NUTRITION AND HEALTH STATUS OF FILIPINO ADULTS

(EXCERPTS FROM THE NATIONAL NUTRITION

AND HEALTH SURVEY (NNHeS): 2003-2004
For the Multi-Sectoral Task Force on NNHeS: 2003-2004

FELICIDAD V. VELANDRIA, CHARMAINE A. DUANTE, EVA T. ABILLE,

JUAMINA BELEN M. TANGCO

ABSTRACT

The National Nutrition and Health Survey (NNHeS:2003-2004) is the clinical component of
the 6th National Nutrition Survey (6th NNS) conducted by the Food and Nutrition
Research Institute of the Department of Science and Technology (FNRI-DOST). The
NNHeS:2003-2004 is the second successful collaborative undertaking of FNRI-DOST with
other fourteen (14) Medical Specialty Associations, the Department of Health (DOH), and
the Department of Adult Medicine & Clinical Epidemiology of the UP College of Medicine,
Philippine General Hospital. Collectively, the group was named as the Multi-Sectoral Task
Force on NNHeS:2003-2004. Objectives: This nationwide survey was undertaken to
determine the national prevalence of 20 nutrition-related and lifestyle diseases and 14 risk
factors among Filipinos 20 years old and above. Methods: A total of 4,753 adults from the
2,636 randomly selected households covered in the 2003 Family Income and Expenditure
Survey (FIES) and the 6th NNS of FNRI-DOST were included in the survey. A stratified
multi-stage sampling design was utilized, covering all the regions and provinces except
Batanes. The study used a combination of anthropometric, biochemical, clinical and
dietary assessment methodologies. Results: Ninety percent (90%) of Filipino adults have
at least one risk factor to atherosclerosis. The identified risk factors were dyslipidemia,
diabetes, hypertension, smoking and obesity. The prevalence of high total cholesterol was
8.5%, high LDL-c was 3.7%, low HDL-c is 54.2% and high triglyceride was 20.6%. Total
cholesterol, LDL-c and triglyceride levels rose with age peaking between 40 to 70 years
old. Based on FBS level (> 125 mg/dl), the prevalence of diabetes was 3.4%, rising at
ages 50-59. Survey also showed that 3.2% of adults have impaired FBS (> 100 to 125
mg/dl) or were in the pre-diabetes stage.

Hypertension based on blood pressure > 140/90 mm Hg was present in 22 out of 100
adults. Blood pressure increased with age peaking in the age group 60-69 years. Current
smoking was the most common risk factor with a prevalence of 56.3% among men and
12.1% among women, with an overall prevalence of 34.8%. Android obesity has remained
more prevalent among women (54.8%) than males (12.1%) based on waist-hip ratio
criteria. Using high waist circumference, the prevalence were 3.1% and 18.3% among
males and females, respectively. On the other hand, the over-all prevalence of obesity
using body mass index (BMI) > 30 was 5.0% Conclusions and Recommendations: The
initial NNHeS:2003-2004 results has determined the prevalence of 5 nutrition-related and
lifestyle risk factors, namely 1) dyslipidemia 2) diabetes 3) hypertension 4) smoking and
5) obesity. Based on the results, prevalence of dyslipidemia and diabetes were relatively
low while prevalence of hypertension remained relatively high. Smoking is the most
common lifestyle risk factor. Android obesity using both WHR and WC was more prevalent
among women men. Thus, the NNHeS 2003-2004 data may be used as basis in policy
and program formulation for the prevention and control of than nutrition-related and
lifestyle diseases and risk factors. Moreover, the data will serve as basis for intensifying
advocacy in the promotion of healthy lifestyle among the general population.

INTRODUCTION

The National Nutrition and Health Survey (NNHeS:2003-2004) was a collaborative

undertaking of the FNRI-DOST with other fourteen (14) medical specialty associations,
the Department of Health (DOH), and the Department of Adult Medicine & Clinical
Epidemiology of the UP College of Medicine, Philippine General Hospital. Collectively,
the group was named as the Multi-Sectoral Task Force on NNHeS:2003-2004. The
associations included were the Philippine Lipid Society (PLS), Philippine Society of
Hypertension (PSH), Philippine Diabetes Association (PDA), Philippine Heart
Association (PHA), Philippine Pediatric Society (PPS), Philippine Society of Nephrology
(PSN), Philippine Society of Endocrinology and Metabolism (PSEM), Osteoporosis
Society of the Philippines Foundation, Inc (OSPFI), Philippine Association for the Study
of Overweight and Obesity (PASOO), Philippine Neurological Association (PNA),
Philippine Rheumatology Association (PRA), Philippine Society of Gastroenterology
(PSG), Philippine Society of Allergy, Asthma and Immunology (PSAA),and the Philippine
College of Physician (PCP).

OBJECTIVES

To determine the national prevalence of about twenty (20) nutrition-related diseases and
fourteen (14) risk factors. In this report, however, only 5 selected nutrition-related and
lifestyle risk factors (dyslipidemia, diabetes, hypertension, smoking and android obesity)
were reported.

METHDOLOGY

Sampling Design and Coverage

A total of 4,753 adults aged 20 years old and over from the 2,636 randomly selected
households using a subsample of the 2003 Family Income and Expenditure Survey
(FIES-NSO) and the 6th NNS (FNRI-DOST).

A stratified multi-stage sampling design was utilized, covering all the regions
and provinces except for Batanes.

Data Collection

The study used the four (4) pronged approach of anthropometric, biochemical, clinical
and dietary assessment methodologies.
1. Dyslipidemia and Diabetes - Blood samples were drawn by venipuncture after 8-10
hours fasting using an enzymatic colorimetric method for analysis of total cholesterol,
LDL-c, HDL-c, triglycerides and fasting blood sugar (FBS). Prevalence of
dyslipidemia and diabetes were determined using the cut-offs recommended by
WHO and American Diabetes Association, respectively.

2. Hypertension - Blood pressure was taken using a conventional mercury

sphygmomanometer. Systolic and diastolic blood pressures were taken from both
arms in the morning before blood extraction.

3 Smoking – WHO STEPwise questionnaire was used to determine the prevalence of

smoking.

4. Obesity - Two criteria were used to determine the prevalence of obesity. Waist and
hip circumferences were measured using fiberglass tape using WHO cut-off for
Waist-Hip Ratio (1.0 for men; 0.85 for women) and Waist Circumference (> 102 cm
for men; > 88 cm for women). Body mass index (BMI) cut-off was > 30 for obese
based on WHO.
RESULTS

Mean and Prevalence of Dyslipidemia among Adults 20 Years Old

and Over, NNHeS: 2003-2004

Means and Distribution of Adults to Fasting Blood Sugar (FBS) by Age,

Philippines: 2003, NNHeS: 2003-2004

% Distribution of Fasting Blood Sugar

Age (y) Mean or Glucose Levels (mg/dL)
100 101-125 >125
20-29 74.2 98.1 1.2 0.7
30-39 78.6 95.8 2.1 2.0
40-49 84.8 90.1 5.0 4.9
50-49 91.2 85.4 5.7 8.9
60-69 85.7 88.1 5.6 6.3
≥ 70 84.2 88.7 6.2 5.1
Philippines 80.6 93.4 3.2 3.4
 Prevalence of Hypertension Prevalence of Current Smoking
(≥140/≥90 mm Hg) by Age, NNHeS: by Sex, NNHeS: 2003-2004
2003-2004

Prevalence of Android Obesity based on WHO Criteria for

Waist-Hip-Ratio (WHR) and Waist Circumference (WC),
NNHeS: 2003-2004
CONCLUSIONS AND RECOMMENDATIONS

• Prevalence of dyslipidemia and diabetes were relatively low.

• Prevalence of hypertension remained relatively high.

• Smoking was the most common lifestyle risk factor.

• Android obesity remained to be more prevalent among Filipino women

than men.

• The NNHeS data may be used as basis in policy and program

prioritization for the prevention and control of nutrition-related and
lifestyle diseases and risk factors.

• In addition, the data will serve as basis for intensifying advocacy in

the promotion of healthy lifestyle among the general populace.

Science and Technology Project FNRI-DOST