old, by region: Philippines, 2008


50 45 40 35 30 25 20 15 10 5 0
44.7 40.8 39.2 28.4 26.9 23.0 29.4 23.1 27.6 37.8 35.1 42.7 40.4 40.1

38.1

36.9 38.1

% Prevalence

Philippines: 33.1

Region

Magnitude of underweight children, 6-10 yearold, by province: Philippines, 2008


Phil. Ave.: 25.6
PREVALENCE GROUP Low Medium High Very High

No.
3 14 35 26

%
3.8 17.9 44.9 33.3

Magnitude of underheight children, 6-10 yearold, by province: Philippines, 2008


Phil. Ave.: 33.1
PREVALENCE GROUP Low Medium High Very High

No.
4 18 31 25

%
5.1 23.1 39.7 32.1

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Pre-adolescents / Adolescents, 11 to 19 Years Old

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Cut-off points used in classifying the nutritional status of adolescents, 11-19 years old based on BMI-forage (Must, et.al) Classification
Underweight Mild Normal Overweight

Cut-off Point
<P5 P5 to <P15 P15 to P85 >P85

Percentage distribution of adolescents, 11-19 years old, by nutritional status classification using BMI-for-age: Philippines, 2008

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

4.8 52.5

4.4

4.6 60.3

69.0

21.1 21.7
Male
Mild

14.8 11.7
Female
Normal

18.1 17.0
Both
Overweight

Underweight

Comparison in the prevalence of underweight among 11-19 years old by gender: Philippines, 2005 & 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

25 20 15 10 5 0

20.5

21.7 16.0 17.0 11.1 11.7

Male

Female 2005 2008

Both

Comparison in the prevalence of overweight among 11-19 years old by gender: Philippines, 2005 & 2008

FNRI
% Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

10 8 6 4 2 0 Male Female
2005 2008

4.9 4.8

4.8 4.4

4.8 4.6

Both

Prevalence of underweight adolescents, 11-19 years old by region: Philippines, 2008

% Prevalence

Philippines: 17.0

Region

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Adults, 20 years old and above

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Cut-off points used in classifying the nutritional status of adults, 20 years old and above, based on BMI WHO Classification
Chronic Energy Deficient Normal Overweight Obese

Cut-off Point
<18.5 18.5 to <25.0 25.0 to 30.0 >30

Percent distribution of adults, 20 years old and over, by age group and BMI classification: Philippines, 2008

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

2.9 13.1

6.1 24.4

6.8 26.3

6.3 24.8

4.6 20.1

2.4 14.4

70.3 62.3 13.7


20-29y
CED

56.2 59.7 7.2


40-49y

57.5 11.5
50-59y

57.5 27.0
>70y

7.2
30-39y
Normal

17.7
60-69y
Obese

Overweight

FNRI
% prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Comparison in the prevalence of CED and overweight among adults, 20 years & over: Philippines, 2003 & 2008
40 30 20
12.3 11.6

2003 2008
24.0 26.6

10 0

CED

Overweight/Obese

Prevalence of CED among adults, 20 years old and over, by region: Philippines, 2008
Philippines: 11.6

% Prevalence

Region

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Pregnant and Lactating Mothers

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Cut-off points used in classifying pregnant women based on weight-for-height (Magbitang, 1988) Classification Cut-off Point

Nutritionally at-risk Not Nutritionally at-risk

<P95 >P95

Percentage distribution of pregnant women by nutritional status and by age group: Philippines, 2008

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100 90 80 70 60 50 40 30 20 10 0

64.9

74.9

73.7

Percent

35.1

25.1 > 20 y

26.3

< 20 y
At-risk

All

Not at-risk

Percentage distribution of pregnant women by nutritional status: Philippines 2005 and 2008

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FOOD AND NUTRITION RESEARH INSTITUTE

Nutritionally-at-risk Not nutritionally-at-risk

90 80 70

71.6

73.7

% Prevalence

DEPARTMENT OF SCIENCE AND TECHNOLOGY

60 50 40 30 20 10 0

28.4

26.3

2005

2008

Prevalence of nutritionally at-risk pregnant women, by region: Philippines, 2008


Philippines: 26.3

% Prevalence

Region

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Cut-off points used in classifying nutritional status of lactating mothers based on BMI for adults (NCHS/WHO, 1978) and BMI-for-age for adolescents (Must, 1991)

Classification
Underweight Mild Normal Overweight Obese

Cut-off Point
Adults < 18.5 18.5 to <25.0 25.0 to <30.0 > 30.0

Adolescents < P5 P5 to <P15 P15 to P85 > P85

Percentage distribution of lactating mothers by nutritional status and by age group: Philippines, 2008

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FOOD AND NUTRITION RESEARH INSTITUTE

100 80
Percent

6.7

16.8

16.1

DEPARTMENT OF SCIENCE AND TECHNOLOGY

60 40 20 0

80.4

70.1

70.9

12.9
< 20 y
Underweight

13.1
> 20 y
Normal

13.0
All
Overweight

Percentage distribution of lactating mothers by nutritional status: Philippines, 2005 and 2008

FNRI
% prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

80 70 60 50 40 30 20 10 0

66.3

Underweight Normal Overweight

70.9

13.9

19.8

13.0

16.1

2005

2008

Prevalence of underweight lactating mothers, by region: Philippines, 2008


Philippines: 13.0

% Prevalence

Region

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among children, 0 to 10 years old Undernutrition (base on weight-for-age and height-for-age) remains to be a public health problem, affecting nearly 3 out of 10 children. Between 2005 and 2008, the proportion of undernourished children has significantly increased, particularly more prevalent in selected provinces in MIMAROPA, Bicol, and selected areas in Visayas and Mindanao.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among children, 0 to 10 years old About 2 out of 10 children are overweight (base on weight-for-age). However, this remains to be the same from 2005. Among adolescents, 11 to 19 years old Underweight is nearly 2 out of every 10 adolescents (base on BMI-for-age), with males being more at-risk than females.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among adolescents, 11 to 19 years old Between 2005 and 2008, undernutrition among this age group has significantly increased while overnutrition has decreased. Regions found to be most at-risk to undernutrition among adolescents are MIMAROPA, Bicol, and Western Visayas.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among adults, 20 years old and above About 1 in every 10 adults are chronic energy deficient, while 3 out of 10 are overweight. The proportion of CED has decreased while overweight and obese has increased between 2003 and 2008. CED is more prevalent among the regions in Ilocos, Cagayan, MIMAROPA, Bicol, Western Visayas, Zamboanga Peninsula, and ARMM.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among pregnant and lactating women Between 2005 and 2008, the proportion of nutritionally at-risk pregnant women has significantly decreased. The nutritionally at-risk pregnant women are mostly found in Ilocos, MIMAROPA, Bicol, Western Visayas, Zamboanga Peninsula, and ARMM. Undernutrition and overnutrition among lactating mothers have decreased significantly from 2005.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
LUZON

VISAYAS

MINDANAO

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

NUTRITIONAL ANEMIA

ASSESSMENT CRITERIA
Normal hemoglobin levels, WHO cut-off, 1972

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

AGE/ SEX/ PHYSIOLOGIC STATE

Normal hemoglobin level (g/dL)

Children: 6 mos - 6 yrs 6.1 - 14 yrs Adult: Males Females


(non-pregnant/non-lactating)

11.0 12.0 13.0 12.0 11.0 12.0

Pregnant Lactating Women

ASSESSMENT CRITERIA

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Epidemiological criteria for assessing severity and magnitude of nutritional anemias in population, FAO / WHO, 1992

PARAMETERS

MAGNITUDE
High Moderate Low 10 - 39 1-9

Percent of population with Hb 40 less than the above cut off points especially women and children

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Prevalence of anemia by age, sex and physiologic state, 2008


Age/Sex/Physiologic State
Philippines 6 mos - < 1 yr 15y 6 12 y, M F

No. of Subjects
22412 205 2279 2039 1830 1778 1488 2436 2079 1955 2123 782 1011 1516 891
0 10

Prevalence (%)
19.5

20.9 20.4 19.2 10.4 18.2 6.8 18.6 12.7 22.7 33.4 32.8 42.5 31.4
20 30 40 50

55.7

13 19 y, M F 20 39 y, M F 40 59 y, M F 60 y, Pregnant Lactating M F

60

Prevalence of anemia among children by age, 2008 Age n Prevalence (%)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

6 mos 5 y 6 mos - < 1 y 15y 1 y 2 y 3 y 4 y 5 y

2484 205

23.6

55.7

2279 439 425 443 482 474


0 10

20.8

41.0 26.6 13.7 13.6 10.6

20

30

40

50

60

Trends in the prevalence of anemia among children Philippines: 1993, 1998, 2003 and 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
%

70 60
56.6

66.2

55.7

50 40 30

49.2 42.0 35.6 29.6 25.7 29.1 20.9 19.8 37.4

20 10 0 1993 1998

6 mos - < 1 y 1-5y 6 - 12 y


2003

2008

Trends in the prevalence of anemia among children, Philippines: 1998, 2003 and 2008
70

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
%

60
53.0

50 40

53.2

1y 2y 3y 4y 5y

36.9

34.8 24.8 18.8

41.0

30
23.4

26.6

20 10 0

20.0 18.2

14.0

13.7 13.6 10.6

1998

2003

2008

Trends in the prevalence of anemia among pregnant and lactating women Philippines: 1993, 1998, 2003 and 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
%

70 60

Pregnant women 50.7 Lactating women

50

43.6
40 30 20 10 0

43.0

45.7

43.9 42.2

42.5 31.6

1993

1998

2003

2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 in the Philippines by region

National prevalence 19.5%

Magnitude High
( 40.0)

% 0.0 100 0.0

Moderate
(10.0-39.0)

Low
(1.0 9.0)

1 FAO-WHO, 1992

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 among preschool children, 6 mos 5 yrs by region

National prevalence 23.6%

Magnitude High
( 40.0)

% 0.0 100 0.0 1992

Moderate
(10.0-39.0)

Low
(1.0 9.0)
1 FAO-WHO,

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 among school children, 6 12 yrs by region

National prevalence 19.8 %


CAR (9.95 %)

Magnitude High
( 40.0)

% 0.0 94.1 5.9

Moderate
(10.0-39.0)

Low
(1.0 9.0)
1

FAO-WHO, 1992

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 among adolescents, 13 19 yrs by region

National prevalence 14.0 %

BICOL BICOL (8.0%) (8.0%)

Magnitude High
( 40.0)

% 0.0 76.5 23.5

MIMAROPA MIMAROPA (6.9%) (6.9%)

Moderate
(10.0-39.0)

Low
(1.0 9.0)
1

ZAMBOANGA ZAMBOANGA PENINSULA PENINSULA (8.1%) (8.1%) DAVAO DAVAO (9.0%) (9.0%)

FAO-WHO, 1992

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 among adults, 20 59 yrs by region

National prevalence 14.9 %

Magnitude High
( 40.0)

% 0.0 82.4 17.6


CENTRAL VISAYAS (9.3%) ZAMBOANGA PENINSULA (9.0%) NORTHERN MINDANAO (8.4%)

Moderate
(10.0-39.0)

Low
(1.0 9.0)
1

FAO-WHO, 1992

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 among elderly, 60 yrs by region

National prevalence 33.0 %


CAGAYAN VALLEY (51.7%) CENTRAL LUZON (41.4%)

Magnitude High
( 40.0)

% 17.6 82.4 0.0


WESTERN VISAYAS (46.9%)

Moderate
(10.0-39.0)

Low
(1.0 9.0)
1

FAO-WHO, 1992

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 among pregnant women by region


Magnitude High
( 40.0)

National prevalence 42.5 %


CAGAYAN VALLEY (60.0%) CENTRAL LUZON (40.7%) NCR (48.0%) BICOL (51.1%)

% 52.9 47.1 0.0 1992

MIMAROPA (49.6%)

Moderate
(10.0-39.0)

WESTERN VISAYAS (61.5%) CENTRAL VISAYAS (40.4%) ARMM (47.3%) SOCCSKSARGEN (49.8%)

Low
(1.0 9.0)
1 FAO-WHO,

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of anemia1 among lactating women by region


% 11.8 88.2 0.0 1992

National prevalence 31.6 %


CAGAYAN VALLEY (58.2%).

Magnitude High
( 40.0)

WESTERN VISAYAS (44.5%)

Moderate
(10.0-39.0)

Low
(1.0 9.0)
1 FAO-WHO,

Comparison of prevalence of anemia: NNS 1998 and 2008


Age/ Physiologic State Philippines 6 mos < 1 y 15y 6-12 y Pregnant Lactating
Total subjects 1998 2008
Prevalence of anemia Increase/ (Decrease) (%) 1998

1998

2008

2008

vs

36364 2990 12089 1542 3103 3260

22412 205 2279 3869 1516 891

30.6 56.6 29.6 35.6 50.7 45.7

19.5 55.7 20.9 19.8 42.5 31.6

(11.1)** (0.9 ) NS ( 8.7 )** (15.8 ) ** (8.2 )** (14.1 ) **

* Significant at 0.05

** Significant at 0.01

NS - Not Significant

Prevalence of anemia and number of anemic children

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Age/ Physiologic Group

Prevalence %

Estimated number of anemic (in millions)

6 mos. - < 1 yr 1 - 5 yrs. 6 - 12 yrs.

55.7 20.9 19.8

0.75 2.11 2.77

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

hOver all,

the 2008 NNS showed a decreasing trend in anemia prevalence among Filipinos

hHowever, in certain packets of the

population, like infants 6 mos to < 1 y, 1 yr old children, and pregnant women, nutritional anemia is still a major health problem

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

IODINE DEFICIENCY DISORDER (IDD)

Epidemiological Criteria for Assessing Severity of IDD Based on Median Urinary Iodine Levels

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

MEDIAN VALUE g/L < 20 20 - 49 50 - 99 > 100

SEVERITY OF IDD

severe moderate mild No deficiency

The indicator of iodine deficiency elimination is a median value of 100 g/L, that is, 50% of the sample should be above 100 g/L, and not more than 20% of the samples should be below 50 g/L.
ICCIDD, 1994

Epidemiological Criteria for Assessing Iodine Nutrition based on Urinary Iodine Concentrations of Pregnant Women

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

POPULATION GROUP Pregnant women

MEDIAN UIE
g/L

IODINE INTAKE
g/day

< 150 150 249 250 499 500

Insufficient Adequate Above requirements Excessive*

required to prevent and control iodine deficiency


WHO, UNICEF, and ICCIDD, 2007

* The term excessive means in excess of the amount

Epidemiological Criteria for Assessing Iodine Nutrition Based on Median Urinary Iodine Concentrations in School-age Children ( 6 years)*
MEDIAN VALUE g/L

IODINE INTAKE
g/day

IODINE STATUS

< 20 20 - 49 50 - 99 100 - 199 200 - 299

Insufficient Insufficient Insufficient Adequate Above requirements

300

Excessive

Severe iodine deficiency Moderate iodine deficiency Mild iodine deficiency Adequate iodine nutrition Likely to provide adequate intake for pregnant/lactating women, but pose a slight risk of more than adequate intake in the overall population Risk of adverse health consequences (iodine induced hyperthyroidism, autoimmune thyroid diseases)
WHO, UNICEF, and ICCIDD, 2001

Applies to adults, but not to pregnant women

Median and percent distribution of UIE levels by age and physiologic groups: 2008
Age/Physiologic Group No. of subjects Median UIE, g/L <20 20-49 50-99

<20%
> 100

Philippines Children, 6 - 12 yrs

13283 3805

133 132 154 137 107 81

7.6 7.7 5.5 6.4 7.5 14.7

12.7 12.0 9.9 11.8 15.6 19.3

20.9 20.0 18.4 20.1 25.3 25.5

58.8 60.2 66.1 61.6 51.7 40.4

13 19 yrs 1904 Adults, 20 59 yrs 5186 Elderly, 60 yrs Lactating Women 1108 837

Median and percent distribution of UIE levels among pregnant women: 2008
Age/Physiologic Group UIE, g/L No. of subjects Median <20 20-49 50-99 > 100 > 150

Pregnant women

443

105

10.5

15.3

23.2

18.3

32.9

Frequency distribution of UIE values, NNS 2008 : PHILIPPINES


70 60 50 40 30 20 10 0
Insufficient
<100

2008 Median = 133 g/L Prev < 50 g/L = 20.3 %

41.2 28.6 15.5


Adequate
100-199

14.7
Excessive
300

Above Requirements
200 -299

UIE, g/L

Magnitude of IDD,1 Philippines: 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude
(Median UIE, g/L)

%
0.0 0.0 29.4 70.6

MIMAROPA ( 22.8%)

EASTERN VISAYAS (85) CARAGA (93)

Severe
(<20)

Moderate
(20 49)

Mild
(50 99)

CENTRAL VISAYAS (22.2%) NORTHERN MINDANAO (98) ZAMBOANGA PENINSULA (85)

No deficiency
(100)
1

ICCIDD, 1994

SOCCSKSARGEN (20.8%)

DAVAO (85)

Frequency distribution of UIE values among 6 12 y old children, NNS 1998, 2003 & 2008 : PHILIPPINES
70

65.4
60

2008 Median = 132 g/L Prev < 50 g/L = 19.7 % Median = 201 g/L Prev < 50 g/L = 11.4 %
2003

50

1998 Median = 71 g/L Prev < 50 g/L = 35.8 %

NNS 2008 NNS 2003 NNS 1998

40

39.7 29.2 26.2 25.9 16.5

%
30

37.0

23.8
20

10

5.4
Insufficient
<100

17.5 13.3 0.1 Excessive


300

Adequate
100-199

Above Requirements
200 -299

UIE, g/L

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of IDD1 among children, 6 12 yrs old by region


Magnitude
Severe
(<20)
MIMAROPA ( 28.3%) EASTERN VISAYAS (83)

(Median UIE, g/L)

%
0.0 0.0 29.4 70.6
WESTERN VISAYAS (24.0%) CENTRAL VISAYAS (24.5%) NORTHERN MINDANAO (90) ZAMBOANGA PENINSULA (84)

CARAGA (85)

Moderate
(20 49)

Mild
(50 99)

No deficiency
(100)
1

ICCIDD, 1994

SOCCSKSARGEN (27.9%)

DAVAO (68)

Frequency distribution of UIE values among 13 19 y old children, 2008 : PHILIPPINES


70 60 50 40 30 20 10 0
Insufficient
<100

2008 Median = 154 g/L Prev < 50 g/L = 14.7 %

33.8 27.7 19.6


Above Requirements
200 -299

18.8

Adequate
100-199

Excessive
300

UIE, g/L

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of IDD1 among children, 13 19 yrs old by region


EASTERN VISAYAS (24.5%)

Magnitude
Severe
(<20)

(Median UIE, g/L)

%
0.0 0.0 11.8 88.2
CARAGA (26.4%)

Moderate
(20 49)

Mild
(50 99)

ZAMBOANGA PENINSULA (93) DAVAO (95)

No deficiency
(100)
1

ICCIDD, 1994

Frequency distribution of UIE values among adults, 20 59 yrs, 2008 : PHILIPPINES


70 60 50 40 30 20 10 0
Insufficient
<100

2008 Median = 137 g/L Prev < 50 g/L = 17.5 %

38.3 30.5 16.2


Above Requirements
200 -299

14.9
Excessive
300

Adequate
100-199

UIE, g/L

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of IDD1 among adults, 20 - <59 yrs old by region


MIMAROPA ( 20.3%)

EASTERN VISAYAS (80)

Magnitude
Severe
(<20)

(Median UIE, g/L)

%
0.0 0.0 29.4 70.6

CARAGA (96)

CENTRAL VISAYAS (20.0%)

Moderate
(20 49)

NORTHERN MINDANAO (99) ZAMBOANGA PENINSULA (89) DAVAO (88)

Mild
(50 99)

No deficiency
(100)
1

ICCIDD, 1994

Frequency distribution of UIE values among elderly, 60 yrs & over, 2008 : PHILIPPINES
70 60 50 40 30 20 10 0
Insufficient
<100

2008 Median = 107 g/L Prev < 50 g/L = 22.3 %

48.4

31.4

11.5
Adequate
100-199

Above Requirements
200 -299

8.8
Excessive
300

UIE, g/L

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of IDD1 among elderly, 60 yrs & over by region


Magnitude
Severe
(<20)

CAR (71) NCR ( 23.7%) EASTERN VISAYAS (64)

CALABARZON ( 22.3%)

(Median UIE, g/L)

%
0.0 0.0 35.3 64.7

MIMAROPA (93) WESTERN VISAYAS (25.0%)

CARAGA (28.1%)

Moderate
(20 49)

CENTRAL VISAYAS (24.3%) NORTHERN MINDANAO (70) ZAMBOANGA PENINSULA (65)

Mild
(50 99)

No deficiency
(100)
1

ICCIDD, 1994

DAVAO (84)

70

Frequency distribution of UIE values among pregnant women, 2003 & 2008 : PHILIPPINES
67.3 52.0
Median = 142 g/L Prev < 50 g/L = 18.0 % Median = 105 g/L Prev < 50 g/L = 25.8 %

2003

60

NNS 2008 NNS 2003


MEDIAN UIE g/L IODINE INTAKE g/day

50

2008

40 30

25.4 18.1
Insufficient Adequate

Insufficient Adequate 150 249 Above requirements 250 499 Excessive 500 ICC-IDD 2007

< 150

22.5 13.5
Above Requirements Excessive

20 10

0 <150 150-249 250 - 499

1.3
500

UIE, g/L

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of IDD among pregnant women1 by region


Magnitude
Severe
(<20)

CAGAYAN VALLEY (157)

(Median UIE, g/L)

%
0.0 5.9 88.2 5.9
NORTHERN MINDANAO (38)

Moderate
(20 49)

Mild
(50 149)

No deficiency
(150)
1

ICCIDD, 1997

Frequency distribution of UIE values among lactating women, 2003 & 2008 : PHILIPPINES
70 60 50 40

59.5

Median = 81 g/L Prev < 50 g/L = 34.0%

2008

Median = 111 g/L Prev < 50 g/L = 23.7 %

2003

NNS 2008 NNS 2003

46.4

29.1

MEDIAN UIE g/L

IODINEINTAKE g/day

30 20 10 0

100 500

Adequate Excessive

25.7 13.9
Insufficient Adequate

24.7

ICC-IDD 2007

Above Requirements

Excessive

0.8
500

<100

100-199

200-499

UIE, g/L

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Magnitude of IDD among lactating women by region


Magnitude
Severe
(<20)

ILOCOS (112) ILOCOS (21.9%) NCR (128)

CAGAYAN VALLEY (161)

(Median UIE, g/L)

%
0.0 11.8 70.6 17.6
CARAGA (49) ZAMBOANGA PENINSULA (48)

Moderate
(20 49)

Mild
(50 99)

No deficiency
(100)
1

ICCIDD, 1994

Progress in the Philippines towards the elimination of IDD, 1998-2003


Indicator Proportion of households using iodized salt, % Median urinary iodine, g/L
6 12 yrs Lactating women Pregnant women

Goal * > 90

Achievements 1998 2003 2008 25.0 56.0 81.1

100 - 200 150 - 249 < 20

71 -

201 111 142 11.4 23.7 18.0

132 81 105 19.7 34.0 25.8

Proportion < 50g/L, %


6 12 yrs Lactating women Pregnant women

35.8 -

* ICCIDD, 2007

hThe iodine status of children, 6 - 12 yrs/

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

13 19 yrs and adults, 20 -59 yrs and 60 yrs & over are optimal as indicated by median UIEs

hThe iodine status of pregnant

and lactating women is of public health concern

hThe proportion of children, pregnant and


lactating women with high UIE levels corresponding to excessive iodine intake has increased iodized salt has increased

hThe proportion of households using

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
LUZON

VISAYAS

MINDANAO

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Assessment criteria for BP classification

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

BP Classification Normal High Normal Pre-Hypertension Hypertension Stage I Stage II

Systolic BP (mm Hg) < 120 120-129 130 -139 and or or

Diastolic BP (mm Hg) < 80 80-84 85-89

140 -159 >160

or or

90-99 > 100

Based on The Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (JNC VII)

Mean systolic BP and diastolic BP (mm Hg) among adults based on a single visit BP, by age, Philippines: 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Age (y)
20-29 30-39 40-49 50-59 60-69 >70 Overall

Mean SBP (mm Hg)


112.2 116.1 122.6 131.2 136.2 140.2 120.7

Mean DBP (mm Hg)


74.5 77.7 81.3 84.2 82.5 81.3 78.8

Percent distribution of blood pressure based on a single visit blood BP among adults by age
100%

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

90% 80% 70% 60% 50% 40% 30% 20% 10% 0%

2.0 8.4 7.4

3.7 13.8 11.6

11.5 19.5 10.3

18.3

21.8

28.8

26.7

28.3 27.2

27.1 24.7 15.6 14.1

14.3 26.1 18.2

53.9 43.7 32.5

17.8 17.8
60-69y

17.8 14.7
>70y

22.6

20-29y

30-39y

40-49y

50-59y

Normal

High Normal Pre-Hypertension

Hypertension Stage 1 Hypertension Stage 2

Trends in the prevalence of hypertensio among adults based on a single visit: Philippines, 1993 - 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
% Prevalence

30.0 25.0 20.0 15.0 10.0 5.0 0.0 1993 1998 2003 2008 22.0 21.0 22.5 25.3

Hypertension, based on a single visit BP has significantly increased from 2003 to 2008

Assessment criteria for fasting blood sugar (FBS) based on WHO classification

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Classification Desirable Impaired Fasting Glucose (IFG) High FBS


Based on WHO cut-off

FBS (mg/dL) < 110 110 125 > 125

Mean fasting blood sugar (FBS) and percent distribution of FBS by age
Age Group Mean (mg/dL)
20-29 79.1 30-39 86.1

Percent
99.0 95.1 90.6 87.3 86.3 91.7 92.5 0.6 1.7 3.7 3.7 4.6 3.9 2.7 0.4 3.2 5.7 9.0 9.1 4.4 4.8

20-29 30-39 40-49 50-59 60-69 >70 ALL

90.0 40-49 95.8 50-59 95.4 60-69 88.3>70 88.1 ALL


0%

Desirable Impaired Fasting Glucose High FBS

50%

100%

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Trends in the prevalence of high fasting blood sugar among adults Philippines: 1998, 2003 and 2008
6.0 5.0 4.0 3.9 3.0 2.0 1.0 0.0 1998 2003 2008 3.4 4.8

Assessment criteria for lipid profile based on ATP III Classification


Total Cholesterol (mg/dL)
< 200 200 239 > 240 Desirable Borderline High High

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

LDL-Cholesterol (mg/dL)
< 130 130 159 > 160 Desirable Borderline High High

HDL-Cholesterol (mg/dL)
< 40 > 60 Low High

Triglyceride (mg/dL)
<150 150-199 >200-399 >400 Desirable Borderline High Very High

Lipid Profile Among Filipino Adults


High total cholesterol = 10.2% (>240 mg/dL) High LDL-cholesterol = 11.8% (>160 mg/dL) Low HDL-cholesterol = 64.1% (<40 mg/dL) High triglyceride (>200 mg/dL) = 14.6%

Cholesterol is a fatty substance that


fills a vital function in the body but it can also increase your risk for heart disease and stroke referred to as good cholesterol

High Density Lipoprotein (HDL) Low Density Lipoprotein (LDL)

referred to as bad cholesterol

most fat is stored in the body

Triglycerides are the form in which

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Comparison in the prevalence of dyslipidemia by total cholesterol, LDLc, HDL-c and triglyceride levels among adults, Philippines: 2003 and 2008

Hypertension

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

The prevalence of hypertension among adults based on a single visit was 25.3%, prevalence peaked at age 40-49 years.

Diabetes Mellitus The prevalence of high FBS ( > 125 mg/dL) among adults was 4.8 % , peaked at age 50-59 years with a prevalence of 9.0%.

Dyslipidemia

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Total

cholesterol, LDL-c and triglyceride levels increased with age, particularly rose between ages 40-60 years. The prevalence of low HDL-c had remained relatively high from 2003 to 2008. Overall, dyslipidemia based on total, HDLcholesterol and triglyceride levels had significantly increased from 2003 to 2008.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
LUZON

VISAYAS

MINDANAO

Operational Definition:
Infant Feeding Practices collective term for
the feeding practices (e.g. breastfeeding, bottlefeeding, and complementary feeding)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Current Feeding Practices refers to the childs


feeding practice at survey time

Breastfeeding a method of feeding an infant


directly from the breast. This is the best and most natural way of feeding an infant

Exclusive breastfeeding a feeding method


where an infant is given no food or drink other than breast milk (except medication)

Weaning cessation of breastfeeding

Operational Definition:

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Colostrum the first thick yellowish fluid which


comes out from the breast usually during the first 5 days after delivery. It contains anti-bodies that give immunity to the newborn against gastrointestinal and viral infections.

Complementary food foods introduced to the


child and given progressively until the child becomes accustomed to family food to complement breast milk.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Percentage distribution of 0-23 month-old children: Philippines, 2008 (n=1,040)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

22.8 % 50.3 % 27.0 %

0-5 months 12-23 months

6-11 months

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Percentage distribution of children, 0-23 month-old, by current feeding practice: Philippines, 2008

Feeding Practice Exclusive Breastfeeding Breastfeeding + Complementary Feeding Other milk or Other milk + Other Foods Other Foods

Percent 8.6 29.9 55.4 6.2

Distribution of children by current feeding practice by age group: Philippines, 2008

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

80 70 60 50 40 30 20 10 0

65.7 59.8

35.9 36.8 27.3

39.4 21.6 0 0.5 0.3 0.6 12.2

0-5 months
Exclusive Breastfeeding

6-11 months

12-23 months

Other Milk or Other milk + Other Foods Other Foods

Breastfeeding + Complementary Feeding

Percentage of ever breastfed 0 to 23 month-old children : Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY Not Ever Breastfed 10.4 %

Ever Breastfed 89.6 %

Distribution of 0 23 month children by exclusive breastfeeding: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY Not Ever Breastfed 10.4 %

PERCENT
Exclusively Breastfed Not Exclusively Breastfed
0 20

Ever Breastfed 89.6 %

82.8 17.2
40 60 80 100

Percentage of ever breastfed children, 0 to 23 month-old by giving of colostrum: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY Not Ever Breastfed 10.4 %

PERCENT
Given Colostrum Not Given Colostrum
0 20

Ever Breastfed 89.6 %

89.4 10.6
40 60 80 100

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Infant feeding practices by distribution of 0-23 months by exclusive breastfeeding: Philippines, 2008
Age in Months
<2 2-3 4-5 6-7 8-9 10-11 12-15 16-19 20-23 All 0-23

Not Breastfeedi ng
14.6 12.3 33.7 43.1 60.9 88.3 74.4 84.5 87.3 61.4

Exclusive Breastfeedi ng
45.6 48.0 15.4 0.0 1.4 0.0 0.6 1.2 0.0 8.6

Distribution of children by time of initiation of breastfeeding: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Time of Initiation of Breastfeeding After 1 hour or more After 1 day or more After child has been cleaned Right after delivery while cutting the umbilical cord After 1 week or more

Percent 46.0 20.9 20.1 11.4 1.5

Distribution of Children by reason why breast milk was given to child: Philippines, 2008
Others

2.7 0.2 1.3 2.8 4.3 7.6 8.2 12.0 35.8 41.7
0 10 20 30 40 50 60 70

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Benefits derived as shown in TV/print media/billboards Own Preference As advised by friends/relatives Foster stronger maternal-child bonding Increases immune responses As advised by physician/other health personne; Safe,convenient and readily available Nutritious/complete food for baby Economical/no money to buy infant formula

Distribution of children by main reason why breastfeeding was stopped: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Reasons
Inadequate milk flow Working outside home/too busy Another pregnancy Child refused Mother ill/weak/underwent surgery Cracked nipple/breast infection Child old enough for weaning Child ill/weak Child abandoned/separated from mother Others As advised by health personnel/relatives/friends Child not gaining weight

Percent
34.5 25.5 9.1 7.8 7.6 5.4 2.8 2.5 1.5 2.9 0.5 0.1

Distribution of children by type of milk given: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

4.0 31.6 64.5

LEGEND:

Infant follow-on/growing-up Milk Powdered, filled milk Powdered, whole milk

Distribution of children by reason for choosing kind of milk: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Others (own decisin of mother) As per benefits shown by media To make child intelligent Always available To make child healthy/active As per advice of relatives/friends As per advice by doctor/health personnel "Hiyang sa bata" Nutritious Affordable

1.0 1.3 2.2 5.3 7.4 8.2 9.9 10.6 13.9 40.3 0 10 20 30 40 50

Distribution of children by first introductory food given to child: Philippines, 2008


others

1.4

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

milk other than the one presently given 0.4 meat soup/broth 1.0 vegetable soup/broth 1.1 fish soup/broth 1.2 fresh juice am water + sugar solid/semi-solid foods water

1.3 3.7 4.6 37.2 48.1 0 10 20 30 40 50 60 70

Distribution of children by reason for giving first introductory food: Philippines, 2008 Reasons Percent
As per advice by relatives/friends 17.7 15.1 13.5 13.1 12.1 8.6 5.0 3.4 2.8 2.6 2.2 1.7 1.0 0.8 0.2 0.2

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

No milk flow As transition to regular diet As per advised by health personnel To familiarize child on taste of food With Health benefits Economical Child is old enough to eat Nutritious Own decision Due to tradition To satisfy thirst Mother cannot breastfeed Preferred by baby Child with cleft palate As shown in TV/print media/billboards

Distribution of children when complementary feeding started and mean age of start: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Complementary Foods
Plain water Water + sugar Am Solid/semi-solid foods Fresh fruit juice Fish soup/broth Meat soup/broth Vegetable soup/broth Powdered or ready to drink juice Milk other than the one presently given Other liquids

Percent
86.2 22.6 36.7 75.4 50.2 71.3 69.6 71.9 48.0 26.6 50.3

Mean Age (in months)


3.0 4.2 6.2 6.1 6.7 6.9 6.9 6.8 10.0 10.0 10.0

Distribution of children by person who feeds the child: Philippines, 2008


2.6

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FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

0.3 1.0

66.7
17.8

8.7

0.9 2.0

LEGEND:

Mother Brother Grandparents "Yaya"

Father Sister Other relatives Others

Distribution of children by reason why mother does not feed the child: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

LEGEND:

Mother working/busy Child is used to him/her Child has appetite when fed by him/her Others

85.6

4.8 8.5

1.5

Distribution of children by person who decides on food to feed the child: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

81.3

4.8 11.9

0.2 0.1

1.4

0.3

Mother

Grandparents Other Relatives Others

LEGEND:

Father Brother Sister

Comparison of the 2003 and 2008 Duration of Breastfeeding: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Mean duration of exclusive breastfeeding Mean duration of breastfeeding LEGEND:


2008 2003
50 45 40 35

2.2 mos 4.9 mos

3.0 mos 5.6 mos

35.9 29.7

Percentage

30 25 20 15 10 5 0

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Exclusive breastfeeding of 0-5 month old children was only 35.9%. This is implies that only more than 1/3 of the children met the WHO recommendation of exclusive breastfeeding for the first 6 months. Of the total sample children, the proportion of ever breastfed children was 89.6%. Out of this ever breastfed, 82.8% were exclusively breastfed and 89.4% were given colostrum. The mean duration of exclusive breastfeeding was 2.3 months. Compared with the 2003 which is 3.0 months, a significant decrease was noted.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Comparing the mean duration of ever breastfeeding, the 2008 was slightly lower at 4.9 months versus 5.6 months in 2008. There was no significant difference between the 2 base year. Only 17.1% of the sample children were breastfed up to 12-23 months. Again, this is far more short of the recommended length of breastfeeding by WHO which is up to 2 years of age.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Introduction of complementary children was between 4-6 months.

foods

to

Untimely or early stopping of breastfeeding has been attributed by mothers to their work as well as inadequate flow of breastmilk.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
LUZON

VISAYAS

MINDANAO

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among households..

Percentage of households participating in government programs


80 70 60

Percentage

51.8 34.2 33.9 24.2 19.8 15.2

50 40 30 20 10 0

13.1

8.8

4.7

3.8

1.8

LEGEND
Food Production Free Medical/Dental Services Botika ng Bayan Tindahan Natin Food-for-School

Senior Citizen Discount Card Nutrition Education Responsible Parenthood Credit Assistance for Livelihood Skills Training Food-for-Work

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Food-for-School Program
.A conditional food transfer program of the government aimed to mitigate hunger and prevent further decline of nutritional status of learners, and to improve their school attendance and academic performance.

Percentage of households covered* and not covered by Food-for-School Program

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Covered
59.0%

Not Covered
41.0 %

*Covered households (n=21,547) are households with children enrolled in Day Care Centers and in elementary schools under DepEd, for the past 12 months

Percentage of covered household who respond to question: Is/Are you child/children recipient of the Food-forSchool Program?

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Not Recipients
80.2 %

Claimed Recipients
19.8%

Recipients are households (n=4,595) with children enrolled in Day Care Centers and in elementary schools under DepEd, for the past 12 months, and received rice as ration

Percentage of households who claimed to be recipients* of Food-for- School Program by frequency of receiving one kilo of rice

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

50 40 30 20 10 0

47.4

28.6

24.0

Daily

Weekly

Monthly

*Recipients are households (n=4,595) with children enrolled in Day Care Centers and in elementary schools under DepEd, for the past 12 months, and received rice as ration

Percentage of households who claimed to be recipients* of Food-for- School Program by duration of receiving one kilo of rice

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100 80

75.2

Percentage

60 40 20 0

14.4 5.0 Less than 5 months 5 months More than 5 months 5.4 New recipients

*Recipients are households (n=4,595) with children enrolled in Day Care Centers and in elementary schools under DepEd, for the past 12 months, and received rice as ration

Percentage of households who claimed to be recipients* of Food-for- School Program by type of rice given

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

60 50 40 30 20 10 0

51.9 30.9 17.2

Fortified rice

Unfortified rice

Do not know

*Recipients are households (n=4,595) with children enrolled in Day Care Centers and in elementary schools under DepEd, for the past 12 months, and received rice as ration

Percentage of households who claimed to be recipients* of Food-for-School Program by presence of other members partaking the rice given
PERCENT
With other members partaking Without other members partaking Given to neighbors
0

97.6 2.1 0.3


20 40 60 80 100

Not Recipients 80.2 %

Claimed Recipients 19.8%

*Recipients are households (n=4,595) with children enrolled in Day Care Centers and in elementary schools under DepEd, for the past 12 months, and received rice as ration

Percentage of households who claimed to be recipients* of Food-for- School Program by sponsor of rice given

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100 80

79.2

Percentage

60 40 20 0

14.6 0.2
DepED

6.1

Others DSWD Both DepEd & DSWD

*Recipients are households (n=4,595) with children enrolled in Day Care Centers and in elementary schools under DepEd, for the past 12 months, and received rice as ration

Food Fortification Program

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Sangkap Pinoy Seal (SPS)


is the local term referring to the Seal given by the DOH to food products that have been certified as fortified singly or in combination of the three essential micronutrients, namely: vit. A, iron and iodine.

Iodized salt
ordinary salt to which iodine has been added.

Percentage distribution of households by awareness of food products with Sangkap Pinoy Seal *

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Awareness
Aware
Gave correct example Gave incorrect example

Percent 11.6 9.8 1.8 88.4

Not aware
*SPS food products are fortified with nutrients at DOHprescribed level, that is 1/3 of the nutrient requirement

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Proportion of households choosing food products with Sangkap Pinoy Seal when buying processed foods: Philippines, 2008
INFORMATION YES 8.6
77.5

NO 3.0 22.5

N/A 88.4

All survey households All households who know SPS

Households knowledge* of food products with

Sangkap Pinoy Seal

Response*
Food products endorsed/approved by DOH Nutritious/good for the body/with added vitamins minerals Philippine made/ pagkaing Pinoy Tasty masarap Affordable Easy to prepare Pampatalino Others (with chemicals, etc.)
*multiple response

Percent of households who know SPS-seal


60.1 42.9 9.5 9.2 8.0 3.9 2.8 2.2

Percentage of households who are aware and using iodized salt

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

AWARENESS / USAGE
Awareness
Presently using Usage among all survey households

PERCENT
78.5 53.3 41.9

Trend of household awareness and usage of iodized salt, 1998-2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100 80

Awareness
79.5 67.3 49.2 38.1 24.8 41.9 83.4 78.5

Percentage

60 40 20 0 1998 2003

Usage

2005

2008

Survey Year

% % %
ILOCOS (78.2)

CAR (80.4 )

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
NCR (87.9) CENTRAL LUZON (91.4) CALABARZON (92.0) MIMAROPA (79.3)

CAGAYAN VALLEY (84.4)

Percentage of households by awareness of iodized salt by region


National Estimate = 78.5%

BICOL (77.6)

EASTERN VISAYAS (66.9)

WESTERN VISAYAS (57.4)

CENTRAL VISAYAS (70.5)

ZAMBOANGA PENINSULA (75.8)

CARAGA (72.5)

NORTHERN MINDANAO (83.7)


DAVAO (79.2)

ARMM (29.7) SOCCSKSARGEN (65.4)

50% and Above Below 50%


CAR (53.4) CAGAYAN VALLEY (57.8) ILOCOS (26.6)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
NCR (51.5) CALABARZON (49.1)

Percentage of households by usage of iodized salt by region


National Estimate = 41.9%

CENTRAL LUZON (38.0)

BICOL (33.1)

MIMAROPA (38.5)

EASTERN VISAYAS (42.8)

WESTERN VISAYAS (32.3)

CENTRAL VISAYAS (35.2)

ZAMBOANGA PENINSULA (25.1)

CARAGA (41.1) NORTHERN MINDANAO (52.0)

ARMM (16.7) SOCCSKSARGEN (46.9)

DAVAO (58.3)

% %
ILOCOS (89.8)

CAR (92.8)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
NCR (82.6)

CAGAYAN VALLEY (96.8)

CENTRAL LUZON (52.8)

BICOL (95.0)

CALABARZON (65.0)

Percent of households by positive reaction of salts samples to potassium iodate solution using RTK by region: 2008
National Estimate = 81.1%

MIMAROPA (66.3)

EASTERN VISAYAS (97.2) WESTERN VISAYAS (91.6)

CENTRAL VISAYAS (92.9) ZAMBOANGA PENINSULA (62.8)

CARAGA (90.6) NORTHERN MINDANAO (83.0) DAVAO (96.3)

ARMM (61.2) SOCCSKSARGEN (96.9)

* Based on the goal set by the WHO, UNICEF, ICCIDD, 2007

Reaction of salt samples to the rapid test kit (RTK) and comparison with 2005

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

90 75 60 45 30 15 0

75.4

81.1

24.6

18.9

2005
Positive

2008
Negative

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Food Labeling...

Percentage of households by response to question: Do you read product labels when buying processed foods? (n=5,014)

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

60 50 40 30 20 10 0

53.8

35.1

11.1

No

Yes

Sometimes

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Percentage of households who are reading product labels by kind of information they are looking in the label 60 WHO USUALLY READ
50

46.0

45.8 38.3 28.2 14.7 7.1 4.5

Percentage
60 50

40 30 20 10 0

WHO SOMETIMES READ


43.1 40.1 44.6

ED

NF

BR

NW

Percentage

40 30 20

25.6 14.7 7.2 3.2

LEGEND
ED - Expiration Date NF - Nutrition Facts I - Ingredients BN - Brand Name M - Manufacturer NW - Net Weight O - Others

10 0

ED

NF

BR

NW

Percentage of households who are reading nutrition facts by kind of information they are looking for

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

80 70 60 50 40 30 20 10 0

73.4

26.1 10.5 7.0 Others

4.7 Percent Daily Values

Nutrients Calories per Serving

Amount per Serving

Percentage of households reading nutrition facts by response to question:

Does nutrition facts influence you in buying a product?

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100

76.6
80
Percentage

60 40 20 0

10.0
No Yes

13.4

Sometimes

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Essential Drugs...
Defined by WHO as those drugs that satisfy the health care needs of the majority of the population, should be available at all times in adequate amounts and in appropriate dosage, at a price that the community can afford.

Percentage distribution of households buying essential drugs

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

97.1
100 80 60 40 20 0

2.9

Buying

Not buying

Percentage of households who are buying essential drugs by place of purchase

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100 80 60

75.8

38.6
40 20 0

27.9 4.1 8.8

1.3

Botika ng Barangay

Drug Hospital Health Sari-Sari Other Store Pharmacy Center Store Sources

Percentage of households buying essential drugs and by perception about the cost

FNRI
60

DEPARTMENT OF SCIENCE AND TECHNOLOGY

Percentage

FOOD AND NUTRITION RESEARH INSTITUTE

50 40 30 20 10 0

47.0 34.5

17.3 1.2

Affordable Expensive Just right

Others

Percentage of households buying essential drugs by availability of the drugs

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

100

74.4
80 60 40 20 0

23.6 2.0

Always Available

Sometimes Available

Not Available

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among children..

Percentage of children, 0-48 months, participating in government programs


100

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY Percentage

86.1

82.4

85.9

85.3

80 60 40 20 0

45.7

13.8

B C G

D P T

O P V

H E P A B

M E A S L E S

Newborn Screening

Immunization

LEGEND
Newborn Screening (for newly born infants) BCG - (children, 0-3 moths) DPT - (children, 1-2 months) OPV (children, 2-6 months) Hepatitis B (children, 0-6 months) Measles (children, 9-48 months)

Percentage of children, 0-5 years, participating in government programs


100

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

80 60

72.1

39.5
40

18.6
20

GM
0

O P T

14.3
OFC

SF

LEGEND
GM - Growth Monitoring (children, 0 5 years) OPT - Operation Timbang (children, 0 5 years) SF - Supplementary Feeding (children, 3 5 years) OFC - Orally Fit Child (children, 3 5 years)

Percentage of children participating in deworming program of the government

FNRI
Percentage FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

70 60 50 40 30 20 10 0

59.0

64.1

1- 5 years

6 - 12 years

% % %
ILOCOS (64.3)

CAR (75.4)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY
NCR (56.6)

CAGAYAN VALLEY (68.7)

CENTRAL LUZON (47.7)

BICOL (68.7)

Percentage of children, 6-12 years by participation in deworming program of the government by region
National Estimate = 64.1%

CALABARZON (45.1)

MIMAROPA (64.5)

EASTERN VISAYAS (78.5) WESTERN VISAYAS (75.6)

CENTRAL VISAYAS (67.9) ZAMBOANGA PENINSULA (67.4)

CARAGA (77.6) NORTHERN MINDANAO (73.1) DAVAO (79.2)

ARMM (68.9)

SOCCSKSARGEN (74.2)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among pregnant and lactating mothers..

Percentage of pregnant and lactating mothers participating in government programs


LEGEND

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY Percentage
100 80 60

Toxoid Immunization Nutrition Counseling Breastfeeding Promotion Other Programs

100.0

42.2
40 20

40.0 24.8 24.4 2.1 22.1 1.9

Pregnant

Lactating

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among households
The Food Production program had the highest percentage of households claiming participation (51.8%) The rest of the programs for households included in the survey had participation below 50-percentage points

Among children

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among the government programs for children, 0 to 5 years, the program on Immunization specifically BCG, DPT, OPV and Hepatitis B, had the highest percentage of children claiming participation, followed by Operation Timbang and Deworming About 64% of children aged 6 to 12 years participated in the deworming program of the government

Among pregnant and lactating mothers

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Among pregnant women, less than 50.0% claimed participation in Toxoid Immunization, Nutrition Counseling and Breast feeding Promotion One hundred percent (100%) of the lactating mothers claimed participation on the Breast Feeding Promotion of the government

Food Labels

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

About 35% of the households claimed reading food labels of which 46.0% looked for expiration date and 45.8% on nutrition facts

Essential Drugs

About 97% of the households claimed buying essential drugs of which 74.4% said the drugs are always available and they usually buy them in drugstores (75.8%)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Food products with Sangkap Pinoy Seal


Awareness of food products with Sangkap Pinoy Seal is 11.6% Among those who are aware, 77.5% choose products with SPS when buying processed foods

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Iodized Salt
Iodized salt survey revealed a relatively high awareness (78.5%) but low in usage (41.9%) There was a decrease in the proportion of households who are aware and users of iodized salt between 2005 and 2008

C onclusions and Implications to Programs


FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Windows for action:


Strengthen and integrate efforts combat malnutrition among children to

Review existing health and nutrition programs to address the emerging problem of double burden of malnutrition, especially among children and pre-adolescents / adolescents

C onclusions and Implications to Programs


FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Windows for action:


Ensure adequate maternal nutritional status
Strengthen promotion of exclusive breastfeeding thru 6 months, and appropriate complementary feeding and breastfeeding;

C onclusions and Implications to Programs


FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Windows for action:


Frequency of distribution of iron supplements in high-risk areas, and particularly among pregnant and lactating women Dietary modification and increased physical activity as part of behavior modification effort to address lifestyle diseases

C onclusions and Implications to Programs


FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Windows for action:


Review current policies on health and nutrition, e.g. asin law, food fortification law, Need to encourage partnership with various stakeholders on program/project implementation, particularly with the local executives (new) and the food industry

United Nations Childrens Fund (UNICEF)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Department of Science and Technology- Grants in Aid (DOST-GIA) through the PCHRD Department of Health, National Center for Disease Prevention and Control (DOHNCDPC), Non-Communicable Disease Office (DOH-NCDO), National Nutrition Council (DOH-NNC) Department of Agriculture, Bureau of Agricultural Research (DA-BAR) Philippine Society of Endocrinology and Metabolism (PSEM) Wyeth Philippines, Inc.

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Philippine Lipid and Atherosclerosis Society (PLAS) Philippine Society of Hypertension (PSH) Philippine Heart Association (PHA) Philippine Society of Nephrology (PSN) Osteoporosis Society of the Philippine Foundation, Inc. (OSPFI) Philippine Association for the Study of Overweight and Obesity (PASOO) Philippine Rheumatology Association (PRA) Philippine Association on Vascular Medicine (PSVM)

Multi-Sectoral Task Force (MTF) member organizations headed by Dr. Dante D. Morales

Philippine College of Physicians (PCP)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Philippine Society of Asthma, Allergy, Immunology (PSAAI)

National Statistics Office (NSO) Local Government Unit- Department of Interior and Local Government (LGU-DILG) and their local executives, the Governors, Mayors, and the Barangay Captains, and their constituents Dr. Isidoro David and Dr. Zita Albacea DOST Regional Directors, Provincial Science and Technology Officers (PSTO)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Regional, Provincial, City and Municipal Nutrition Action Officers The 36,344 households and their 191,351 members All technical and non-technical FNRI Staff, Local Researchers, and their Local Survey Aids

OUR ADDRESS

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

FOOD AND NUTRITION RESEARCH INSTITUTE Department of Science and Technology DOST Compd., Bicutan, Taguig Metro Manila, PHILIPPINES

FNRI HOME PAGE:

http://www.fnri.dost.gov.ph

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Maraming salamat po!

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

THANK YOU

Rationale for the development of the WHO child growth standards (CGS)

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

The recommended NCHS/WHO international reference was re-assessed due to the following: Individual infants
interferes with sound nutritional management of breastfed infants, increasing their risk of morbidity and mortality

Populations
provides inaccurate estimates of undernutrition and overweight

How will the development of the WHO child growth standards (CGS) help?

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Reconfirm the right to the highest attainable standard of health Reinforce breastfeeding as the best source of nutrition for infants Provide an opportunity to strengthen growth promotion programmes Improve assessment of poor growth and monitoring of progress towards the MDGs

Percentage distribution of 0-5 yearold children by nutritional status using CGS/WHO: Philippines, 2008

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

*
* For 0-60 months only

Comparison of nutritional status of 0-5 year-old children by weight-for age classification using NCHS IRS and WHO CGS: Philippines, 2008

FNRI
%Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

80 70 60 50 40 30 20 10 0

71.8

76.7

26.2 2.0
NCHS IRS
Underweight Normal

21.6 1.7
CGS
Overweight

Comparison of nutritional status of 0-5 year-old children by height-for-age classification using NCHS IRS and WHO CGS: Philippines, 2008

FNRI
%Prevalence
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

80 70 60 50 40 30 20 10 0

71.0

66.5

27.9

32.3

1.1
NCHS IRS
Underheight Normal

1.2
CGS
Tall

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Comparison in the trends of the prevalence of underweight among children, 0-5 years old, using NCHS IRS vs CGS: 1989 to 2008
40 30 20 10 0 1989 1992 1993 1996 1998 2001 2003 2005 2008
NCHS IRS CGS
34.5 29.3 34.0 28.1 29.9 24.6 30.8 25.1 32.0 26.7 30.6 24.4 26.9 21.4 24.6 21.7 26.2 21.6

% Prevalence

FNRI
FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

Comparison in the trends of the prevalence of underheight among children, 0-5 years old, using NCHS IRS vs CGS: 1989 to 2008
50 40
%Prevalence
45.6 39.9 41.5 36.8 39.3 34.3 40.4 34.5 39.5 34.0 36.4 31.4

30 20 10 0

34.4 29.9

33.8 26.3

32.3 27.9

1989 1992 1993 1996 1998 2001 2003 2005 2008


NCHS IRS CGS