Abstract

Philippine is a developing country in Southeast Asia. It has rapid economic

growth but 25.2% of Filipinos living under poverty in 2012. Agriculture sector in
Philippine is associated with poverty hence its employment share is decreasing,
absorbed by service sectors. Abandoning the agriculture sector, the poor rural
population migrates to urban area causes the proportion of the poor is higher in
urban area. The traditional diet of Filipinos are influenced by other cultures,
emphasising on combinations of bold flavours. Following income inequality,
undernutrition is a manifestation of the poor not eating well. The national rate of
stunting is 30.3% whereas the rate of wasting is 7.9%. Stunting and wasting is
more prevalent in rural areas and among the poor. They are challenged with high
food cost, rendering their food insecurity. Nutritional promotion and food
subsidies are carried out to provide adequate nutrients and to improve food
security of the needy. In general, the micronutrients status of Filipinos have
been improved over the years. The prevalence of vitamin A deficiency among
infants 6 months to 1 year old is 15.2% in 2008, highest across all age groups in
Philippine. This prevalence decreases along with age. Next, iodine status has
been improved greatly since the universal salt iodisation program, but there is
recent drop in iodine urinary excretion. Mild iodine deficiency occurs in some
pregnant and lactating women. On the other hand, about 11.1% of Filipinos
suffered from anaemia in 2013. Infant has the highest prevalence of anaemia
across age groups, whereby 39.4% is anaemic. Iron deficiency is the primary
cause of anaemia. Some food fortification is made mandatory by law to improve
the micronutrient status of Filipinos. Rice, sugar and oil are the major vehicles to
deliver micronutrients as these are the top three most frequently consumed
products among Filipinos. Besides undernutrition, 31.1% of adult Filipinos are
overweight

or

obese.

In

short,

Philippine

faces

the

double

burden

of

malnutrition.
1. Introduction
Philippine is a lower middle-income country located in Southeast Asia which
composed of 7107 islands occupying 298,171km 2 (United Nation Development
Programme, 2013; Philippine Statistics Authority & ICF International, 2014).
Philippine can be broadly divided into three main regions, the Luzon, Visayas and
Mindanao and 17 administrative regions. Begin from October 2015, the 18 th

region, which is the Negros Island Region, is formed (Manila Bulletin, 2015).
However, this report will still be based on the 17 administrative regions as the
statistics available are categorised based on 17 administrative regions. There are
differences between income, education and health status among these three
regions, most probably due to the geographical nature of the country whereby
the exchange of resources between islands is difficult. Philippine is prone to
natural disaster such as earthquakes and typhoons. Typhoon Haiyan in 2013 was
disastrous to the country, inevitably leads to poor health among the victims.

Figure 1: 17 administrative regions in Philippine. (Philippine Statistics Agency &

ICF International, 2014).
Up to 1 May, 2010, the Philippine Statistics Authority reported a
population of 92.34 million people. Philippine is a culturally diverse country with
many ethnicities and indigenous tribes. Tagalog is the main ethnicity in
Philippine, comprises of 28.1% of the population, meanwhile 80.1% of the
Filipinos are Roman Catholic (Central Intelligence Agency, 2015). According to

United Nations Department of Economic and Social Affairs (2015), the average
population annual growth rate between 2010 and 2015 is 1.58%, higher than
the worlds average, which is 1.18%. The rate has been decreasing from past
few decades, following the trend that when a country becomes more developed,
birth rate tends to decrease.
Economic inequality is a major problem in Philippine whereby poverty is
high in some regions of Philippine. Despite high economic growth, about 25.2%
of Filipinos live below the national poverty line in 2012 (The World Bank, 2015).
However, efforts have been made by the government to enable the poor to enjoy
the economic growth by creating better job, reducing the underemployment
while aiming to improve the income of bottom 20% of the population greatly
(The World Bank, 2015). Majority of the poor people worked in agriculture sector
and has low education level (Asian Development Bank, 2009).
Table 1: Distribution of poor people in urban and rural area.
Percentage of population
In Urban Area

In Rural Area

Total

Poor

73.06

26.94

100.00

Non-poor

42.69

57.31

100.00

(Asian Development Bank, 2009)

Philippine is an agrarian country but it intended to be an industrialised
country. The employment share in agriculture has been decreased from past few
decades dramatically, while the service sectors absorbed the employments
(Asian Development Bank, 2009). Ironically, the industry and manufacturing
sectors also experience reduced employment share (Asian Development Bank,
2009). The reduction rate of employment and the migration of poor from rural to
urban may be due to the fact that the people hope for better income as almost
half of the population involved in agriculture experiences poverty in the past
decades (Asian Development Bank, 2009). After determining the barriers to
agriculture sectors, the Philippine government took initiatives to improve the
productivity of agriculture sector. Governments initiative is notable when P86.1
billion is allocated for agriculture sector in the National Budget for 2015,

particularly investing in agriculture infrastructure (Official Gazette, 2014). The

major crop of Philippine is rice crop, yielding 19 million tonnes in 2014 (Food and
Agriculture Organisation of the United Nations, 2014).
Philippines traditional diet is very diverse, influenced by Spanish, Chinese,
Americans and some Asian cultures, only some brief examples are included in
this report. In general, Filipinos traditional diet is characterised by bold flavour
combinations such as sweet, sour and salty (Heberlein, n.d.). Dipping sauce is
commonly used and banana ketchup always caught the attention of visitors
(Heberlein, n.d.). Mango is the national fruit and can be eaten with fish or
shrimp paste (Baringer, n.d.). Fish products are usually consumed, especially
islanders. Dried fish is the major source of calcium for Filipinos as they do not
drink milk habitually (Heberlein, n.d.). Adobo is a special cooking method in
Philippine whereby meat is braised in vinegar, soy sauce and garlic (Heberlein,
n.d.). Halo-halo is the Filipinos dessert, made up of a mix of sweet ingredients
topped with shaved ice with milk, sugar and ice-cream (Baringer, n.d.). Filipinos
even have special religious food practices, for example lechon, roasted pork with
hard brown crust (Baringer, n.d.).
2. Aim
This aim of report is to investigate major nutrition-related health issues in
Philippine and the existing programs and policies to improve the health of
populations through diet.
3. Methods
The data used in this report were mostly from government reports,
particularly the National Nutritional Survey as this is the source that represents
the Filipinos as a whole. Some other reports and journals were searched via
Google Scholar. Websites of international organisations and news were visited.
4. Literature Review
4.1 Food Insecurity and Under-nutrition
Food insecurity and under-nutrition are main issues in Philippine despite
the rapid economic growth in the Metro Manila. The Philippines Gini Index of
income inequality score 46 out of 100 (Global Nutrition Report, 2014). When the
Gini Index is increasing, it indicates that the wealth of a country is concentrated

on certain groups of people, while others are not benefited from growing
economy. Poverty leads to food insecurity and under-nutrition.
According to Global Nutrition Report 2015, the rate of stunting is 30.3%
whereas the rate of wasting is 7.9%. Stunting reflects chronic under-nutrition, in
contrast to wasting which reflects acute under-nutrition. The Philippines 8 th
National Nutrition Survey showed that underweight, stunting and wasting are
dominant among those rural populations and populations in the poorest quintile.
Several regions which are particularly associated with poverty also showed high
prevalence of under-nutrition.
Table 2: Differences in prevalence of under-nutrition across regions among
children under 5 years old.
Form of Under-

Highest prevalence regions

Lowest

prevalence

nutrition

(percentage prevalence)

regions

(percentage

prevalence)
Underweight
MIMAPORA (27.5%)
NCR (12.9%)
Western Visayas (25.9%)
CAR (16.5%)
Bicol (24.6%)
Central Luzon (17.7%)
Stunting
Bicol (39.8%)
NCR (22.4%)
ARMM (39.0%)
Central Luzon (23.1%)
Zamboanga Peninsula (38.7%) CALABARZON (25.3%)
Wasting
MIMAROPA (9.8%)
CAR (5.9%)
Ilocos Region (9.8%)
NCR (6.5%)
Western Visayas (8.9%)
SOCCSKSARGEN (6.6%)
(Food and Nutrition Research Institute Department of Science and Technology,
2013)
Male adolescents have greater prevalence in underweight and stunting,
probably due to their need to contribute to familys income in poor family. When
children growing up from the under-nutrition environment, they develop chronic
energy deficiency at adult stage.
According to the World Food Summit of 1996, food security is defined as
when all people at all times have access to sufficient, safe, nutritious food to
maintain a healthy and active life (World Health Organisation, 2015).
Zamboanga Peninsula, Northern Mindanao, SOCCSKSARGEN, Bicol and ARMM
are top 5 regions of food insecurity. Within these regions, urban areas have
greater food security than rural areas except ARMM, where there is little
difference. Food insecurity in Philippine is generally attributed to high food cost
and poor infrastructure and facilities (Roel & Casandra, 2012). Although

Philippine attained self-sufficiency in rice, the cultivation is costly as modern

technology is not adopted. As a result, food costed more than 40% of household
budget among Filipinos in 2009 (Roel & Casandra, 2012). Philippine is
susceptible to natural disaster which leads to rising of food price as a result of
harvest lost. The Filipinos are prone to food insecurity during periods of low
harvest. CARAGA, ARMM, Bicol and Zamboanga Peninsula score the highest rates
of poverty among all regions (Carleneth & Juanito, 2012). They have low income
hence many households spent more than 50% of their household income on
food (Carleneth & Juanito, 2012). Volatility in food price affects economical
access of food to these families. Rural populations have greater access to empty
land as compared to urban populations however, rural populations consume
insufficient fruits and protein-rich food as they usually plant tubers and
vegetables in their backyard (Roel & Casandra, 2012).
There are few strategies to tackle the problem of food insecurity and
under-nutrition in Philippine. The government recognises the importance of
childrens nutritional status in their healthy development hence more strategies
are targeted on children. The government categorises the strategies into
nutritional promotion and food subsidies (Roel & Casandra, 2012). These
strategies

are

carried

out

by

local

and

international

non-government

organisations too. Nutritional promotion can be subdivided into Feeding

Programs,

Nutrient

Fortification,

Information,

Education,

and

Nutrition

Awareness, and Food Production.

Food for School Program is part of the Feeding Programs which provide
food for selected children in targeted regions over a period of time (Roel &
Casandra, 2012).

School-Based Feeding Program is another Feeding Program

developed to recover children from severely wasting stage to normal through

120 days of food provision in school (Amin, 2014). This program ensures
beneficiaries obtain additional 300 calories each day in a nutritious meal sourced
from local commodities prepared by schools (Amin, 2014). Nutrient fortification
will be explained in the next section which discussed about the micronutrient
deficiency among Filipinos. In Information, Education and Nutritional Awareness
category, health and nutritional knowledge are taught to school children through
Teacher-Child-Parent Approach (Roel & Casandra, 2012). Campaigns and special
events are also fall under this category. On top of that, Food Production category

promotes backyard garden and community garden to improve self-sufficiency of

households. Different programs offer various aids such as planting material,
small animals and technical assistance (Roel & Casandra, 2012).
Food subsidies are provided to improve the economic accessibility of
staple food to the poor household. Tindahan Natin Program is established to
provide shops that sell wholesome staple food such as rice and noodles at
cheaper price to the selected beneficiaries (Rosario & Janet, 2007). The shops
are specifically located at areas which are easily accessible by the beneficiaries.
Each beneficiary household is given purchase quota to control the food supply
(Rosario & Janet, 2007). These shops on the other hand also provide job
opportunities to the locals.
4.2 Micronutrients Status
Micronutrient status of Filipinos has been improving since the last
decades. Filipinos had been suffering from Vitamin A, iodine and iron deficiency.
There are many data gaps in the area of Filipinos micronutrient status.
The Philippines 7th National Nutritional Survey is the latest data available for
Filipinos Vitamin A status. Children between 6 months to 5 years old have the
highest prevalence of vitamin A deficiency among other age groups, which is
15.2%. It scores lower than the global average vitamin A deficiency among
preschool children, which is about 33% during that time. The prevalence is
followed by children between 6 years to 12 years, which is 11.1%. 9.5% of
pregnant women and 6.4% of lactating women experienced vitamin A deficiency,
may partly act as a hindrance to further reduce the prevalence of vitamin A
deficiency among infants. There has been a reducing in the prevalence of
vitamin A deficiency over the years. However, the government should keep track
on the statistics to make sure the intervention strategies can further reduce the
prevalence of the deficiency. In general, the prevalence of the vitamin A
deficiency reduces by age possibly due to the greater consumption of meat and
fish products, which is in consistent with the survey whereby meat and fish
products contributes 71.3% of the retinol equivalents of vitamin A intake. On the
other hand, children who suffer from extreme vitamin A deficiency may not
survive to adult age as they have higher morbidity and mortality. The
consequences are a result of compromised immune response.

Prevalance of vitamin A deficiency between groups over years

Percentage (%)

45
40
35.3
35
30
25
20
16.4
15
10
5
0
1993

40.1

38

22.2

20.1
17.5

16.5

15.2
9.5
6.4

1998

2003

2008

Year of survey
6 months to 5 years old

Pregnant

Lactating

Prevalance of vitamin A deficiency between groups over years

Percentage (%)

45
40
35.3
35
30
25
20
16.4
15
10
5
0
1993

40.1

38

22.2

20.1
17.5

16.5

15.2
9.5
6.4

1998

2003

2008

Year of survey
6 months to 5 years old

Pregnant

Lactating

Figure 2: The success in reducing the prevalence of Vitamin A deficiency in

Philippine.
The prevalence of goitre among Filipinos 7 years and older are 3.5% and
6.7% at year 1987 and 1993 respectively as recorded in the 7 th National
Nutrition Survey. There is no report on the prevalence of goitre after that. Iodine
sufficiency is measured by urinary iodine excretion (UIE) whereby 100g/L of

iodine excretion is the cut-off value for having optimum iodine intake for normal
and lactating individuals, whereas 150 g/L is considered ideal for pregnant
women. Philippine attains optimum iodine status among children 6 to 12 years
at the year 2008 in the 7th National Nutrition Survey. However, iodine intake at
year 2008 is lower than 2003, as a result of lowered level of salt iodization.
Hence, mild iodine deficiency is still a problem among pregnant and lactating
women. Iodine is crucial for the brain development of the foetus, thus it is a
serious concern which should be undertaken to produce next intelligent
generation. It is important to recognise that the drop in average iodine intake
will result in more Filipinos fell into the range of moderate iodine deficiency for
those who were at marginal line of sufficiency. At national level, only 41.9% of
households used iodised salt during Philippines 7th National Nutritional Survey.

Trends in urinary iodine excretion of Filipinos over years

250
201

200

Urinary iodine excretion (g/L)

142
150
111

132
105
82

100
71
50
0
1998

2003

2008

Year of survey
Children 6 to 12 years

Lactating women

Pregnant women

Trends in urinary iodine excretion of Filipinos over years

250
201

200

Urinary iodine excretion (g/L)

142
150
111

132
105
82

100
71
50
0
1998

2003

2008

Year of survey
Children 6 to 12 years

Lactating women

Pregnant women

Figure 3: The trends of urinary iodine excretion reflecting the sufficiency of

iodine intake among Filipinos.
High prevalence of anaemia is primarily caused by iron deficiency among
Filipinos. About half of the anaemic cases can be attributed to iron deficiency but
it also coexists with other factors, including deficiency of other micronutrients
(Fiedler et al., 2014). According to 8th National Nutrition Survey, the average
prevalence of anaemia in 2013 is 11.1%. A closer look showed that 39.4% of
infants between 6 months to 1 year old were anaemic, almost ranks a severe
public

health

significance.

Premenopausal

women

generally

has

higher

prevalence of anaemia than men due to menstrual loss of iron. More women
become anaemic when they become pregnant and lactating and possesses
crucial impact on the infants iron status. The result is consistent with the fact
that only 13.5% of the household achieved Philippines Recommended Energy
and Nutrient Intake (RENI) of iron. Interestingly, household income and
urbanisation is more associated with greater difference in anaemia among
infants between 6 months to 1 year old than other age groups or physiologic
states.

Trends in the average prevalence of anaemia in Philippine across years

35
28.9
30

30.6

25
19.5

20

Prevalence (%)

15

11.1

10
5
0
1993

1998

2008

2013

Year

Trends in the average prevalence of anaemia in Philippine across years

35
30
25
20

Prevalence (%)

15
10
5
0
1993

1998

2008

2013

Year

Figure 4: The reduction in the rate of anaemia among Filipinos across years.

Figure 5: The prevalence of anaemia is highest among infants, followed by

pregnant women, elderlies and lactating women.

Figure 6: The greatest difference in the prevalence of anaemia when classified

according to income is among infants aged between 6 months to 1 year.
The Philippine Act Promoting Salt Iodisation Nationwide makes all foodgrade salt available for human consumption to be fortified with iodine (Lindsay et
al., 2006). Similarly, many food is fortified with Vitamin A in Philippines,
including sugar and cooking oil, which are the top commodities consumed after

rice (Justin & Geoffry, 2015). These Vitamin A fortified food are fed to children as
part of the nutritional program showed improvement in retinol concentration or
greater liver stores (Lindsay et al., 2006). Iron is fortified mandatorily in rice
which can provide 1 to 2mg iron per 100g of rice when cooked (San Juan et al.,
2011).

Supplementation

program

which

provides

tablets

contained

micronutrients also proved to be useful (Pedro et al., 2002; Risonar et al., 2008).
4.3 The double-burden of malnutrition
Along with other middle income countries, Philippine also faces the
double-burden

of

malnutrition.

While

the

prevalence

of

undernourished

individuals is decreasing, the rate of over-nutrition is on the rise among the

individuals who lead an affluence lifestyle. According to the Philippines 8 th
National Nutrition Survey, only about 10% of adults are underweight, but 31.1%
of adults are either overweight or obese. Overweight and obesity are the risk
factors for many non-communicable diseases such as hypertension and diabetes
mellitus. It is expected the prevalence of non-communicable diseases will be
rising in the near future, hence over-nutrition should be given attention to the
same extent as undernutrition.

Changes in the prevalnce of overweight/obese and chronic energy deficiency among Filipino's adults
35
30
25
20
16.6
Prevalence(%) 13.9
15

26.6

24

28.4

31.1

20.2
13.2

12.3

11.6

2003

2008

10

10

10

2011

2013

5
0
1993

1998

Year
Overweight/Obese

Column1

Changes in the prevalnce of overweight/obese and chronic energy deficiency among Filipino's adults
35
30
25
20
16.6
Prevalence(%) 13.9
15

26.6

24

28.4

31.1

20.2
13.2

12.3

11.6

2003

2008

10

10

10

2011

2013

5
0
1993

1998

Year
Overweight/Obese

Column1

Figure 7: While adults suffered from chronic energy deficiency is decreasing

slowly, the prevalence of adults who are overweight/obese almost doubled at
2013 when compared to 1993.
A prospective study carried out in Cebu, the fastest developed region in
Philippine, showed that the prevalence of obese women is six times greater in
2005 than in 1983 (Adair et al., 2011). Adair et al. (2011) also showed that
women aged 40 years in 2005 is about 9.6kg heavier than women aged 40 years
in 1985. The greatest rate of weight change is associated with the highest rate
of modernisation and economic development (Adair et al., 2011). Nowadays,
Filipinos consumed food with higher caloric value although the mass of food
consumed does not differ greatly from past few decades (Pedro et al., 2006).
This suggest the increased availability of energy-dense food in the markets.
Overweight and obesity is associated with affluence lifestyle regardless living in
urban or rural area.

yea

Figure 8: Comparison of the amount and the caloric value of food consumed by
Filipinos across the years.

The 2015 Nutrition Month organised by National Nutrition Council themed

Achieve normal weight through proper nutrition and physical activity to
increase the awareness of proper nutrition. Several policies and plans have been
implemented to provide knowledge and guide healthy food choices through
multimedia and school education, in addition to the installation of public
infrastructure to promote physical activity (National Nutrition Council, n.d.).
5. Discussion
5.1
Disasters
The report on nutritional issues in Philippine is not comprehensive without
considering the impact of disasters. Philippine is prone to natural disasters such
as typhoon and earthquakes with World Risk Index of 28.25%, ranks the second
highest in the world (United Nations University, 2014). The recent deadliest
natural disaster is Typhoon Haiyan, which strikes on 8 November 2013 (UNICEF,
2014). Typhoon Haiyan strikes the areas where 40% of children were living
under poverty, exacerbating their situation (UNICEF, 2014). About 20 typhoons
affect Philippine annually, resulting in the loss of assets and livelihood, leaving
the poor vulnerable to future shocks such as increase in food price. The
Philippine government should take initiative in building resilience towards natural
disaster to minimise the loss and to speed up the recovery process, for example
buildings with designs which are more resistant to typhoons and usage of
alternative power supply to power health care systems. UNICEF provided food
aid and supplementation to the undernutrition children to prevent acute
symptoms of undernutrition in periods of limited food availability (UNICEF,
2014). Other than natural disaster, the civil conflicts in ARMM renders the nearby
regions susceptible to the violence and hence affecting the poor.
5.2 Food insecurity and under-nutrition
Backyard farming may promote self-sufficiency in some products like
tubers and vegetables but fruits consumption of rural populations remain less as
fruits required longer growing period before first harvest. Rural populations faced
great challenges to meet the requirements of diverse food groups due to poor
accessibility to the market (Roel & Casandra, 2012). Tiongco and Francisco
(2011) suggested that rural populations are forced into being more self-sufficient
by growing more foodstuffs however this does not promote food security as they

found that those who have greater self-sufficiency in staple food consume less
diverse food products, as compared to those who are less self-sufficient, living in
urban areas. Therefore, encouraging backyard farming may not seem to
promote a diverse diet, also not a strategy to eradicate poverty.
Feeding program was reported to have leakage in the distribution system,
whereby the food supplied did not reach the target group (Roel & Casandra,
2012). Therefore, monitoring and evaluation of the program is necessary to
oversee the effectiveness of an intervention.
5.3 Micronutrient Status
The government report has many limitations for research use because its
primary sources are not available. Important statistical indicators such as
standard error, confidence interval and p-value are missing, therefore, the trends
of micronutrients status cannot be interpreted as significant. Other than that,
data gap is present for vitamin A and iodine status in the year 2013. The iodine
intake fell from the year 2003 to 2008, therefore it is important for the
government to continue monitoring the iodine status to prevent the relapse of
iodine deficiency among Filipinos especially pregnant and lactating women.
A trial carried out by Mason et al. (2010) showed the effectiveness of
vitamin A oil fortification over vitamin A capsule. Oil fortification of vitamin A is
able to sustain the raised of serum retinol level over time. In the study 12 out of
14 branded cooking oil was found to be fortified with vitamin A ranging between
172-2349 g/100 g.
40ppm is the standard iodine level of salt at retail site according to Act for
Salt Iodisation Nationwide (ASIN) Law in 1995. However, a quantitative
assessment showed that the iodine level of salt was below the standard,
whereas only 19.5% of Filipino households consumed adequately iodised salt
due to the low initial salt iodisation by the manufacturer because iodide is
chemically stable (Perlas & Capanzana, 2011). Some households claimed to use
iodised salt but tested negative for iodine, suggesting that Filipinos may not
aware of the non-iodised salt, which is not intended for food use (Perlas &
Capanzana, 2011). At 2007, ASIN Law lowered the standard of iodine level in
salt to 20ppm at retail site, in line with international standard (Perlas &

Capanzana, 2011). This may partly explain the falling in urinary iodine excretion
in 2008.

Table 3: The low median urinary iodine excretion of children is associates with
low mean iodine level in salt. Children in Eastern Visayas, Zamboanga, Northern
Mindanao, Davao and Caraga are at risk of iodine deficiency.

Awareness and Usage of Iodised Salt Among Philippine's Households Across Years
90
80
67.3
70
60
50
Percentage 40
24.8
30
20
10
0
1998

83.4
75.4

79.5
56.4

49.2

38.1

2003

2005

83.2
78.5

41.9

2008

Year
Awareness of Iodised Salt

Claimed Usage

Positive Test for Usage

Figure 9: There is notable differences in awareness, claimed usage and tested

usage of iodised salt among Philippines households across years. Awareness
does not translate into true usage of iodised salt.
During the fortification of iron to rice, it is important to consider the
acceptability of the products to the public as fortification changes its odour (San

Juan et al., 2011). San Juan et al. (2011) reported their respondents like the rice
moderately.
5.4 The Double Burden
The Philippines Global Burden of Disease Profile showed that the mortality
related to over-nutrition ranks greater than mortality related to under-nutrition,
even after younger deaths are given more weight in the statistical model.
Ischemic heart disease and stroke ranks second and third in the causes of
premature deaths in Philippine (Institute for Health and Metrics Evaluation,
n.d.). These are associated with altered lipid profile in individuals resulted from
high caloric diet, meanwhile other risk factors such as smoking and low physical
activity have to be taken into account. However, micronutrient deficiency also
costly in direct medical cost, productivity loss and other intangible cost. The
Philippines Global Burden of Disease Profile also ranks dietary factors as the
greatest risk factors of disease among other risk factors (Institute for Health and
Metrics Evaluation, n.d.). Therefore, primary intervention in Philippine should
focus on dietary patterns among Filipinos.
The average caloric intake per capita at 2008 is 1867kcal as reported in
the 7th National Nutrition Survey using household food weighing method. Caloric
intake per capita is calculated without considering age, sex and physiologic
status thus it is an overestimation for children while underestimation for adults.
According to the same survey, ironically only 33.1% of the household meet the
RENI of energy intake, the result is susceptible to suspicion when the prevalence
of overweight and obese Filipinos is 26.6% at the same year. More in-depth
studies especially on consumption of calories have to be carried out to
understand the increase in the rate of overweight and obesity to curb the
problem.

6. Conclusion
In short, Philippine faces the problems of typical developing country.
Although Philippine did not reach the targets of Millennium Development Goals,
many efforts have been done to reduce the prevalence of poverty and hunger, in
addition to improve the micronutrient status among children. More efforts have

to put in to evaluate the efficiency of the programs and policies. On the other
hand, nutrition surveillance data should be made more comprehensive. It is
hoped that the National Nutrition Survey can include other micronutrient status,
such as zinc and calcium. Some micronutrients such as iodine and vitamin A has
not been follow up in the 8th National Nutrition Survey. Among the poor, natural
disasters inevitably further aggravates their situation, building resilience towards
natural disaster is important to minimise the cost to respond to the disaster and
to minimise the impact of natural disaster on the lives of the population.
Productivity of the country can be increased if the country has better coping
capacity for disasters. Lastly, overweight and obesity become a problem in the
country when caloric food becomes more available in the country. Control
measures should be taken by the government to inculcate proper nutrition
among Filipinos along with the Philippines 2015 Nutrition Months theme.

(3998 words excluding tables and graphs)

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[Assessed

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