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.

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.

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.

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.

The Impact of Wealth Status on Food Intake Patterns in Filipino School-Aged Children and Adolescents.

Socio-economic status (SES) has an impact on food consumption in developing countries. However, the impact of SES on dietary patterns in Filipino school-aged children is currently unknown. The aim of this study was to fill this knowledge gap, using data from the 2013 National Nutrition Survey. Dietary intake of 11,691 children (6-18 years) were assessed using a 24-h recall. All food and beverages were assigned to one of 85 food groups. Mean daily intake, percent consuming (prevalence), and contribution to energy intake were determined, and stratified by SES, in 6-9 years old, 10-12 years old, and 13-18 years old. Rice was the most consumed food and the primary source of energy across all three age groups, independent of SES. Children of poor SES presented greater consumption of fish, vegetables, fruit, and table sugar (p < 0.05). In comparison, children of rich and middle SES presented greater consumption of milk, chicken, pork, sausages, and soft-drinks (p < 0.05). In conclusion, SES impacts the type of foods consumed by Filipino children, with children in the poorest households being most at risk of consuming low-variety diets. This analysis could be used to support public health strategies to improve dietary diversity, and potentially nutrient intake, in Filipino children.

Inadequate nutrient intakes in Filipino schoolchildren and adolescents are common among those from rural areas and poor families.

BACKGROUND: Adequate nutrition during childhood and adolescence is essential to promote growth and development. OBJECTIVE: This study evaluated usual energy and nutrient intakes of Filipino schoolchildren and adolescents. DESIGN: Food and beverage intakes were collected from a nationally representative sample of schoolchildren aged 6-9 and 10-12 years (n = 3,594 and n = 2,971, respectively) and adolescents aged 13-18 years (n = 5,447) using 24-h dietary recalls. The distributions of usual energy and nutrient intakes and the prevalence of inadequate intakes, which is defined as the percent of children with intakes less than estimated average requirements or acceptable macronutrient distribution ranges, were estimated using the Personal Computer Software for Intake Distribution Estimation (PC-SIDE) program. RESULTS: The results showed that the mean energy intakes were 19-35% lower than estimated energy requirement. High prevalence of inadequate intakes was found for most macro- and micronutrients. Prevalence of inadequacies was as follows: protein 12-47%, total fat (as percentage of energy) 38-52%, calcium 92-94%, iron 75-90%, vitamin C 68-96%, folate 61-93%, vitamin A 58-81%, riboflavin 58-91%, thiamin 27-75%, and phosphorus 18-91%. CONCLUSIONS: Generally, prevalence of inadequacy of key nutrients were relatively high among adolescents and schoolchildren, especially those from poor families and rural areas. This study demonstrated that nutrient intakes of Filipino schoolchildren and adolescents were highly inadequate, particularly among the poor and those living in rural areas.

Nutrient Intakes and Food Sources of Filipino Infants, Toddlers and Young Children are Inadequate: Findings from the National Nutrition Survey 2013.

Comprehensive assessment of nutrient intakes and food sources of nutrients in Filipino children under 5 years old are lacking. We studied energy and nutrient intakes and food sources in 4218 children aged 6⁻59.9 months using two 24-h dietary recalls. Usual energy and nutrient intakes were estimated using the PC-SIDE program. Reported foods and beverages were assigned to one of 85 food groups. Percentage contribution of each food group to nutrient intake was calculated. The results showed that the intake of total fat as a percentage of energy and of most micronutrients were highly inadequate. The prevalence of inadequate nutrient intakes, defined as the percent of children with intakes less than the estimated average requirements (EAR) ranged from 60⁻90% for iron, calcium, vitamin C, and zinc and ranged from 30⁻50% for others such as vitamin A, thiamine, riboflavin, niacin, vitamin B6, and phosphorus. The diets of these children were composed of limited foods, namely a large amount of refined rice and other low-nutrient-dense foods (cookies and sugar), while vegetables, fruits, meats, and eggs made little contribution to daily energy or nutrients. These findings provide direction to health professionals developing food-based recommendations and strategies to tackle the shortfalls in the diet of this population.