Acceptance and Compliance With Micronutrient Powder and Complementary Food Blend Use by Filipino Mothers and Their Promotion by Community Workers.

BACKGROUND: Despite the nationwide micronutrient powder (MNP) supplementation, the Philippines only saw limited success in reducing the prevalence of anemia-a condition that has remained a public health concern among young children. OBJECTIVE: To assess and explore the acceptability and compliance to MNP and Bigas-Mongo (BigMo) complementary food blend among mothers/caregivers of children aged 6 to 23 months and the promotion of these products by community health workers (CHWs). METHODS: This study was part of the randomized controlled trial involving 3 methods of data collection: (1) bimonthly visits to mothers and caregivers for 6 months to determine the level of acceptability and compliance of the 4 intervention groups; (2) initial and final interviews with mothers/caregivers (initial = 141; final = 130) to gather their experiences and difficulties in MNP and BigMo preparation and feeding; and (3) focus group discussion (n = 4) among CHWs (n = 13) to understand their perceptions and difficulties in promoting MNP and BigMo. RESULTS: The overall compliance to MNP consumption was 74.7%, with some difference between the groups. Analysis of the information received from mothers/caregivers showed that maternal adaptive strategies in preparing and feeding MNP to their children could affect MNP use, while nonreceptiveness of mothers to integrating MNP into the child's feeding routine, perceived side effects, and perceived unfavorable taste and smell were key factors considered to limit MNP use. CONCLUSION: This study provides insights into MNP and BigMo acceptability and compliance by mothers and their promotion by CHWs, which may be useful in improving MNP program and complementary feeding projects and programs in similar settings.

Recommended energy and nutrient intakes for Filipinos 2002.

The Food and Nutrition Research Institute (FNRI) of the Department of Science and Technology (DOST), as in the past, led the review and revision of the 1989 Recommended Dietary Allowances (RDAs) for Filipinos, a vital and essential tool recognized in the nutrition and health community as the source of information on recommended energy and nutrient intakes for the maintenance of good health. This set of dietary standards is periodically evaluated and updated to keep pace with new knowledge on energy and nutrient requirements and metabolism. The set of updated standards is now called Recommended Energy and Nutrient Intakes (RENIs), defined as levels of intakes of energy and nutrients which, on the basis of current scientific knowledge, are considered adequate for the maintenance of good health and well-being of nearly all healthy Filipinos. As in the 1989 edition, intakes of energy, protein, calcium, phosphorus, iron, iodine, zinc, vitamins A, C, D and E, thiamin, riboflavin, niacin, folate, pyridoxine, water and electrolytes (sodium, potassium, chloride) are recommended in this new edition. The desirable proportions of protein, fats, carbohydrates as well as fiber are also provided, in addition to information on recommended intake levels for selenium, magnesium, manganese, fluoride, cobalamin, and vitamin K. These recommendations were derived from a review of current evidences, principally the UN-FAO/WHO's 2002 human vitamin and mineral requirements and the US-Institute of Medicine-Food and Nutrition Board (IOM-FNB)'s series of Dietary Reference Intakes, taking into consideration applicability in and achievability among specific population groups.

The effect of vitamin A-fortified coconut cooking oil on the serum retinol concentration of Filipino children 4-7 years old.

A 6-month intervention trial was conducted among 542 Filipino children aged 4 to 7 years to determine the effect of vitamin A-fortified coconut cooking oil intake on their vitamin A status and to identify factors that influence this. Children were randomly assigned to the Experimental group, with vitamin A-fortified cooking oil ration; to Control-1 group with unfortified cooking oil ration; and to Control-2 group without cooking oil ration. In all groups, children's serum retinol concentration improved. Relative change in serum retinol concentration was significantly higher among the Experimental group, with one-third of total vitamin A intake coming from vitamin A-fortified cooking oil intake, than in the Control groups, with more than half of intake from other vitamin A-rich foods. Determinants of post-intervention serum retinol concentration included baseline serum retinol concentration, caregiver's education, receipt of high-dose vitamin A capsule, interaction between consumption of vitamin A-fortified cooking oil and of other vitamin A-rich foods, and between households purchasing cooking oil and food expenditure. Intake of vitamin A-fortified cooking oil combined with vitamin A-rich foods was necessary to increase serum retinol concentration. It is recommended to vigorously promote the consumption of vitamin A-fortified cooking oil together with other vitamin A-rich sources to sustain the prevention and control of vitamin A deficiency.

A case study on dual forms of malnutrition among selected households in District 1, Tondo, Manila.

The co-existence of under-and overnutrition in developing countries might be the resultant factor of a marked shift in dietary and lifestyle practices of people, especially in urban areas. The eating of high fat, high caloric diets, the presence of inactive entertainment devices and mechanized labour influence patterns of food demand and physical activity. This study identified factors associated with the occurrence of under/overweight or normal/normal nutritional status of child-mother pairs in one household. This study was conducted in two phases. The first phase was a survey of 376 child-mother pairs. The children aged 33-83 months were attending classes in government day care centres. Anthropometric indices: weight-for-age Z score (WAZ) < or = -2SD was used to classify underweight in children. WAZ+1 to -1SD was used to indicate normal nutritional status in children, specifically for this study, in order to establish a more homogenous group. Body mass index (BMI) > or = 25 kg/m2 was used to measure overweight among mothers. Results showed that about 59% of the child-mother pairs were suffering from two different types of malnutrition. From this, 31 (8.2%) child-mother pairs in the same household were experiencing underweight/overweight: the child was underweight and the mother was overweight. The second phase of the study was an in-depth study of these 31 under/overweight child-mother pairs and 30 randomly selected normal/normal pairs. Pre-tested questionnaires were used to gather socio-economic-demographic data; 3 day 24-h food recall for dietary intake and 24-h activity recall for physical activity. Results showed that the different factors associated with the existence of underweight child/overweight mother (UC/OM) or normal child/normal mother (NC/NM) in this study were: mother's educational level, mother's occupation, and number of children in the household; energy intake, the preference of meats, sweets and sugars among children or meats and fried foods among mothers; and mother's perception on body size. Physical activity of both mothers and children was higher in the UC/OM than in the NC/NM group. The problem of undernutrition and overnutrition in one household poses enormous challenges. Although this study cannot make an inference to the whole population, the results indicate that there is a need to consider whether public health programs should focus on healthy diet and lifestyle patterns that will lead to optimal health outcomes at both ends of the spectrum of nutritional status.