Impact of COVID-19 in the participation of Filipino children 0-12 years old to nutrition-specific programs and their mothers' knowledge based on a Rapid Nutrition Assessment Survey

Background@#As the SARS-CoV-2 virus (COVID-19) continues to affect the capacity of the health system to deliver essential nutrition and health services, many countries, especially the low- and middle-income countries, including the Philippines, are beset with addressing undernutrition and micronutrient deficiencies among children. @*Objective@#The rapid nutrition assessment survey (RNAS) was conducted in selected areas in the Philippines to provide evidence of the effect of the COVID-19 pandemic on children's participation in the nutrition services and their mothers' knowledge level on nutrition. @*Methodology@#The RNAS was a cross-sectional survey conducted through phone interviews in nine (9) selected areas in the Philippines. A total of 7,092 children aged 0 to 12 years were included in the survey, of which 5,239 mothers and caregivers were interviewed regarding nutrition program participation of their children, and their knowledge on nutrition. @*Results@#A significant decline in children's participation in the Operation Timbang (OPT) Plus (83.0% vs. 51.1%), Vitamin A supplementation (65.4% vs. 54.9%), supplementary feeding (21.6% vs. 11.9%), and deworming (60.4% vs. 11.9%) was recorded during the COVID-19 pandemic based on RNAS as compared to the pre-pandemic period using the 2019 Expanded National Nutrition Survey (ENNS). The most commonly cited reasons for health service disruptions include: child did not visit health centers due to fear of infection, community health workers did not visit the child at home, and no available health workers in the facility. Stunting among children was more likely to be perceived by food insecure (19.7% vs 14.4%; p <0.001) and poor (22.1% vs 16.6%; p<0.000) mothers or caregivers than their counterpart mothers from food secure and rich households. @*Conclusion@#With prolonged limited access to health and nutrition services, children, particularly those from poor households, are at risk of hunger, malnutrition, and consequently, of not developing their full potential. Findings can guide efforts to ensure the continuity of essential health and nutrition services towards improving maternal knowledge and promotion of child health and nutrition during the COVID-19 outbreak and crisis recovery period.

Existence of double burden of malnutrition among Filipino children in the same age-groups and comparison of their usual nutrient intake

@#Introduction: This study aimed to determine the prevalence of underweight and overweight children in the same age-groups and if differences existed in their usual nutrients intake. Methods: Data were obtained from 8992 children aged 3-12 years who participated in 2013 National Nutrition Survey. Dietary intake information was collected using two days non-consecutive dietary recall. Usual intakes and distributions of energy and nutrients were estimated in pre-schoolers (3-5 years, n=2427), younger (6-9 years, n=3594) and older schoolchildren (10-12 years, n=2971) using PC Software for Intake Distribution Estimation (PC-SIDE) from Iowa State University. Energy inadequacy was assessed by the Estimated Energy Requirements (EER) method calculated using the equation of Institute of Medicine. The prevalence of nutrient inadequacy was estimated as the proportion of individuals with usual food intakes below the estimated average requirement (EAR). Results: The prevalence of underweight among preschool, younger and older schoolchildren was 22%, 30% and 16%, respectively, and 4%, 9% and 10%, respectively, among overweight. The average usual energy and nutrient intake of underweight was significantly lower than overweight. The major source of energy of underweight and overweight was from carbohydrates. However, contribution of fats to total energy was higher among overweight. Most nutrients were below EAR in underweight while only folate (50-79%) and calcium (58-84%) in overweight. Conclusion: The double burden of malnutrition co-exists in children of the same age-groups with higher prevalence nutrient inadequacies in underweight children. Percentage of fat contribution to energy intake was higher among overweight than the underweight.

Vitamin D status of Filipino adults: Evidence from the 8th National Nutrition Survey 2013

@#Introduction: This study reports the vitamin D status of Filipino adults in selected areas in the Philippines and determinants of deficiency, based on the 2013 National Nutrition Survey (NNS). Methods: The NNS collected blood samples from all members aged ≥20 years from selected households of the National Capital Region (NCR), Cebu and Davao del Sur. Serum vitamin D was determined by electrochemiluminescence assay. Data on age, sunscreen use, intake of supplement were collected. Body mass index was calculated. Results: The overall prevalence of combined vitamin D deficiency (<50 umol/L) and insufficiency (51-75 umol/L) was 48.7%, and was highest in the NCR (54.1%) and lowest in Davao del Sur (28.9%). Adults in NCR were more likely to have vitamin D insufficiency compared with those in Cebu (OR=0.59) and Davao (OR=0.30). Females had higher prevalence (62.5%) of vitamin D insufficiency than males (32.1%). Higher prevalence of vitamin D insufficiency was observed among 20-39 y (55.5%) and lowest among ≥60 y (38.1%). The younger adults (20-39 y) were more likely to have vitamin D insufficiency compared to 40-59 y (OR=0.63) and the ≥60 y (OR=0.43). Among sunscreen users aged 20-39 y and 40-59 y in Cebu and Davao del Sur, mean vitamin D levels were significantly lower than non-sunscreen users. Conclusion: The 2013 NNS revealed a high prevalence of vitamin D insufficiency among Filipino adults. Gender, age, and area of residence were significant determinants of vitamin D insufficiency. Determining the vitamin D status is crucial in crafting interventions for its prevention and control.

Do probiotics and fibre in milk powder have an effect on functional constipation and general wellbeing of Filipino mothers?

Introduction: This study aimed to evaluate the effect of probiotics and fibre in milk powder on functional constipation and general well-being of a sample of Filipino mothers. Methods: The study employed a single group, controlled, before-after intervention design. Out of 115 females recruited from 7 military camps in Metro Manila aged 21-31 years, 85 mothers met the inclusion criteria namely, defecation frequency of <3 days/week or constipated for about 2-8 weeks, experienced bloating, flatulence, gurgling, feeling heavy after eating, and abdominal pain, willing to stop vitamin supplementation a week before the start of the study. Milk powder (40 g) in 200 ml of water was consumed twice a day for 28 days under supervision at the workplace. Digestive health, health and wellness, bowel habit and Bristol stool chart questionnaires, which were modified and pre-tested, were administered every 3-4 day visits. Constipation was defined as <3 days/week defecation frequency (Rome II). Appropriate statistical tests were employed in data analysis. Results: A total of 72 participants completed the study. At 4 weeks, a significant improvement in defecation frequency was reported. There was an increasing percentage of participants who were highly satisfied with their defecation frequency, stool characteristics, comfort during defecation and defecation duration as the number of intervention days increased. Conclusion: The consumption of a probiotic and fibre fortified milk powder might have contributed in alleviating functional constipation and the improvement in general health and wellbeing of the participants. Further studies should be conducted to confirm these results.