Data-driven development and validation of a nutrient-based score to measure nutritional balance of meals in the Philippines.

BACKGROUND: The goal of the present study was to design an easily computable score, based on nutrient composition data instead of food groups, to evaluate the nutritional quality and balance of meals, adapted to the nutritional recommendations for Filipino adults. METHOD: The score was defined as a weighted average of 9 nutrient scores. Protein, total fat, saturated fat, free sugars were scored as % of energy; calcium, fiber, sodium, vitamin C, magnesium were scored based on the local dietary reference intakes. The scoring algorithm was an adaption of a score previously developed by the authors based on US data. In the present study, the score was applied to 69,923 meals reported by 31,218 adult Filipinos aged 20 to 59 in the 2018 edition of the Philippine Expanded National Nutrition Survey to evaluate its validity and compare against exemplary meals designed as part of 24 h diet plans that meet local dietary guidelines. RESULTS: Meals from these exemplary menu plans, developed by local nutrition experts, scored on average 72.2 ± 13.9 (mean ± standard deviation) while those of survey participants scored 46.1 ± 12.9. Meal scores were significantly associated with the density of positive micronutrients (e.g., Vit A, Vit C) and favourable food groups (e.g. fruits, whole grains) not directly included in the algorithm. CONCLUSION: The score, between 0 and 100, is a valid tool to assess the nutritional quality of meals consumed by the PH population, accounting for both shortfall and excess nutrients, adjusted for the energy content of the meal. If applied to consumer-facing applications, it could potentially help users to understand which meals are nutritionally balanced.

The International Breakfast Research Initiative-Evaluation and Comparison of Breakfast Nutrient Intakes in Indonesia, Malaysia and the Philippines with a View to Proposing a Harmonised Nutrient-Based Breakfast Recommendation.

The International Breakfast Research Initiative is a global study of breakfast nutrition, involving 17 countries in four continents, aiming to derive nutrient-based regional recommendations for breakfast. This study aimed to propose a harmonised recommendation for three South-East Asian countries: Indonesia, Malaysia, and the Philippines. For each country, data from nationally representative dietary surveys on the contribution of breakfast to daily nutrient intakes at both the adult population level and at the level of the upper tertile of daily nutrient density using the Nutrient Rich Food (NRF) Index were collated and examined. Energy intakes at breakfast ranged from 26 to 27% of daily energy intake. In all three countries, breakfast was carbohydrate-rich, providing 52 to 72% of breakfast energy intake, while it was higher in total and saturated fat in Malaysia and Indonesia. Intakes of fibre and vitamin C were low in all countries, while Malaysia tended to have higher intakes of most minerals, including sodium. Daily and breakfast nutrient intakes (at the population level and in the upper tertile of the NRF Index) were compared to the Codex Alimentarius nutrient reference values (NRVs) to assess adequacy. A decision tree was established based on these data to guide the development of recommendations for nutrient intakes at breakfast across the three countries.

Drivers of Anemia Reduction among Women of Reproductive Age in the Philippines: A Country Case Study.

BACKGROUND: Anemia prevalence among women of reproductive age (WRA) in the Philippines was 25% in 2000, decreasing to 13% in 2018. To date, an in-depth assessment of the determinants associated with this decline has not been conducted. OBJECTIVE: To conduct a systematic in-depth assessment of the quantitative and qualitative determinants of anemia among WRA in the Philippines between 2008 and 2018. METHODS: Employing standard Exemplars methodology, we conducted quantitative analyses using the Philippines' National Nutrition Survey, the Expanded National Nutrition Survey, and the Philippines National Demographic and Health Surveys. Qualitative analyses included a comprehnsive literature review, program/policy analysis, and interviews with stakeholders to understand country-level enablers and barriers to WRA anemia decline in the Philippines. A final Oaxaca-Blinder decomposition analysis (OBDA) evaluated the relative contribution of direct and indirect factors. RESULTS: Among non-pregnant women (NPW), mean hemoglobin (Hb) increased from 12.7 g/dL in 2008 to 13.1 g/dL in 2018 (p<0.01), corresponding to an 11%-point decline in anemia prevalence (23% to 12%). Inequities by geographical region, household wealth, and women's educational attainment narrowed considerably during this time. Important direct and indirect nutrition programs were introduced during our study period, including universal healthcare and food fortification. Country experts interviewed credited programs focused on alleviating micronutrient deficiencies and poverty, and improvements in women's health and well-being, for the country's extraordinary success. OBDA explained ∼50% of the observed change in mean Hb among NPW, with family planning (35%), household socio-demographics (29%), and improvement in women's nutrition (23%) emerging as critical drivers of anemia decline, corroborating our qualitative and policy analyses. CONCLUSIONS: To protect these gains, WRA anemia prevention efforts in the Philippines should continue to focus on universal healthcare access, women's empowerment, and poverty alleviation.

An Ex-Ante Analysis of the Impact of Biofortified Zinc Rice on Dietary Zinc Inadequacy: Evidence from Bangladesh, Indonesia, and the Philippines.

BACKGROUND: South, East, and Southeast Asia are among the regions of the world with the highest estimated prevalence of inadequate zinc intake. Because populations in those regions eat rice as their main staple, zinc biofortification of rice can potentially improve zinc intake, especially among the most vulnerable. OBJECTIVES: We modeled the impact of the consumption of zinc-biofortified rice on zinc intake and inadequacy among women of childbearing age and young children nationally in Indonesia, the Philippines, and at a subnational level in Bangladesh. METHODS: We conducted an ex-ante analysis by applying increments of zinc content in rice, from a baseline level of 16 parts per million (ppm) to 100 ppm, and based on rice consumption data to substitute levels of conventional rice with zinc-biofortified rice varying between 10% and 70%. RESULTS: Among all datasets evaluated from these 3 countries, the prevalence of dietary zinc inadequacy at baseline was 94%-99% among women of childbearing age, 77%-100% among children 4-5 y old, and 27%-78% among children 1-3 y old. At the current breeding target of 28 ppm, zinc-biofortified rice has the potential to decrease zinc inadequacy by ≤50% among women and children in rural Bangladesh and among children in the Philippines where consumption of rice is higher compared with Indonesia. CONCLUSIONS: Our analysis shows that increasing zinc content in rice ≤45 ppm reduces the burden of zinc inadequacy substantially, after which we encourage programs to increase coverage to reach the highest number of beneficiaries.

Virgin coconut oil (VCO) supplementation relieves symptoms and inflammation among COVID-19 positive adults: a single-blind randomized trial.

A clinical study conducted in 2020 showed that virgin coconut oil (VCO) has been found effective in the rapid relief of COVID-19 symptoms and normalization of the C-reactive protein (CRP) concentration among probable and suspected cases of COVID-19. This present study aimed to validate those results and to evaluate the effects of VCO among COVID-19 patients through a 28-day randomized, single-blind trial conducted among 76 SARS-CoV-2 RT-PCR (reverse transcription-polymerase chain report)-confirmed adults, with VCO given as a COVID-19 adjunct therapy. The results showed that VCO recipients were free from symptoms and had normal CRP concentrations by day 14. In comparison, participants in the control group reported relief from signs and symptoms on day 23, with normal CRP concentrations on day 25. This second study bolsters the use of VCO as an effective adjunct therapy for COVID-19-positive patients showing mild-to-moderate symptoms.

Considerations for modelling a broad food tax in the Philippines and other low-income and middle-income countries.

Fiscal policies to improve diet are a promising strategy to address the increasing burden of non-communicable disease, the leading cause of death globally. Sugar-sweetened beverage taxes are the most implemented type of fiscal policy to improve diet. Yet taxes on food, if appropriately structured and applied across the food supply, may support a larger population-level shift towards a healthier diet. Designing these policies and guiding them through the legislative process requires evidence. Equity-oriented cost-effectiveness analyses that estimate the distribution of potential health and economic gains can provide this critical evidence. Taxes on less healthy foods are rarely modelled in low-income and middle-income countries.We describe considerations for modelling the effect of a food tax, which can provide guidance for food tax policy design. This includes describing issues related to the availability, reliability and level of detail of national data on dietary habits, the nutrient content of foods and food prices; the structure of the nutrient profile model; type of tax; tax rate; pass-through rate and price elasticity. Using the Philippines as an example, we discuss considerations for using existing data to model the potential effect of a tax, while also taking into account the political and food policy context. In this way, we provide a modelling framework that can help guide policy-makers and advocates in designing a food policy to improve the health and well-being of future generations in the Philippines and elsewhere.

A comparative analysis of the cost-utility of the Philippine tax on sweetened beverages as proposed and as implemented.

Background: In response to increasing overweight and obesity, the Philippine government introduced a tax on sweetened beverages (SBs) in 2018. Evidence suggests that the beverage industry influenced the final tax design, making it more favourable for industry than the initially proposed bill. This study aimed to compare the relative health and economic benefits of the proposed SB tax with the implemented SB tax. Methods: Philippine dietary consumption data were combined with price elasticity data from Mexico and data from Australia adapted to the Philippine context to estimate reductions in SB purchases and changes in body mass index (BMI) following the implementation of the tax. A multi-state, multiple-cohort Markov model was used to estimate the change in health-adjusted life years (HALYs) due to reduction in the epidemiology of obesity-related diseases, healthcare cost savings and government taxation revenue, resulting from both the proposed and implemented tax policies, over the lifetime of the 2018 Philippine population. Findings: The proposed and implemented taxes were modelled to be dominant (cost-saving and improving health). Intervention costs were modelled to be PHP305.2 million (M) (approximately US$6M). Compared to the proposed tax, the implemented tax was modelled to result in a 43.0% smaller reduction in targeted beverage intake (51.1 ml/person/day vs. 89.7 ml/person/day), a 43.5% smaller reduction in BMI (0.35 kg/m2 vs. 0.62 kg/m2), 39.7% fewer HALYs gained (2,503,118 vs. 4,149,030), 39.9% fewer healthcare cost savings (PHP16.4 billion (B) vs. PHP27.3B), and 27.7% less government taxation revenue (PHP426.3B vs. PHP589.4B). Interpretation: While the implemented tax in the Philippines will benefit population health, it is likely to yield less benefit than the proposed tax. The influence of the food and beverage industry on policy processes has the potential to lessen the benefits of population NCD prevention policies. Funding: OH was supported to conduct this research by an Australian Government Research Training Program Stipend Scholarship. The funding body had no role in data collection and analysis, or manuscript preparation.

Estimation of Free Sugars in the Filipino Food Composition Table and Evaluation of Population-Level Intake.

Recommendations to reduce intake of free sugars are included in some national dietary guidelines. However, as the content of free sugars is absent from most of the food composition tables, the adherence to such recommendations is hard to monitor. We developed a novel method to estimate the free sugar content in the Philippines food composition table, based on a data-driven algorithm that enabled automated annotation. We then used these estimates to analyze the free sugar intake of 66,016 Filipinos aged 4 years and over. The average free sugar consumption was 19 g/day, accounting for an average of 3% of the total caloric intake. Snacks and breakfast were the meals with the highest content of free sugars. Intake of free sugars, in grams per day and as % of energy, was positively associated with wealth status. The same pattern was observed for the consumption of sugar-sweetened beverages.

Assessment of the quality of inpatient meals and nutrition and dietetics service processes in select Philippine public hospitals.

AIMS: The nutrition and dietetics service in Philippine public hospitals was implemented by the Department of Health in 2016 to standardise the daily allowance and nutritional content of inpatient meals. Five years later, it is timely for the Department of Health to assess the quality of inpatient meals and mandated nutrition processes in areas such as staffing, food service, and outcomes monitoring. METHODS: A mixed-method sequential explanatory design was employed using (1) quantitative assessment through a facility survey (n = 193 hospitals) and (2) qualitative exploration of quantitative results through 6 focus group discussions (n = 36 hospitals). RESULTS: Philippine public hospitals were unequipped with the inputs necessary to implement processes that produce high-quality meals for patients. The hospitals were unable to comply with the required minimum meal allowance (51%), nutritional content of meals (40%), and food service standards. Moreover, they had insufficient human resources and inefficient food procurement practices. CONCLUSIONS: The quality of nutrition care and inpatient meals in Philippine public hospitals, who serve mostly people on low incomes, is a neglected problem in the Philippines. Moving forward, a systems approach involving the Department of Health, its regional offices, and hospital management is necessary to equip Philippine public hospitals with the inputs and structures necessary to provide high-quality nutrition care and inpatient meals that will facilitate patient recovery and overall patient health.

Does plate waste matter?: A two-stage cluster survey to assess the household plate waste in the Philippines.

BACKGROUND: Plate waste is an urgent global public health problem. Gaining better knowledge of the quantity and patterns of plate waste among households may give critical insights into resolving the greater problem of unnecessary plate waste. The study was conducted to determine the amount of plate wastage across food security levels of households and evaluate possible factors associated with plate waste. METHODS: This investigation analyzed the data from the 2018 Expanded National Nutrition Survey. Food weighing, food inventory, and food recall were the methods used to collect household food consumption and plate waste. Household Food Insecurity Access Scale was used to identify levels of food security among households. RESULTS: The present study has revealed that the average household plate waste of rice was 49.6 g ± 4.7; meat, fish, & poultry was 7.5 g ± 0.5; and vegetable was 6.7 g ± 0.3. Rice (58%), vegetables (18%), and meat (9%) were the top 3 most wasted foods among Filipino households. Test showed that there was a significant difference in the wastage of rice (p < 0.001), corn (p < 0.001), vegetables (p < 0.05), fish (p < 0.001), meat (p < 0.001), and fats and oils (p = 0.001) across household food security levels. Households with the highest consumption of rice was 1.24 (CI: 1.06 - 1.46) times more likely to have rice waste compared to those households with the lowest consumption. Households with a female household head was 0.82 (CI: 0.78 - 0.87) times less likely to have plate waste of rice and rice products compared to those with male household head. The odds of rice wasting of household in urban areas was 0.83 (CI: 0.77 - 0.89) times higher in contrast to rural areas. The odds of rice wasting was 1.38 (CI: 1.15 - 1.66) times higher for households in the rich quintile compared to the poorest quintile. Household with highest vegetable consumption were 3.56 (CI: 2.51 - 5.03) times more likely to have vegetable waste compared to those with the lowest consumption. Households with 5 members were 1.13 (CI: 1.01 - 1.27) times more likely to have vegetable waste. The odds of wasting vegetables was 1.50 (CI: 1.14-1.97) times greater among households in the richest quintile compared in the poorest quintile. Families with the highest fish, meat & poultry consumption was 1.38 (CI: 1.01 - 1.91) times more likely of having fish, meat & poultry waste than households with lowest consumption. Fish, meat, and poultry plate waste was 0.81 (CI: 0.68 - 0.96) times less likely in households with 5 members or less than in households with more than 5 members. Compared to households in the lowest quintile, those in the middle quintile were 1.55 (CI: 1.01 - 2.38) times more likely to throw away fish, meat, and poultry. The odds of wasting fish, meat, and poultry was 2.26 (CI: 1.35 - 3.79) times higher for those in the richest than those in the poorest quintile. CONCLUSIONS: Findings suggest that plate waste is indeed a public health problem that should be addressed. Future research studies should explore the nutrient losses that might stem from plate wastage in order to have a more accurate approach when it comes to the development of strategies and interventions aimed at reducing household plate waste.

Role of Vitamins and Minerals in Health and Diseases.

We have adopted the following four topics: 1) dietary phosphorus management in chronic kidney disease (CKD) patients, 2) inadequate nutrient intakes in Filipino schoolchildren and adolescents, 3) clinical and societal implications of vitamin insufficiency, and 4) zinc transporters. Vitamins and minerals play essential roles in health promotion in clinical and societal perspectives with marked advances in understanding the mechanism underlying such effects.

Breakfast in the Philippines: food and diet quality as analyzed from the 2018 Expanded National Nutrition Survey.

BACKGROUND: The quality of foods taken during breakfast could contribute in shaping diet quality. This study determined the regularity of breakfast consumption and breakfast quality based on the food, energy and nutrient intakes of Filipinos. MATERIALS AND METHODS: Data from the 2018 Expanded National Nutrition Survey (ENNS) was extracted for analysis. There were 63,655 individuals comprising about 14,013 school-aged children (6-12 years old), 9,082 adolescents (13-18 years old), 32,255 adults (19-59 years old), and 8,305 elderly (60 years old and above). Two-day non-consecutive 24-h food recalls were used to measure food and nutrient intakes. Diet quality was measured using Nutrient-Rich Food Index (NRF) 9.3. The sample was stratified by age group and NRF9.3 tertiles. RESULTS AND FINDINGS: Results showed that 96 - 98% Filipinos across age groups were consuming breakfast. Children age 6-12 years have the highest NRF9.3 average score (417), followed by the elderly (347), adolescents (340), and adults (330). These scores were very low in comparison with the maximum possible NRF score which is 900. The essential nutrient intakes of respondents were significantly higher among those with the healthiest breakfast diet (Tertile 3) compared to those with the poorest breakfast diet (Tertile 1). However, participants in the healthiest breakfast diet did not meet 20% of the recommendations for calcium, fiber, vitamin C, and potassium. CONCLUSION AND RECOMMENDATIONS: This study revealed that majority of the population are regular breakfast consumers. However, the breakfast consumed regularly by Filipinos were found to be nutritionally inadequate. And even those classified under Tertile 3 which were assumed as having a better quality of breakfast were still found to have nutrient inadequacies. Thus, the study suggests that Filipinos must consume a healthy breakfast by including nutrient-dense foods such as fruits, vegetables, whole grains, fresh meat, and milk to provide at least 20-25% of the daily energy and nutrient intakes.

The Philippines' snapshot situation of pregnancy-related and child feeding practices during the COVID-19 pandemic.

Background: Maternal, infant and young child health and nutrition are affected during the COVID-19 pandemic. Aim: This study aimed to present the snapshot situation of maternal health practices of pregnant women including infant and young child feeding (IYCF) practices of children under two during the COVID-19 pandemic. Methods: A rapid nutrition assessment survey (RNAS) was conducted through phone interview in nine selected areas from November 3 to December 3, 2020. A multi-stage sampling design was employed in the selection of areas with low, medium, and high risk categories across the islands of Luzon, Visayas, and Mindanao in the Philippines. A total of 792 mother-child pairs, and 148 pregnant women were covered. Results: Majority (84.5%) of pregnant women availed pre-natal check-ups, 82.4% of them had micronutrient supplements, of which 20.5% took IFA tablets. Almost 60.0% of children under two were currently breastfed during the pandemic, with 60.8% of infants less than 6 months receiving breastmilk exclusively. Appropriate complementary feeding practices based on this study were not drastically affected by the COVID-19 pandemic. However, access to pregnancy-related information, along with breastfeeding and complementary feeding messages and advice were disrupted during the community lockdown. Conclusion: Although maternal and child feeding practices were unchanged, innovative delivery of community health and nutrition services such as tele-visits by midwives, and community health workers are some of the ways to move forward in improving the health and nutrition of women and children in the wake of the pandemic and during subsequent waves.

Impacts of COVID-19 Pandemic on Household Food Security and Access to Social Protection Programs in the Philippines: Findings From a Telephone Rapid Nutrition Assessment Survey.

This study assessed the status and factors that affected the food security of Filipino households and their access to social protection programs and coping mechanisms during the coronavirus disease 2019 (COVID-19) pandemic in the Philippines. A rapid nutrition assessment survey through telephone interview was conducted on November 3 to December 3, 2020, among households covered in the 2019 Expanded National Nutrition Survey (ENNS) to compare the status of household food security before and during the pandemic. A total of 9 provinces and highly urbanized areas were selected as study sites based on risk to COVID-19 infection categorized as low, medium, and high. A total of 5717 households with contact numbers participated in the study. Results showed that almost two-thirds (62.1%) of the households experienced moderate to severe food insecurity when strict community quarantines started. The increase in the proportion of moderate to severe food insecurity was higher in the low- and medium-risk areas of COVID-19 infection than in high-risk areas (P < .05). The poorest households were 1.7 times more likely to become moderate to severely food insecure compared to middle-income households. No money to buy food (22.1%) was the top concern of food-insecure households. Purchasing food on credit, borrowing food from family, and loans from relatives and friends are the top coping strategies of food-insecure households. The results imply the need to extend assistance equitably to households and areas with fewer resources and minimal or no benefactors.

Analysis of food sources and nutrient intakes of selected breastfeeding mothers in Metro Manila, Philippines.

BACKGROUND: This study evaluated the food and nutrient intakes of selected breastfeeding mothers and identified the top food sources of nutrient intakes. METHODS: This is a cross-sectional, non-interventional study conducted in one of the private medical centers in Metro Manila, Philippines. PARTICIPANTS: The sample size included 70 mothers of healthy, term, exclusively breastfed infants aged 21-26 days at enrollment. Mothers were scheduled to visit the clinic at days 1, 22, 57, and day 90.Similarly, food diaries were obtained during these periods with a 3-day food record per clinic visit totaling to 12 records per mother at the end of 90 days. At every clinic visit, the records were validated face - to - face by the registered nutritionist - dietitians. An extension of the mother's participation until day 155 was implemented for the collection of clinical outcomes used by Pediatricians. Mean food intakes were calculated. A PC-Software for Intake Distribution Estimation (PC-SIDE) program was used in the estimation of inadequate intakes. Socio-economic status was collected using standard questionnaires. Weight and height were measured using standard techniques to compute for BMI. RESULTS: Anthropometric results for the breastfeeding mothers reported a mean weight of 56.9 kg (SE = 1.3) and a mean height of 152.4 cm (SE = 0.6). In terms of body mass index (BMI), 8.6% were chronic energy deficient, and 34.3% were overweight while 12.9% were obese. Mean energy intake of breastfeeding mothers was 2516.7 kcal/day, which was 28.6% higher than the EER of 1957 kcal/day. Mean protein intake was 78.4 g/day, which was 37% inadequate while fat intake as percentage of total energy was excessive by 4%. Nutrient inadequacy is high for almost all nutrients: iron (99%), folate (96%), riboflavin (39%), vitamin B6 (63%), vitamin B12 (46%) and thiamine (22%). The top 5-food sources with highest percent contribution to energy are rice (43.1%), bread (8.1%), pork (7.7%), powdered milk (5.9%), and sweet bakery products (5%). CONCLUSIONS: There is a high prevalence of protein and micronutrient inadequacies in the diet of breastfeeding mothers. The prevalence of overweight and obesity is high among breastfeeding mothers. These findings might be explained by the low variety and nutrient-poor foods consumed by the breastfeeding mothers. Understanding the major food sources of nutrient intake of breastfeeding mothers could be used to intensify if not craft interventions to address the nutrient gaps. Improving the maternal nutrition may contribute to having quality breastmilk to infants.

Moderate and Severe Level of Food Insecurity Is Associated with High Calorie-Dense Food Consumption of Filipino Households.

Food insecurity is often deeply rooted in poverty. Hence, accessibility and the quality of foods consumed may affect the dietary pattern. The study aims to assess the relationship between food insecurity and dietary consumption. This investigation analyzed the data from the 2015 Updating of Nutritional Nutrition Survey. The Household Food Insecurity Access Scale (HFIAS) was used to determine household food security status and the prevalence of food insecurity. Food weighing, food inventory, and food recall were the methods used to collect food consumption data of sampled households. The study revealed poor nutrient quality and a greater likelihood of inadequacy of nutrients among moderate and severe food insecure households. Mild, moderate, and severe levels of food insecurity were found to affect 12%, 32%, and 22% of the population, respectively. The test showed that both moderate and severe food insecure families have significantly lower mean consumption of meat, milk, and fats and oils in contrast to food secure households. In comparison with food secure households, moderate and severe food insecure households consume higher amounts of cereals and cereal products, rice, and vegetables. Moderate and severe food insecure households have higher consumption of total carbohydrates but have significantly lower average intake of vitamin A, riboflavin, niacin, and total fat related to food stable households. Moreover, the results of the multiple logistic regression revealed that food insecure households have a higher likelihood to be deficient in energy, protein, calcium, vitamin A, thiamin, riboflavin, niacin, and vitamin C intakes, but except for iron (p value <0.05). Indeed, household food insecurity was associated with the higher consumption of calorie-dense food among Filipino households. This explains a lower nutrient quality and a higher likelihood of inadequacy of nutrients among moderate and severe food insecure households.

Virgin coconut oil is effective in lowering C-reactive protein levels among suspect and probable cases of COVID-19.

Understanding the complex pathogenesis of COVID-19 continues to evolve. With observation and quarantine as the prevailing standard of care, this study evaluated the effects of virgin coconut oil (VCO) in the biochemical markers of suspect and probable cases of COVID-19. A 28-day randomized, double-blind, controlled intervention was conducted among 63 adults in two isolation facilities in Santa Rosa City, Laguna, Philippines. The participants were randomly assigned to receive either a standardized meal (control) or a standardized meal mixed with a predefined dosage of VCO. Changes in clinical markers were measured at three time points (day 0, 14, and 28), with daily monitoring of COVID-19 symptoms. Participants in the intervention group showed a significant decline in the C-reactive protein level, with the mean CRP level normalized to ≤ 5 mg/dL on the 14th day of the intervention. As an adjunct therapy, meals mixed with VCO is effective fostering faster recovery from COVID-19.

The Nutritional Impact of Milk Beverages in Reducing Nutrient Inadequacy among Children Aged One to Five Years in the Philippines: A Dietary Modelling Study.

Around half of Filipino children are not consuming any dairy products on a given day, which has shown to be associated with increased risk of inadequate nutrient intakes. The current study applies dietary modelling to assess the nutritional impact of meeting dairy recommendations in reducing nutrient inadequacy in children aged one to five years in the Philippines. Dietary intake data of Filipino children aged one to five years (n = 3864) were analyzed from the 8th National Nutrition Survey 2013. Children who did not meet national dairy recommendations were identified. Two scenarios were applied, based on two types of commonly consumed milk products by the survey participants. In scenario one, one serving of powdered milk was added to the diet of these children. In scenario two, one serving of a young children milk (YCM) or preschool children milk (PCM) was added to the diet of children aged one to two years and three to five years, respectively. Mean nutrient intakes and percentages of children with inadequate intakes were estimated before and after applying modelling scenarios. Scenario one demonstrated improvement in calcium, phosphorus, sodium, vitamin A and riboflavin intakes, while in scenario two, further improvement of intakes of a wider range of nutrients including iron, selenium, zinc, magnesium, potassium, vitamins C, D, E, thiamin, niacin, vitamins B6, and B12 was observed. In both scenarios, if all children would meet their dairy recommendations, theoretical reductions in population nutrient inadequacy would be observed for all micronutrients, for example, only 20% of children aged one to two years would be inadequate in vitamin A instead of the current 60%, iron inadequacy would see a 5% reduction, and approximately 10% reduction for calcium and 20% reduction for folate. The present study is the first to apply dietary modelling to assess the theoretical impact of meeting dairy recommendations on nutrient inadequacy in children in the Philippines. Dairy consumption should be encouraged as part of the strategy to reduce nutrient inadequacies. Calcium, iron, vitamins D, E, and folate are of concern in the Philippines as the level of inadequacies are extremely high in early years, YCM and PCM can help increase the intake of these nutrients.

Complementary feeding patterns of Filipino infants and toddlers lack diversity, especially among children from poor households.

BACKGROUND: Consumption of nutritionally adequate complementary foods is essential for optimal growth and development of infants and toddlers, including those in developing countries. The aim of this study was to describe the food and beverage consumption patterns among 6-23.9 month old Filipino infants and toddlers, by household wealth. METHODS: Data from 1087 infants and toddlers from the 2013 National Nutrition Survey were included. Dietary intake data was assessed using a 24Hr recall and population food intakes were stratified into pre-defined wealth categories. RESULTS: Breast milk, infant formula, powdered milk and rice were the most commonly consumed foods and beverages across the age groups. Several differences in complementary feeding by wealth status were observed. Infants from poor households (69%) reported significantly greater consumption of human milk, than those from rich households (42%) who reported a significantly greater consumption of infant/toddler formula (Poor: 22%, Rich: 56%) (P < 0.05). A higher percentage of toddlers from rich households consumed protein-containing foods, cookies and cakes. There was a significant difference in vegetable consumption in 12-17.9 month old children (Poor: 17%, Rich: 31%; P = 0.021). Human milk and formula were the top contributors to energy in 6-17.9 month old children, while rice was the top energy contributor in 18-23.9 month old children. CONCLUSION: Milk and rice were the main dietary components in all Filipino children, contributing up to 60% of energy in the infants from poorer households. Consumption of protein-containing foods and vegetables were typically lower in poorer households. Interventions are required to enable caregivers of young Filipino children to provide complementary foods of high nutritional quality, particularly among children from the poor households.

Dietary pattern and nutrient intakes in association with non-communicable disease risk factors among Filipino adults: a cross-sectional study.

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.