NatlNuritionSurv2008 FNRI

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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Introduction Legal Basis Methodology Survey Results Summary Conclusion and Program Implication
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LEGAL BASIS
EO 128 Section 22.
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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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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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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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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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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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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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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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SAMPLING DESIGN AND COVERAGE

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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

All 17 Regions 79 Provinces & NCR 3,377 Enumeration Areas (EAs)
36,634 Households
191,316 Individuals
BREAKDOWN OF COVERAGE
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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

To update the official statistics on the Philippine food, nutrition and health situation
Specific Objectives: FNRI

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
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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

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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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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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

Blood collection for lipid profile and fasting blood sugar determination
Measurement of blood pressure
Specific Objective:
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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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Interview on infant feeding practices through face-to-face interview
Specific Objective:
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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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Face-to-face interview
Specific Objective:
GIVERNMENT PROGRAM PARTICIPATION
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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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Face-to-face interview
GOVERNMENT PROGRAM PARTICIPATION
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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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LUZON
VISAYAS
MINDANAO
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Children, 0 to 5 Years Old
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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
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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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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
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% Prevalence
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
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% Prevalence
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
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% Prevalence
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
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40
% prevalence

% 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
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% prevalence
40 35 30
26.7 34.7

% 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
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% prevalence
16
14.7
14
12.7
13.7
13.4

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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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
No.
11 21 38 8
%
14.1 26.9 48.7 10.3
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Children, 6 to 10 Years Old
Percentage distribution of children, 6-10 years old, by nutritional status classification using NCHS/WHO IRS: Philippines, 2008
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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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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
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% Prevalence
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
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% Prevalence
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
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% Prevalence
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
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
No.
4 18 31 25
%
5.1 23.1 39.7 32.1
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Pre-adolescents / Adolescents, 11 to 19 Years Old
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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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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
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% Prevalence
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
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% Prevalence
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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Adults, 20 years old and above
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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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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
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% prevalence
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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Pregnant and Lactating Mothers
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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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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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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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100 80
Percent
6.7
16.8
16.1
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
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% prevalence
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
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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.
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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.
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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.
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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.
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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.
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LUZON
VISAYAS
MINDANAO
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NUTRITIONAL ANEMIA
ASSESSMENT CRITERIA
Normal hemoglobin levels, WHO cut-off, 1972
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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
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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
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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 (%)
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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
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%
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
%
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
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%
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
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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
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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
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
Magnitude of anemia1 among adolescents, 13 19 yrs by region
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
Magnitude of anemia1 among adults, 20 59 yrs by region
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
Magnitude of anemia1 among elderly, 60 yrs by region

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
Magnitude of anemia1 among pregnant women by region

Magnitude High
( 40.0)

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
Magnitude of anemia1 among lactating women by region

% 11.8 88.2 0.0 1992

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
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
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
IODINE DEFICIENCY DISORDER (IDD)
Epidemiological Criteria for Assessing Severity of IDD Based on Median Urinary Iodine Levels
FNRI
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
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
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
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
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
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
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
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
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
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
LUZON
VISAYAS
MINDANAO
FNRI
Assessment criteria for BP classification
FNRI
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
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
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
% 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
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
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
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
Comparison in the prevalence of dyslipidemia by total cholesterol, LDLc, HDL-c and triglyceride levels among adults, Philippines: 2003 and 2008
Hypertension
FNRI
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
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
LUZON
VISAYAS
MINDANAO
Operational Definition:
Infant Feeding Practices collective term for
the feeding practices (e.g. breastfeeding, bottlefeeding, and complementary feeding)
FNRI
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:
FNRI
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
Percentage distribution of 0-23 month-old children: Philippines, 2008 (n=1,040)
FNRI
22.8 % 50.3 % 27.0 %
0-5 months 12-23 months
6-11 months
FNRI
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
PERCENT
Exclusively Breastfed Not Exclusively Breastfed
0 20
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
PERCENT
Given Colostrum Not Given Colostrum
0 20
89.4 10.6
40 60 80 100
FNRI
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
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
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
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
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
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
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
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
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
FNRI
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
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
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
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
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
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
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
LUZON
VISAYAS
MINDANAO
FNRI
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-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
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
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
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
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
Percentage of households who claimed to be recipients* of Food-for- School Program by type of rice given
FNRI
60 50 40 30 20 10 0
51.9 30.9 17.2
Fortified rice
Unfortified rice
Do not know
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%
Percentage of households who claimed to be recipients* of Food-for- School Program by sponsor of rice given
FNRI
100 80
79.2
Percentage
60 40 20 0
14.6 0.2
DepED
6.1
Others DSWD Both DepEd & DSWD
Food Fortification Program
FNRI
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
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
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
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
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
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
NCR (51.5) CALABARZON (49.1)
Percentage of households by usage of iodized salt by region

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)
DAVAO (58.3)
% %
ILOCOS (89.8)
CAR (92.8)
FNRI
NCR (82.6)
BICOL (95.0)
CALABARZON (65.0)
Percent of households by positive reaction of salts samples to potassium iodate solution using RTK by region: 2008
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)
* 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
90 75 60 45 30 15 0
75.4
81.1
24.6
18.9
2005
Positive
2008
Negative
FNRI
Food Labeling...
Percentage of households by response to question: Do you read product labels when buying processed foods? (n=5,014)
FNRI
60 50 40 30 20 10 0
53.8
35.1
11.1
No
Yes
Sometimes
FNRI
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
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
100
76.6
80
Percentage
60 40 20 0
10.0
No Yes
13.4
Sometimes
FNRI
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
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
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
Percentage
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
100
74.4
80 60 40 20 0
23.6 2.0
Always Available
Sometimes Available
Not Available
FNRI
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
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
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
NCR (56.6)
BICOL (68.7)
Percentage of children, 6-12 years by participation in deworming program of the government by region
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
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
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
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
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
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 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
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
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

FNRI
Windows for action:

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

FNRI
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

FNRI
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
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
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
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
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 RESEARCH INSTITUTE Department of Science and Technology DOST Compd., Bicutan, Taguig Metro Manila, PHILIPPINES
FNRI HOME PAGE:
http://www.fnri.dost.gov.ph
FNRI
Maraming salamat po!
FNRI
THANK YOU
Rationale for the development of the WHO child growth standards (CGS)
FNRI
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
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
*
* 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
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
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
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
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

NatlNuritionSurv2008 FNRI

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FNRI

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

MARIO V. CAPANZANA, PhD

DESIGNATED STATISTICAL ACTIVITY

Outcome: Programs of various

Outcome: Corporate Programs

Outcome: Intervention Programs

Home News Diocesan Statements

A Pastoral Letter: Ash Wednesday 2010

SAMPLING DESIGN AND COVERAGE

17 Regions/ 79 Provinces + NCR

Multi-Stage Stratified Sampling Design

SCOPE AND COVERAGE FNRI

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

NATIONAL Enumeration Areas Households Individuals

852 5,033 40,649

3,377 36,634 191,316

NUTRITION SURVEY COMPONENTS

Clinical Nutrition & Health Survey

Government Program Participation Survey

General Objective: FNRI

Specific Objectives: FNRI

Specific Objectives: FNRI

CLINICAL AND HEALTH FNRI

Measurement of blood pressure

DIETARY Infant Feeding Practices

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

SOCIO-ECONOMICS AND FOOD INSECURITY

SOCIO-ECONOMICS AND FOOD INSECURITY

GOVERNMENT PROGRAM PARTICIPATION

GOVERNMENT PROGRAM PARTICIPATION

Laboratory analysis of salt samples using WYD

Children, 0 to 5 Years Old

Underweight / Short / Thin Average / Normal Overweight / Tall

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

Underweight/ Underheight/ Thin

*Using NSO 2008 Projected Population based on 2000 Census

34.2 24.4 27.5

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

28.7 28.1 27.3

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

FOOD AND NUTRITION RESEARH INSTITUTE DEPARTMENT OF SCIENCE AND TECHNOLOGY

5.4 4.2 4.1 3.1 4.0

30.6% 26.9% 26.2% 24.6% 17.2%

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

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

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

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

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

Children, 6 to 10 Years Old

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

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

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

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

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

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

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

Pre-adolescents / Adolescents, 11 to 19 Years Old

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