This study evaluates the effects of nutrition education on improving knowledge, attitude, and practice (KAP) of mothers and the improvement of the nutritional status of their children. A cluster randomized controlled design using multistage sampling was employed. The integrated school‐based nutrition programme included gardening, nutrition education for parents, and supplementary feeding for children (GarNESup). KAP of mothers was assessed using pretested questionnaires administered by teachers. The randomly selected schools were randomly allocated into two groups: Both schools provided lunch to targeted children with one‐dish indigenous vegetable recipe, but School 1 received iron‐fortified rice whereas School 2 was provided ordinary rice. Eighty wasted and/or anaemic children in each school were fed for 120 days. Nutrition education for children's parents was done every school card claim day and during parent–teacher meetings using 10 developed modules. Weight, height, and haemoglobin level of children and KAP of mothers were measured at baseline and endpoint using standard techniques. KAP of mothers who had completed more than six modules had significantly increased from baseline to endpoint: Negative consequence of worm infestation (33.3% to 60.6%, P = 0.035), importance of serving breakfast for children (42.4% to 78.8%, P = 0.004), cooking vegetables (63.6% to 93.9%, P = 0.002), and purchasing fortified foods was recorded (51.5% to 93.9%, P = 0.000). Children in School 1 had significantly higher weight gain (1.33 ± 0.72) and haemoglobin level (0.49 ± 0.99) than children in School 2 (0.84 ± 0.59; 0.12 ± 0.70). Nutrition education resulted to significant increase of mother's KAP and the implementation of the integrated school‐based nutrition model significantly improved children's nutritional status.

Background: This study evaluated the relationship between dietary quality and food patterns of Filipino adults and the rising prevalence of selected cardiometabolic non-communicable disease (NCD) risk factors. Methods: This is a cross-sectional study that examined the association of dietary pattern and NCDs using data collected in the 2013 National Nutrition Survey. A total of 19,914 adults aged 20 years and above were included in the analyses. The Alternative Healthy Eating Index (AHEI-2010) was used to characterize the dietary quality, and principal component analysis (PCA) was used to identify dietary patterns specific to the study population. Logistic regression models were applied to assess the association between the dietary pattern scores and selected cardiometabolic NCD indices including diabetes, hypertension, dyslipidemia and overweight and obesity with adjustment for potential confounders. Results: The mean AHEI-2010 score was 19.7 for women and 18.9 for men out of a total possible score of 100. Three major dietary patterns were identified through PCA: 1) meat and sweetened beverages (MSB); 2) rice and fish (RF) and 3) fruit, vegetables and snack (FVS). After adjustment for potential confounding factors, the AHEI pattern was associated with higher odds of overweight/obesity [extreme-tertile odds ratio (OR) 1.10, 95% confidence interval (CI) 1.02–1.21]. Subjects in the highest tertile of the MSB pattern had greater odds for overweight/obesity, diabetes, high total cholesterol, low HDL-cholesterol, high LDL-cholesterol, and high triglycerides (OR ranging 1.20 to 1.70, all p-value < 0.001). The RF pattern was associated with higher probability of overweight/obesity (OR 1.20, 95% CI 1.08–1.32) high LDL-cholesterol (OR 1.20, 95% CI 1.07–1.37), and less likelihood of diabetes (OR 0.87, 95% CI 0.77–0.98). The FVS pattern was associated with lower probability of overweight/obesity, diabetes, high triglycerides, and hypertension (OR ranging 0.85 to 0.90, all p-value < 0.05). Conclusions: Diet quality of Filipino adults is extremely poor. MSB and RF patterns were associated with a higher risk of cardiometabolic NCD indices, while FVS pattern was associated to lower risks. Identifying healthy and detrimental dietary patterns in the local diet could be informative for future local-based dietary recommendation and area-specific intervention programs.

Background: Iron deficiency anemia (IDA) in the Philippines is a serious public health problem. Fortifying rice offers a great opportunity to control IDA. However, information on other types of fortificants that can be used is scarce. Objective: To compare the effects of two types of iron fortificants in rice in improving the hematological status of schoolchildren. Design: 180 randomly selected 6-to 9-year-old anemic children were randomly allocated to three groups in a double-blinded manner: One group received iron-enriched rice (IER) with extruded iron premix rice (IPR) using ferrous sulfate as fortificant (ExFeSO₄); the second group received IER with extruded IPR using micronized dispersible ferric pyrophosphate (ExFeP80); and the third group received non-fortified rice (Control). These were administered daily for 5 days a week for 6 months. Blood samples were collected at baseline after 3 and 6 months. Results: At baseline, one child in the ExFeP80 group was suffering from IDA; at 3 months, no IDA was found in any groups; while at 6 months, one child in the ExFeP80 developed IDA. The baseline prevalence of anemia in all groups, which was 100%, was significantly reduced to 51%, 54%, and 63% in the ExFeSO₄, ExFeP80 and Control groups respectively. After 6 months, further significant reductions were observed in the ExFeSO₄ (38%) and ExFeP80 (33%) but remained at 63% in the Control group. Greater, significant increases were also observed in plasma ferritin in the fortified groups than in the Control group from baseline to 6 months. The predictors of change in hemoglobin (Hb) and plasma ferritin were group allocation and basal values. Conclusion: The consumption of rice fortified with FeP80 using extrusion technology has similar effects as that of FeSO₄ in reducing the prevalence of IDA among schoolchildren.

Background: Comprehensive assessment of dietary intakes of foods and nutrients in Filipino adults are lacking. This study evaluated energy and nutrient intakes and food sources of key nutrients consumed by Filipino adults. Methods: The participants were from the 2013 National Nutrition Survey wherein food intake of young adults aged 19–49 years (n = 12,896) and older adults aged 50 years and above (n = 7853) were collected using 24-h recalls. Usual nutrient intakes were estimated using PC-SIDE program. The Philippines Dietary Reference Intakes were used to calculate proportions of inadequate intake using Estimated Average Requirement (EAR) and Acceptable Macronutrient Distribution Ranges (AMDR). Energy adequacy was evaluated using the Institute of Medicine (IOM) equation for Estimated Energy Requirements (EER). Results: The nutrient intakes with the highest prevalence of inadequacy (> 50%) were: iron (97–99%), vitamin C (96–98%), calcium (95–98%), riboflavin (86–91%), folate (89–90%), thiamine (73–89%), energy (67–70%), total fat (55–67%), and vitamin A (54–56%). Refined rice, pork and breads contributed most to daily intakes of energy, protein, carbohydrates, thiamine, riboflavin, and iron. Low intake of vegetables, fruits and dairy was common in both age groups. Conclusions: This study demonstrated that intakes of many nutrients were markedly inadequate among adults in the Philippines, due to the rice-dominant dietary pattern with few nutrient-dense foods. These results can be used to support the development of specific interventions to improve the shortfalls in nutrient intakes.

Micronutrient deficiencies (MNDs) are a chronic lack of vitamins and minerals and constitute a huge public health problem. MNDs have severe health consequences and are particularly harmful during early childhood due to their impact on the physical and cognitive development. We estimate the costs of illness due to iron deficiency (IDA), vitamin A deficiency (VAD) and zinc deficiency (ZnD) in 2 age groups (6–23 and 24–59 months) of Filipino children by socio-economic strata in 2008.

Nutrition is an integral part of economic development, since it influences workers’ health and productivity. This study evaluated the usual nutrient intakes and food sources of working adults. We conducted a cross-sectional survey that involved 1264 selected working adults aged 19 to 59 years old from randomly selected job sectors. Quantitative dietary data was collected by a 2-day, non-consecutive 24 h recall, while a dietary diversity questionnaire was used to assess the types and frequency of foods consumed. Physical activity was measured using the World Health Organization global physical assessment questionnaire. The prevalence of inadequate intakes, defined as the percentage of adults with intakes less than the estimated average requirements (EAR) or acceptable macronutrient distribution ranges (AMDR) were estimated using the PC—Software for Intake Distribution Estimation (PC-SIDE) program. The mean daily energy intake of working adults was 1768 kcal/day or 74% of the Estimated Energy Requirements (EER) for this age group. The percentage contribution to the total energy of fats (58%) and proteins (34%) were excessively high. Consumption of fruits and vegetables was only 30% and 40% of the recommended nutrient intake, respectively. Salt intake was 52% above the adequate intake. Nutrient inadequacy was high in almost all nutrients, including iron (99%), folate (97.9%), riboflavin (95.8%), calcium (94.7%), vitamin C (87.3%), and thiamin (76.6%). The top five food sources of energy included rice (35.6%), pork (15.1%), fats and oils (4.7%), chicken (4.4%), and bread (3.8%). Energy and nutrient intakes of working adults is extremely sub-optimal due to the consumption of few nutrient-dense foods. This may pose a triple burden of malnutrition if left unsolved.